Ho lieha ho khothaletsa thobalano ho scanner: Taba ea thobalano le ts'ebetso ea moputso, le likhokahano tsa tšebeliso e mpe ea litšoantšo tsa bootsoa le ts'usumetso ea thobalano (2021)

2021 Apr 2.

doi: 10.1556 / 2006.2021.00018. 

inahaneloang

Ka morao le sepheo

Ts'ebeliso ea litšoantšo tse manyala tse hlephisang boitšoaro, leha e se na bothata ho ba bangata, e ka fetoha boitšoaro bo ts'oanang le bokhoba boo ka sebopeho sa bona bo fetelletseng bo tsejoang e le khatello ea boitšoaro bo hlephileng ba thobalano ho ICD-11 (WHO, 2018). Morero oa phuputso ena e ne e le ho etsa lipatlisiso mabapi le ts'ebeliso e ikhethileng ea lithethefatsi ho utloisisa hantle mekhoa ea ho holisa bothata bona.

mekhoa

Re sebelisitse ts'ebetso e ntlafalitsoeng ea Ts'ebetso ea Thobalano ea ho Kopanela Liphate ho ithuta tšebetso ea boko meputsong e amanang le likarolo tsa bokooa nakong ea tebello (ka lintlha tse bolelang esale pele livideo tsa bootsoa, ​​livideo tse laolang kapa tse se nang livideo) le karolo e tsamaellanang ea phano ea banna ba phetseng hantle. Ho amana le lits'oants'o tsa ts'ebeliso e nang le bothata ba litšoantšo tse manyala tse hlephisang boitšoaro, nako e sebelisitsoeng litšoantšong tsa bootsoa, ​​le boits'oaro ba thobalano li ile tsa hlahlojoa.

Results

Liphetho tsa banna ba 74 li bontšitse hore libaka tsa boko tse amanang le moputso (amygdala, dorsal cingulate cortex, orbitofrontal cortex, nucleus accumbens, thalamus, putamen, caudate nucleus, le insula) li ile tsa ts'oaroa haholo ke livideo tsa bootsoa le lits'oants'o tsa bootsoa ho feta ka laola livideo le ho laola likarolo, ka ho latellana. Leha ho le joalo, ha rea ​​fumana kamano lipakeng tsa lits'ebetso tsena le lits'oants'o tsa ts'ebeliso e thata ea litšoantšo tsa bootsoa, ​​nako e sebelisitsoeng ho sebelisoa litšoantšo tsa bootsoa, ​​kapa ka tšusumetso ea thobalano.

Puisano le liqeto

Ketsahalo e libakeng tsa boko tse amanang le moputso ho tse peli tse bonts'ang thobalano hammoho le lintlha li bonts'a hore ntlafatso ea Ts'ebetso ea Ts'ebetso ea Ts'ebetso ea thobalano e atlehile. Mohlomong, mekhatlo lipakeng tsa ts'ebetso ea kelello e amanang le moputso le lits'oants'o tsa ts'ebeliso ea litšoantšo tse manyala tse hlephisang boitšoaro e ka hlaha feela ka mehlala e nang le litekanyetso tse eketsehileng eseng ka sampole e phetseng hantle e sebelisitsoeng thutong ea hajoale.

Kenyelletso

Ho sebelisa litšoantšo tse manyala tse hlephisang boitšoaro Inthaneteng ke boitšoaro bo atileng haholo sechabeng ka kakaretso (Blais-Lecours, Vaillancourt-Morel, Sabourin, & Godbout, 2016; Bőthe, Tóth-Király, Potenza, Orosz, & Demetrovics, 2020; Martyniuk, Okolski, & Dekker, 2019). Le ha bongata bo bontša ts'ebeliso e litšila ea litšoantšo tse manyala tse hlephisang boitšoaro, ho batho ba 'maloa e tsamaea le khatello ea maikutlo, ho haelloa ke taolo, le ho sitoa ho fokotsa boits'oaro leha ho bile le litlamorao (tse ka bang 8%, ho latela maemo a sebelisitsoeng; Cooper, Scherer, Boies, & Gordon, 1999; Gola, Lewczuk, & Skorko, 2016; Grubbs, Volk, Exline, & Pargament, 2015). Litšoantšo tse manyala tse hlephisang boitšoaro tse tsamaeang le ho ipholla litho tsa botona kapa botšehali ke bothata bo atileng haholo bathong ba nang le boitšoaro bo bobe ba ho kopanela liphate (Kraus, Voon, & Potenza, 2016; Reid et al., 2012; Lentsoeecha et al., 2018). Ka lekhetlo la pele, Mokhatlo oa Lefatše oa Bophelo (WHO) e hlalositse mekhoa e khethehileng ea ho hlahloba matšoao ana khatisong ea bo11 ea Tlhatlhobo ea Machabeng ea Mathata (ICD-11) tlasa poleloana ena. Bothata ba ho Kopanela Liphate ka ho Kopanela Liphate (CSBD, Mokhatlo oa Lefatše oa Bophelo, 2018). Bakeng sa kutloisiso e betere ea tšebeliso ea litšoantšo tsa bootsoa le tse nang le mathata, metheo ea eona ea methapo ea kutlo e tlameha ho hlakisoa.

Le ha tlhalohanyo e nepahetseng ea tšebeliso ea litšoantšo tse manyala tse hlephisang boitšoaro e le taba e tsekisanoang, liphuputso tsa methapo ea kutlo li bontša hore e haufi le mathata a tahi (Lerato, Laier, Brand, Hatch, & Hajela, 2015; Stark, Klucken, Potenza, Brand, & Strahler, 2018). Robinson le Berridge ba hlalositse Thutong ea bona ea Khothatso ea Khothaletso bakeng sa nts'etsopele ea litlhare kamoo ho pepeseha ha lithethefatsi khafetsa ho lebisang liphetohong tsa neuroadaptive ka har'a lipotoloho tsa moputso (Robinson & Berridge, 1993, 2008). Nakong ea nts'etsopele ea bokhoba ba tahi, karabelo lithutong ("ho batla") ea eketseha ha litlamorao tse lakatsehang tsa tšebeliso ea lithethefatsi ("ho rata") li kanna tsa fokotseha. Ka hona, cue reactivity e kenyelletsang karabelo ea maikutlo, boits'oaro, mmele le boits'oaro liketsong tse amanang le bokhoba ba tahi (Berridge & Robinson, 2016; Tiffany le Wray, 2012ke mohopolo oa bohlokoa ho hlalosa phetoho ho tloha ts'ebelisong ea lithethefatsi ka linako tse ling ho ea ts'ebetsong (Brand et al., 2019; Koob & Volkow, 2010; Volkow, Koob, & McLellan, 2016).

Liphuputso ho bakuli ba nang le mathata a fapaneng a amanang le lithethefatsi li fumane ts'ebetso e eketsehileng ho ventral striatum, dorsal striatum, anterior cingulate cortex (ACC), orbitofrontal cortex (OFC), insula le amygdala ho lintlha tse amanang le lithethefatsi (Jasinska, Stein, Kaiser, Naumer, & Yalachkov, 2014; Kühn & Gallinat, 2011a; Stippekohl et al., 2010; Zilverstand, Huang, Alia-Klein, le Goldstein, 2018). Mabapi le litloaelo tsa boits'oaro, ho na le litlhahlobo tse 'maloa tse bonts'ang keketseho ea mesebetsi libakeng tse amanang le moputso ho mekhoa e amanang le lithethefatsi.Likokoanyana, Brand, & Potenza, 2020; Fauth-Bühler, Mann, & Potenza, 2017; Starcke, Antons, Trotzke, & Brand, 2018; Van Holst, van den Brink, Veltman, le Goudriaan, 2010). Hore na lits'ebetso tse kenyellelitsoeng ho CSBD li tšoana le tsa mathata a ts'ebeliso ea lithethefatsi le boits'oaro ba boits'oaro e ntse e le taba ea ngangisano ea mahlale.

Litlhahlobo tse 'maloa li bonts'a ts'ebetso e eketsehileng ea ventral le dorsal striatum, OFC, ACC, insula, caudate nucleus, putamen, amygdala, thalamus, le hypothalamus ho barupeluoa ba phetseng hantle ha ba shebile tšusumetso ea thobalano (VSS) ha e bapisoa le tšusumetso e sa nke lehlakore (Georgiadis & Kringelbach, 2012; Poeppl, Langguth, Laird, & Eickhoff, 2014; Stoléru, Fonteille, Cornélis, Joyal, le Moulier, 2012). Ntle le moo, ho na le lithuto tse mabapi le likarabo tsa methapo ea kutlo tse lebisang ho VSS empa ha li na litaba tsa thobalano (mohlala, Banca et al., 2016: mekhoa ea mebala; Klucken, Wehrum-Osinsky, Schweckendiek, Kruse, & Stark, 2016: mabala a mebala; Stark et al., 2019: mantsoe a hlalosang sehlopha). Boko bo arabela ho lintlha tsena tse fetileng tsa VSS (Banca et al., 2016; Klucken et al., 2016; Stark et al., 2019) li ne li ts'oana le likarabo ho VSS (ventral striatum, OFC, occipital cortex, insula, putamen, thalamus). Ho feta moo, batho ba nang le bothata ba ho sebelisa litšoantšo tse manyala tse hlephisang boitšoaro ba sebelisa (PPU) ha ba bapisoa le barupeluoa ba laolang ba bonts'a ts'ebetso e eketsehileng ea amygdala ho lipalo tsa jiometri tse amanang le VSS (Klucken et al., 2016). U sebelisa VSS joalo ka lintlha, Voon et al. (2014) e fumane likarabo tse phahameng mokokotlong oa kantle ho ntlo, ventral striatum le amygdala ea batho ba nang le PPU. Liphuputso tsena tsa keketseho e ncha ea ts'ebetso mabapi le likhakanyo tsa ho bolela esale pele VSS ho batho ba nang le PPU li tsamaellana le litebello tse tsoang Thutong ea Khothatso.

Ho ithuta nts'etsopele ea bokhoba ba tahi, Monetary Incentive Delay Task (MIDT) ke sesebelisoa se tiisitsoeng sa ho etsa lipatlisiso tsa likarabo tse fetotsoeng tsa methapo ea kutlo le tšusumetso ho (Balodis & Potenza, 2015). MIDT e qala ka mohato o lebelletsoeng moo ho bonts'ang hore na ho hapa chelete kapa tahlehelo ho ka etsahala nakong ea phepelo e atlehang. Qalong, mosebetsi ona o ne o sebelisetsoa ho lekola phallo e akaretsang ea moputso ka ho lemalla, leha ho le joalo, liphetho tse sa lumellaneng mabapi le tebello le karolo ea phano (Balodis & Potenza, 2015; Beck et al., 2009; Bustamante et al., 2014; Jia le al., 2011; Nestor, Hester, & Garavan, 2010). Ho lekola ts'ebeliso ea maikutlo ho PPU, mofuta o fetotsoeng oa MIDT (Knutson, Fong, Adams, Varner, & Hommer, 2001; Knutson, Westdorp, Kaiser, & Hommer, 2000) e ile ea hlahisoa: Mosebetsi oa Ts'ebetso ea Ts'ebetso ea Ts'oaetso ea Thobalano (SIDT) o sebelisa lits'oants'o tsa thobalano le meputso. Liphuputso tse tharo li sebelisitse tšusumetso ea ho chechisa mesebetsi ka thobalano le meputso ho fihlela joale (Gola et al., 2017; Sescousse, Li, & Dreher, 2015; Sescousse, Redouté, & Dreher, 2010). Sescousse le basebetsi-'moho ba batlisitse mekhahlelo ea mesebetsi e fapaneng mabapi le meputso e litšila le ea chelete ho batho ba baholo ba phetseng hantle 'me ba supa karolo e kamorao ea OFC le amygdala joalo ka libaka tse hlahisitsoeng ka kotloloho ke meputso e litšila (Sescousse et al., 2010). Gola le basebetsi-'moho (2017) bapisa banna ba nang le PPU le banna ba laolang mabapi le ts'ebetso ea bona ea boko le MIDT / SIDT e tsoakaneng. Le ha barupeluoa ba PPU ba bonts'a ts'ebetso e eketsehileng ho ventral striatum bakeng sa likhakanyo tse bolelang esale pele meputso ea thobalano, li ne li sa fapane le taolo mabapi le ts'ebetso ea boko le meputso ea thobalano. Tumellanong le Khopolo ea Khothatso ea Khothaletso, bangoli ba phehile khang ea "ho batla" ho eketsehileng ha meputso ea thobalano ho bankakarolo ba PPU ha "ho rata" litakatso tsa thobalano ho sa amehe.

Le ha lithuto tsa pejana tse sebelisang SIDT li ts'episa haholo mabapi le ho hlahlojoa ha cue mabapi le thobalano le meputso ho batho ba phetseng hantle le batho ba nang le PPU, ho na le mekhoa e meng e lokelang ho tšohloa. Mabapi le bonnete ba kantle, lithuto tsa pejana li sebelisitse litšoantšo tse emeng ho fapana le livideo, leha tse morao-rao e le mofuta oa litšoantšo tsa bootsoa o sebelisoang haholo (Solano, Eaton, & O'Leary, 2020). Mabapi le boemo ba taolo, lithuto tsa khale li ne li sebelisa mefuta e mengata ea VSS joalo ka maemo a taolo (Gola et al., 2017; Sescousse et al., 2010, 2015). Ka lebaka leo, maemo a liteko le taolo a ne a fapane mabapi le litšobotsi tse 'maloa (maemo a tlholeho khahlano le lipaterone tse sa hlakang, tharollo ea litšoantšo, ponahalo ea motho le papiso eo e seng ea motho). Ha ho na lipelaelo haeba tšusumetso ena e emela tšusumetso e nepahetseng ea taolo. Ho feta moo, bafuputsi ba sebelisitse litšoantšo tsa basali ba hlobotseng e le matšoao. Ka tsela ena li-cue li ne li ke ke tsa ba le boleng ba ponelopele feela, empa hape li emela litaba tsa thobalano. Ho feta moo, ho ka ba molemo ho fuputsa tšusumetso ea lisosa tsa kotsi bakeng sa nts'etsopele ea CSBD, moo tse latelang li bonahalang li le bohlokoa ka ho fetisisa: mathata a itlalehang mabapi le ts'ebeliso ea litšoantšo tsa bootsoa (Moetso, Snagowski, Laier, & Maderwald, 2016; Laier, Pawlikowski, Pekal, Schulte, & Brand, 2013), nako e sebelisitsoeng ho shebella litšoantšo tsa bootsoa (Kühn le Gallinat, 2014) le ho ba le tšusumetso ea thobalano (Baranowski, Vogl, & Stark, 2019; Kagerer et al., 2014; Klucken et al., 2016; Stark et al., 2018; Strahler, Kruse, Wehrum-Osinsky, Klucken, & Stark, 2018).

Ka hona, sepheo sa thuto ea hajoale e ne e le se latelang: (1) Re ne re batla ho theha SIDT e ntlafalitsoeng re sebelisa linepe tsa filimi sebakeng sa litšoantšo tse emeng. Re ne re lebelletse hore mekhoa ea tšebetso nakong ea tebello le karolo ea phano ea litšebeletso e ts'oane le sephetho sa lithuto tsa pele tse bonts'ang ho nka karolo ha ACC, OFC, thalamus, insula, amygdala, nucleus accumbens (NAcc), caudate, le putamen. (2) Re ne re batla ho batlisisa hore na lisosa tsa kotsi tsa CSBD (PPU e itlalehang, nako e sebelisitsoeng litšoantšong tsa bootsoa, ​​le boits'oaro ba thobalano) li hokahane le ts'ebetso ea methapo nakong ea tebello le mohato oa pelehi sebakeng se seng sa bongaka sampole. Ho ea ka Khopolo ea Khothatso ea Khothatso ea Robinson le Berridge (1993), re ne re lebelletse hore tšebetso ea methapo ea kutlo ea libaka tse boletsoeng ka holimo tsa boko nakong ea tebello ea SIDT e tla hokahana hantle le mabaka ana a kotsi. Ho latela boithuto ba Gola et al. (2017), Re ne re lebelletse hore tšebetso ea methapo ea kutlo ea libaka tse boletsoeng kaholimo nakong ea phumants'o e se ke ea tsamaellana le mabaka ana a kotsi.

mekhoa

barupeluoa ba

Banna ba mashome a supileng a metso e robeli ba phetseng hantle ba bong bo fapaneng lipakeng tsa lilemo tse 18 le 45 ba ile ba hiroa ka lethathamo la mangolo, melaetsa le phatlalatso ea litaba. Barupeluoa ba babeli ba ile ba tlameha ho qheleloa ka thoko ka lebaka la mathata a tekheniki, ba babeli ka lebaka la lintho tsa maiketsetso tsa setšoantšo 'me a le mong ka lebaka la neuroanatomy ea tlhaho. Sampole ea hoqetela e ne e na le banna ba 73 ba nang le lilemo tse bolelang tsa 25.47 (SD = 4.44) lilemo. Boholo ba bankakarolo (n = 65; lilemo tse 89.04 45.21%) e ne e le baithuti. Barupeluoa ba mashome a mararo a metso e meraro (36%) e ne e le masoha, ba 49.32 (5.48%) ba ne ba lula kamanong ea lerato mme barupeluoa ba bane (32.88%) ba ne ba nyetse. Barupeluoa ba mashome a mabeli a metso e mene (XNUMX%) ba itlhalosa e le ba bolumeli ("Na u ipolela u le bolumeli kapa bolumeli?" "E" / "che"). Ho sebelisitsoe mekhoa e latelang ea ho kenyelletsa: bosieo ba mafu a ha joale a somatic / a kelello, ha ho na kalafo ea psychotherapeutic / pharmacological ea hajoale, ha ho ts'ebeliso e mpe ea joala / nicotine, ha ho na sesupo sa fMRI, le phollatsi puong ea Sejeremane.

Tsamaiso

Ha ho kenoa boithutong, bankakarolo ba saenetse tokomane ea tumello e nang le tsebo. Mohlala oa hajoale o tsoa phuputsong e kholo ho fuputsa litlamorao tsa khatello e matla ea ts'ebetso ea VSS ka ho bapisa boemo ba khatello ea maikutlo le boemo ba taolo. Phuputso e 'ngoe e sebelisang lintlha tse tsoang morerong ona e se e phatlalalitsoe ho fihlela joale. Klein le ba bang. (2020) e hlahlobile tšusumetso ea khetho ea motho ka mong ho neural reactivity ho VSS. Litlhahlobo li bonts'itse hore libaka tse ngata tse amanang le moputso tse amanang le moputso li amana hantle le sekhahla sa VSS le hore khokahano ena e hokahana hantle le boemo ba PPU. Ha ho na data e tlalehiloeng mona e phatlalalitsoeng pejana. Barupeluoa ho tsoa tlhahlobisong ea hajoale ba abetsoe maemo a taolo mme ba fuoa mofuta oa placebo o se nang khatello ea teko ea Trier Social Stress Test (placebo TSST, 15 min, Het, Rohleder, Schoofs, Kirschbaum, le Wolf, 2009pele ho skena sa MRI. Teko ena e na le mesebetsi e 'meli e bonolo ea kelello (puo e sa lefelloeng le lipalo tse bonolo tsa kelello) tse sa bakeng khatello ea kelello e kholo kapa liphetoho tse tšoaeang' meleng ho bankakarolo, ka hona tšusumetso ho SIDT e latelang ha ea lebelloa. Kamora sebaka sa placebo TSST, bankakarolo ba ile ba nka karolo ho SIDT. Kamora ho tsoa ho skena, barupeluoa ba ile ba beha likoto tsa filimi ba le bang ka phapusing e arohaneng ho netefatsa boinotšing le bonnete ba lintlha. Karolo ea tlhaiso-leseling ea lipotso tsa sechaba le tsa batho ba sa amaneng le thobalano e ne e se e bokelletsoe pele TSST e qala (bolelele ba metsotso e 45) ho sebelisoa sethala sa SoSci Survey se inthaneteng. Kamora ho skena ha MRI, bankakarolo ba ile ba fuoa nako ea ho lekanya lifilimi le ho tlatsa lipotso tse ling (tse ka bang 60 min).

Mehato

Ts'ebetso ea Ts'ebetso ea Ts'ebetso ea thobalano

Re sebelisitse SIDT e tsoang ho MIDT e thehiloeng (Knutson et al., 2001). Meputso ea chelete e ile ea nkeloa sebaka thutong ena ke likoto tsa lifilimi tse bolelele ba metsotso e tšeletseng tse neng li hlahisoa ntle le molumo mme li bonts'a VSS (Sekotwana sa VSS), livideo tse sa silang tsa thobalano (laola clipkapa skrine e ntšo (ea mong). Ts'ebeliso ea livideo tsa ho silila e netefalitse papiso ea likarolo tsa pono (tšebelisano-'moho, bofeela bo itseng, metsamao ea morethetho, jj.) Ho likoto tsa filimi tse bonts'ang VSS. Thutong ea pele, likoto tsohle tsa lifilimi li ne li lekantsoe mabapi le monate (ho tloha "1" = "e sa thabiseng haholo" ho isa "9" = "e khahlisang") le ho tsosa takatso ea thobalano (ho tloha "1" = "ho sa tsose thobalano ho hang" ho "9" = "ho tsosa takatso ea botona le botšehali") ka sampole e ikemetseng ea banna ba 58 bao e seng basodoma. Litekanyetso tse kaholimo ho 5 li ile tsa hlalosoa li le holimo. Likarolo tsa 21 VSS tse sebelisitsoeng thutong ea 'nete li fihletse maemo a phahameng a valence (M = 6.20, SD = 1.12) le ts'oaetso e phahameng ea thobalano (M = 6.29, SD = 1.34 thutong ea pele ho moo, athe lipalo tse mahareng ho isa ho tse phahameng tsa valence (M = 5.44, SD = 0.97) le lintlha tse tlase tsa ho tsosa takatso ea thobalano (M = 1.86, SD = 0.81) e tlalehiloe bakeng sa likarolo tsa taolo tsa 21. Sekoto se seng le se seng sa filimi se ne se hlahisoa hang feela nakong ea mosebetsi. Teko e fumanoe ka sephutheloana sa software ea Presentation (Version 17.0, Neurobehavioral Systems, Inc, USA) mme e nkile metsotso e ka bang 20. SIDT e kenyelelitse liteko tse 63 tse nang le karolo ea tebello le karolo ea phano le maemo a mararo (21 × VSS21 × laola, 21 × ea mong).

Nakong ea karolo ea tebello, lipalo tse tharo tse fapaneng tsa jiometri, li ile tsa hlahisoa e le lintlha tse phatlalatsang sekhechana sa VSS (CueVSS), clip ea taolo (CueControlkapa skrine e ntšo (CueNone, bona hape Feie. 1). Kabo ea lipalo tsa jiometri ho sephetho se ka bang teng (VSS clip, clip clip, ha ho le e 'ngoe) e neng e hlophisitsoe ka bongata ho bankakarolo. Re sebelisitse lipalo tsa jiometri e le lintlha ho netefatsa hore ha ho na mekhatlo e fetileng lipakeng tsa lintlha tsena le VSS. Barupeluoa ba ile ba tsebisoa ka mekhatlo e lipakeng tsa likhakanyo le livideo pele ho tlhahlobo ea fMRI. Mekhatlo ena e koetliselitsoe liteko tsa boikoetliso tse 21 kantle ho sekena. Kamora hore e 'ngoe ea lintlha e bonahale bakeng sa 4 s, sefapano sa tokiso se ile sa lateloa bakeng sa karohano ea interstimulus ea 1-3 s. Ebe sepheo sa sepheo (sekwere se tšoeu, pixel ea 200 × 200) se bontšitsoe lipakeng tsa 16 ms (bonyane) le 750 ms (maximum). Ho sa tsotelloe tlhahiso ea pejana, taelo e ne e le ho arabela sepheo kapele kamoo ho ka khonehang ka ho tobetsa konopo. Haeba CueVSS kapa CueControl e hlahile mme bankakarolo ba tobetsa konopo ha sepheo sa sepheo se bonahala, barupeluoa ba "hapile" sekoto sa filimi. Sepheo se ile sa lateloa ke tlhahiso ea sefapano se seng sa tokiso bakeng sa nako e fapaneng ea interstimulus ea 0-2 s. Kamora moo, barupeluoa ba ile ba bontšoa sekhechana sa VSS, sekhechana sa taolo kapa skrine e ntšo ka nako ea 6 s. Liteko tsa boikoetliso pele ho skena li boetse li sebelisitse ho bala karolelano ea linako tsa karabelo (meanRT) le liphapang tse tloaelehileng (SDRTho fumana linako tsa nehelano ea ts'usumetso ea sepheo (win: meanRT+2 × SDRT; no win: BolelaRT-2 × SDRT). Katleho e ne e reretsoe hoo e ka bang 71% ea VSS le liteko tsa taolo (15 ho tse 21 tsa liteko), ha liteko tsa letho li sa kopantsoe le katleho. Liteko tsa pele tse tharo li hlahisitse CueControl, TlhahisoVSS, le CueNone ka tatellano e sa reroang. Tsena CueControl le CueVSS liteko li ne li lula li reriloe joalo ka ho hlola liteko. Kamora liteko tse tharo tsa pele, ho ile ha thehoa lithibelo tsa liteko tsa 6 ka ngoe (2 × CueLaola, 2 × TlhahisoVSS le 2 × TlhahisoNone). Pakeng tsa liteko tsa ho hapa (liteko tsa ho hapa VSS kapa liteko tsa ho hlola) ha ho lumelloe liteko tse ling tse fetang 5 (liteko tse ling tsa ho hapa kapa liteko tse ling). Boemo bo tšoanang bo ka hlahisoa makhetlo a fetang a 2 ka tatellano. Tlhahiso ea sepheo sa sepheo e fetotsoe marang-rang ka ho tlosa kapa ho eketsa 20 ms ka 'ngoe haeba bankakarolo ba hlotse litekong tse sa reroang kapa ba sa hlotse litekong tse reriloeng ho netefatsa sekhahla sa matlafatso litekong tse tlang. Liteko tsa VSS le liteko tsa taolo, tse sa kang tsa hlahisa litholoana joalo ka ha ho ne ho reriloe, li ile tsa phetoa litekong tse hlophisitsoeng ka nako e ncha ea tlhahiso ea sepheo.

Setšoantšo sa 1.
Setšoantšo sa 1.

Ts'ebetso ea Ts'ebetso ea Ts'ebetso ea thobalano. Nakong ea karolo ea tebello, bankakarolo ba ile ba bona leseli (setšoantšo sa jiometri). Kamora nako e fapaneng ea nako, sepheo se ile sa hlahisoa ka nako e khuts'oane, moo bankakarolo ba ileng ba botsoa ho arabela kapele kamoo ho ka khonehang ka ho tobetsa konopo. Haeba tlhahiso ea karolo ea tebello e ne e le CueVSS kapa CueControl, Video e tsamaellanang e ka fumanoa ka ho arabela kapele ho sepheo (bona le Klein et al., 2020)

Tlhaloso: Leqephe la Lithethefatsi tsa Boitšoaro JBA 2021; 10.1556/2006.2021.00018

Tlhahlobo ea data ea psychometric

Kamora SIDT, bankakarolo ba lekantse boemo ba bona ba hajoale ba ho tsosa takatso ea thobalano ka sekala sa Likert sa lintlha tse 9 ba ntse ba le ka hare ho sekena. Likoto tsa filimi li ne li lekantsoe ho sebelisa litekanyo tsa Boithati-Manikin (Bradley & Lang, 1994) bakeng sa valence (ho tloha 1 = e sa thabiseng haholo ho isa ho 9 = e khahlisang haholo) le ho tsosa takatso ea thobalano (ho tloha 1 = ho sa tsose thobalano ho 9 = ho tsosa takatso ea thobalano haholo) kamora ho siea sekena ka phapusing e arohaneng.

Nako e sebelisitsoeng ho shebella VSS bophelong ba letsatsi le letsatsi e ile ea hlahlojoa ka ntho e reng "U qetile nako e kae u sebelisa litšoantšo tse manyala tse hlephisang boitšoaro, u theha karabo ea hau khoeling e fetileng?". Barupeluoa ba ile ba khona ho khetha lihora le metsotso "ka khoeli", "ka beke" kapa "ka letsatsi" ho hlakisa karabo ea bona. Pele ho litlhahlobo, mefuta e fapaneng ea likarabo e ile ea fetoloa "lihora ka khoeli".

PPU e ne e lekantsoe ke mefuta ea Sejeremane ea Short Internet Addiction Test (s-IAT) (Pawlikowski, Altstötter-Gleich, le Brand, 2013e fetotsoe bakeng sa cybersex (s-IATho kopanela liphate; Laier et al., 2013) le ka Hypersexual Behaeve Inventory (HBI; Reid, Garos, & Carpenter, 2011). Tšepo ea kahare ea data e bokelletsoeng ea lipotso e baliloe bakeng sa sampole ea hajoale. E 'ngoe le e' ngoe ea lintho tse leshome le metso e 'meli tsa s-IATho kopanela liphate e lekantsoe sekaleng sa Likert sa lintlha tse 5 ho tloha ho 1 (ha ho mohla) ho 5 (khafetsa). Lintlha kaofela (s-IATho kopanela liphate kakaretso, Lintho tse 12, Cronbach's ɑ = 0.90) ho tloha ho 12 ho ea ho 60. Lits'ebeletso tse peli li ka baloa hape: tahlehelo ea taolo (lintho tse 6, Cronbach's ɑ = 0.89) le takatso (lintho tse 6, Cronbach's ɑ = 0.73). HBI e na le lintho tse 19 tse lekantsoeng ho tloha ho 1 (ha ho mohla) ho 5 (khafetsa) ka lintlha tse felletseng (HBIkakaretso, 19 dintho, Cronbach's ɑ = 0.89) ho tloha 19 ho ea 95. Lits'ebeletso tse tharo li ka baloa: taolo (lintho tse 8, Cronbach's ɑ = 0.89), ho sebetsana ka katleho (lintho tse 7, Cronbach's ɑ = 0.84) le litlamorao (lintho tse 4, Cronbach's ɑ = 0.76). Likamano tsa kahare li ne li amoheleha maemong a matle thutong ea hajoale (bona data e kaholimo).

Tšusumetso ea thobalano e ne e lekantsoe ke Trait Sexual Motivation Questionnaire (TSMQ; Stark et al., 2015). TSMQ e na le lintho tse 35 tse jarang liphallelo tse 4: thobalano e le mong (lintho tse 10, Cronbach's ɑ = 0.77), bohlokoa ba thobalano (lintho tse 15, Cronbach's ɑ = 0.89), ho batla thobalano (lintho tsa 4, Cronbach's ɑ = 0.92), le papiso le tse ling (lintho tse 6, Cronbach's ɑ = 0.86). Ho feta moo, lenane le akaretsang la tšusumetso ea thobalano (TSMQBolela) e ka baloa e le moelelo oa lintho tsohle tse 35 (Cronbach's ɑ = 0.91). Ntho e ngoe le e ngoe e lekantsoe sekaleng sa Likert sa lintlha tse 6 ho tloha 0 (ho hang) ho 5 (haholo). Barupeluoa ba laetsoe ho amahanya lipolelo tsa bona le lilemo tse hlano tse fetileng. Poleloana "ts'usumetso ea thobalano" e sebelisitsoeng sekaleng sena e kenyelletsa liketso tsa thobalano le molekane hammoho le likamano tsa thobalano u le mong. Litekanyetso tse phahameng li supa boits'oaro bo phahameng ba thobalano.

Lintlha tsa boitšoaro

Nako ea karabelo e hlalosoa e le nako e lipakeng tsa ho qala ha sepheo le ho qala ho arabela. Lintlha tsa nako ea karabelo li ile tsa hlahlojoa bakeng sa barekisi ka ntle le tlhaiso-leseling e ka tlase ho 100 ms kapa kaholimo e bolelang + 1.5 × SD ka boemo bo ipapisitse le litekanyetso tsa lipalo-palo. Ho ea ka sena, ho ne ho e-na le barekisi ba bararo ka har'a sampole kaofela (e le 'ngoe ho latela maemo). Lipalo-palo tse hlalosang li kenyellelitsoe ntle le kantle ho naha le boleng bo haellang ba data. Litekanyetso tse lahlehileng li ne li na le likarabelo tsa morao haholo kapa ha ho na karabelo sefapanong sa fixation. Liphapang ho baemeli ba linako tsa karabelo litekong tse atlehileng li ile tsa hlahlojoa ka liteko tsa Kruskal-Wallis le liteko tsa Dunn-Bonferroni. Kamora nako, likamano tsa Pearson lipakeng tsa linako tsa karabelo tsa maemo a mararo le lisosa tsa kotsi tsa CSBD li baliloe.

Ho fumana lintlha tsa fMRI le tlhahlobo ea lipalo

Litšoantšo tse sebetsang le tsa anatomical li fumanoe ho sebelisoa 3 Tesla body-body MR tomograph (Siemens Prisma) e nang le kela ea hlooho ea 64-channel. Setšoantšo sa sebopeho se ne se kenyelletsa likarolo tsa sagittal tse 176 T1 (boima ba selae 0.9 mm; FoV = 240 mm; TR = 1.58 s; TE = 2.3 s). Bakeng sa litšoantšo tse sebetsang, kakaretso ea litšoantšo tse 632 li tlalehiloe ho sebelisoa tatellano ea T2 e boima ba gradient echo-planar imaging (EPI) ka likhae tse 36 tse koahelang boko bohle (voxel size = 3 × 3 × 3.5 mm; gap = 0.5 mm; selae se theohang ho fumana; TR = 2 s; TE = 30 ms; flip angle = 75; FoV = 192 × 192 mm2; boholo ba matrix = 64 × 64; GRAPPA = 2). Tšimo ea pono e ne e eme ka boiketsetso ha e bapisoa le mohala oa AC-PC ka mokhoa oa -30 °. Statistical Parametrical Mapping (SPM12, Wellcome Department of Cognitive Neurology, London, UK; 2014) e kentsoe tšebetsong Matlab Mathworks Inc., Sherbourn, MA; 2012) e ne e sebelisetsoa ho hlophisa lintlha tse sa tsoakoang, hammoho le tlhahlobo ea boemo ba pele le ea bobeli.

Ho nts'etsopele ha litšoantšo tsa EPI ho kenyellelitse ngoliso ea semmuso ho template ea Montreal Neurological Institute (MNI), karohano, tokiso le ho se ts'oane, tokiso ea nako ea selae, ho tloaela sebaka se tloaelehileng sa MNI le ho boreleli ka kernel ea Gaussian ho 6 mm FWHM. Lintlha tse sebetsang li ile tsa hlahlojoa bakeng sa bongata bo boholo bo sebelisa mokhoa o sa lefelloeng oa kabo bakeng sa tlhaiso-leseling e fapakaneng (Schweckendiek et al., 2013). Bophahamo bo bong le bo bong bo hlahang hamorao bo ile ba etsisoa ka har'a mofuta o akaretsang oa linear (GLM) joalo ka regressor ea ho hloka thahasello. E 'ngoe le e' ngoe ea maemo a liteko (ka tatelloVSS, ka tatelloControl, ka tatelloNone, ShopVSS, NoDeliveryVSS, TlhahisoControl, NoDeliveryControl, NoDeliveryNone 'me sepheo) e ile ea etsisoa e le regressor ea phaello. Li-regress tsohle li ile tsa ntlafatsoa ka tšebetso ea karabelo ea hemodynamic reaction. Mehato e tšeletseng ea motsamao e kentsoe e le li-covariate ntle le li-regress tsa meqolo e khethiloeng e ka thoko. Lenaneo la nako le ne le tlhotliloeng ka sefahleho se phahameng (nako e sa fetoheng = 128 s).

Boemong ba sehlopha, ho ile ha hlahlojoa liphapang tse peli: ka tatelloVSSHlokomelaControl le PhumantshoVSS-PhatlalatsoControl. Mohlala o le mong t-liteko hammoho le ho khutla ha linear ka mefuta e latelang e le likhakanyo li ile tsa etsoa ka liphapano: s-IATho kopanela liphate, HBI, nako e sebelisitsoeng ho sebelisa litšoantšo tsa bootsoa (lihora tse ngata ka khoeli), le TSMQ. Bakeng sa TSMQ le bakeng sa HBI, ho ile ha etsoa liphokotso tse ngata tse nang le liphallelo tsohle hang-hang. Re ne re sebelisa mekhahlelo e fapaneng bakeng sa nako eo re e sebelisitseng ts'ebeliso ea litšoantšo tsa bootsoa le s-IATho kopanela liphate.

Liphuputso tsa ROI maemong a voxel li ile tsa etsoa ho sebelisoa khalemelo e nyane ea molumo (SVC) ka P <0.05 (phoso e bohlale ea lelapa e lokisitsoe: FWE-e lokisitsoe). Caudate, NAcc, putamen, dorsal anterior cingulate cortex (dACC), amygdala, insula, OFC, le thalamus li khethiloe joalo ka li-ROI hobane ho kile ha tlalehoa liphuputsong tsa cue reactivity le VSS processing (Ruesink & Georgiadis, 2017; Stoléru et al., 2012). Li-mask tsa ROI tse kopaneng tsa anatomical tsa OFC le DACC li thehiloe MARINA (Walter et al., 2003); limaske tse ling kaofela li nkiloe Harvard Oxford Cortical Atlas (HOC). Mefuta e ka letsohong le letšehali le le letona ea ROI e kopantsoe ho mask o le mong. Bakeng sa li-ROI tsena tse robeli, litlhahlobo tsa boemo ba voxel li entsoe ka P <0.05 e lokisitsoe ke FWE.

Re lekanyelitse litlhaloso tse fapaneng tsa lipotso tsa lipotso le litšoantšo tsa bootsoa tse sebelisoang CueVSSHlokomelaControl phapang le PhanoVSS-Ke nehelanoaControl phapano. Ke li-voxels tsa bohlokoa feela (SVC, FWE-corrected) tse tsoang sampoleng e le 'ngoe tLiteko ka har'a li-ROI moo li sebelisetsoang SVC. Ka hona, li-ROI tse nyane li ne li sebelisetsoa tlhahlobo ea khatello ea maikutlo. Litlhahlobo tsa boko bo felletseng (FWE-corrected) li tlatselitse tlhahlobo ea ROI.

Ethics

Phuputso e ile ea amoheloa ke komiti ea melao ea boitšoaro ea lehae mme ea etsoa ho latela phatlalatso ea 1964 ea Helsinki le liphetoho tsa eona hamorao. Barupeluoa bohle ba fane ka tumello e nang le tsebo pele ho tlhahlobo efe kapa efe. Ngaka ea methapo e ne e fumaneha ho hlakisa ho se ts'oane ho belaetsang ha methapo ea pelo.

Results

Mehlala ea mohlala

Lethathamo 1 e akaretsa lipalo-palo tse hlalosang. Likhokahano tsa bivariate lipakeng tsa lenane la lipotso li hlahisitse likamano tse matla tse mahareng tse bonts'ang lintho tse peli li feta le likarolo tse ngata tsa meralo e fapaneng (bona Feie. 2).

Tafole 1.Litekanyo tsa psychometric le lintlha tsa livideo tsa thobalano le taolo tse sebelisoang mosebetsing oa ho lieha ho khothaletsa thobalano (N = 73)

E bolelang (SD)Range
s-IATho kopanela liphateHo lahleheloa ke taolo10.56 (4.66)6.00-30.00
Ho lakatsa9.60 (3.44)6.00-26.00
s-IATho kopanela liphate palo eohle20.16 (7.74)12.00-56.00
HBIControl14.86 (6.28)8.00-39.00
Ho sebetsana le ona17.92 (5.48)7.00-32.00
Liphello6.71 (2.81)4.00-20.00
HBIkakaretso39.49 (11.48)20.00-90.00
TimePU [h / khoeli]6.49 (7.21)0.00-42.00
TSMQHo kopanela liphate u le mong3.74 (0.68)1.80-5,00
Bohlokoa ba thobalano3.82 (0.74)1.27-5.00
Batla thobalano1.50 (1.40)0.00-4.75
Bapisa le ba bang1.73 (1.10)0.00-4.33
TSMQBolela2.70 (0.69)1.05-4.35
Litekanyetso tsa ts'usumetso ea thobalanoValencia6.35 (1.17)2.14-8.67
Ho tsosoa ka thobalano6.63 (1.16)2.14-8.62
Litekanyetso tsa tšusumetso ea taoloValencia5.51 (1.27)2.95-8.86
Ho tsosoa ka thobalano2.01 (0.97)1.00-5.00

Hlokomela: s-IATho kopanela liphate = phetolelo e khuts'oane ea Teko ea Ts'ebeliso ea Inthanete e fetotsoeng bakeng sa cybersex (Laier et al., 2013), HBI = Boitšoaro ba Boitšoaro bo Botle ba Thobalano (Reid et al., 2011), NakoPU = Nako e sebelisitsoeng ho sebelisa litšoantšo tsa bootsoa TSMQ = Potso ea lipotso tsa ts'usumetso ea thobalano (Stark et al., 2015).

Setšoantšo sa 2.
Setšoantšo sa 2.

Ho se kopane ha litšobotsi tse amanang le lithethefatsi (N = 73): s-IATho kopanela liphate le HBI = kakaretso ea lintlha tse sebelisang mathata a litšoantšo tsa bootsoa, ​​NakoPU = nako e sebelisitsoeng litšoantšong tsa bootsoa ka h / khoeli; TSMQ = boleng bo bolelang ba tšusumetso ea thobalano

Tlhaloso: Leqephe la Lithethefatsi tsa Boitšoaro JBA 2021; 10.1556/2006.2021.00018

Teko ea Kruskal-Wallis e bonts'itse phapang e kholo lipakeng tsa nako ea karabelo ea karolelano ho arabela sepheo ho maemo a mararo (CueNone, TlhahisoControl, TlhahisoVSS; Χ2(2) = 12.05, P <0.01). Lethathamo 2 e akaretsa lipalo-palo tse hlalosang tsa linako tsa karabelo nakong ea SIDT. Liteko tse latelang tsa post hoc (liteko tsa Dunn-Bonferroni) li senotse hore nako ea karabelo ho sepheo se maemong a CueVSS e ne e potlile haholo ho feta nako ea karabelo boemong ba CueControl (z = 2.68, P <0.05, ea Cohen d = -0.65) le maemong a CueNone (z = 3.35, P <0.01, ea Cohen d = -0.82). Ka lehlakoreng le leng, linako tsa karabelo ho sepheo sa sepheo sa maemo a CueControl le ho CueNone ha ea ka ea fapana haholo ho e mong (z = 0.59, P = 0.56). Ha ho likamano tse bohlokoa tse fumanoeng lipakeng tsa linako tsa karabelo maemong a mararo le lisosa tsa kotsi tsa CSBD (all r <0.1, P > 0.10). TlhahisoNone e ile ea lateloa ke likarabo tse 75 (4.89%) tse haellang, CueControl e ile ea lateloa ke likarabo tse 51 (3.33%) tse haellang, le CueVSS e ile ea lateloa ke likarabo tse 17 (1.11%) tse haellang ho bankakarolo bohle.

Tafole 2.Lipalo-palo tse hlalosang tsa linako tsa karabelo mosebetsing oa ho lieha ho khothaletsa thobalano (N = 73)

Mediane (SD)
ka tatelloVSS235.11 (60.94)
ka tatelloControl296.63 (135.01)
ka tatelloNone314.42 (158.64)

Hlokomela: ka tatelloLitlhaku = ho tseba ho phatlalatsa video ea bootsoa, ​​CueControl = ho tseba ho phatlalatsa video ea ho silila, CueNone = ho tseba ho phatlalatsa video.

Likarabo tsa hemodynamic

Lits'oants'o tsa ho tšoaea VSS ha li bapisoa le likarolo tse supang likhechana tsa taolo li hlahisitse karabelo e phahameng ea mali-oxygenation-level e itšetlehileng ka (BOLD) ho NAcc, caudate, putamen, le insula (tsohle tse kopaneng), le ho DACC le thalamus e nepahetseng. Karabo e phahameng ea BOLD e fumanoe hape ho NAcc le LEC le letšehali, ho caudate, putamen, dACC, insula, amygdala, le thalamus nakong ea ho tsamaisoa ha likoto tsa VSS ha ho bapisoa le likarolo tsa taolo (liphetho tsohle bona Lethathamo 3 'me Feie. 3).

Tafole 3.Liphetho tsa ROI bakeng sa Cue e fapanengVSSHlokomelaControl le PhumantshoVSS-Ke nehelanoaControl (Mohlala o le mong t-liteko) ka boholo ba sehlopha (k) le lipalo-palo (FWE-khalemeloa; N = 73)

bapisasebopeholehlakoreng laxyzkT, maxPcorr
ka tatelloVSSHlokomelaControlNAccL-68-4778.71
R810-4657.50
caudateL-81024499.66
R101444768.18
putamenL-168-27746.72
R24247667.42
dACCR1216361,69710.77
e leng sehlekehlekeL-341465929.43
R381446048.65
ThalamusR8-202,1648.91
ShopVSS-Ke nehelanoaControlNAccL-814-8699.49
caudateL-12-618564.24
R16-1622715.32
putamenL-1812-103146.58
R32-12-10637.28
dACCL-220289535.43
R44329539.19
amygdalaL-22-4-1623210.71
R20-4-1428012.20
e leng sehlekehlekeL-36-4145179.52
R382-164769.19
OFCL-644-182,82517.45
ThalamusL-20-30-21,74725.67
R20-2801,74724.08
Setšoantšo sa 3.
Setšoantšo sa 3.

Mosebetsi oa ROI bakeng sa phapang ea CueVSSHlokomelaControl (A) le TlhahisoVSS-Ke nehelanoaControl (B). Melao ea selae sagittal ka lehlakoreng le letona e bontša likarolo tsa coronal tse bontšitsoeng ka ho le letšehali. Lintlha tse bontšang VSS (CueVSS) ha e bapisoa le matšoao a bontšang likarolo tsa ho silila (CueControl) e hlahisitse karabelo e phahameng ea BOLD ho putamen, NAcc, caudate, le insula. Likoto tsa VSS (DeliveryVSS) bapisoa le likarolo tsa ho silila (DeliveryControl) e hlahisitse karabelo e phahameng ea BOLD ho thalamus, insula, amygdala, putamen, le OFC. E bontšitsoe t-e lekantsoeng e thibetsoe ho t <5

Tlhaloso: Leqephe la Lithethefatsi tsa Boitšoaro JBA 2021; 10.1556/2006.2021.00018

Litlhahlobo tsa boko bo felletseng li senotse likarabo tse phahameng tsa hemodynamic sehlopheng se tsoelang pele ho kenyeletsoa likarolo tse kholo tsa boko bakeng sa phapang ea CueVSS ha e bapisoa le CueControl (Boholo ba sehlopha k = 174,054 voxel) hape bakeng sa Phano ea PhanoVSS bapisoa le DeliveryControl (k = 134,654)

Lisosa tsa kotsi bakeng sa CSBD le likarabo tsa hemodynamic

Ha ho na khatello ea maikutlo e hlahlobang likhokahanyo lipakeng tsa lisosa tsa kotsi tsa CSBD (PPU e itlalehang, nako e sebelisitsoeng litšoantšong tsa bootsoa, ​​le boits'oaro ba thobalano) le ketso ea khethollo ea neural ho ROI efe kapa efe nakong ea tebello (CueVSSHlokomelaControl) kapa karolo ea phano (DeliveryVSS-Ke nehelanoaControl) e hlahisitse litlamorao. Setšoantšo sa 4 e hlahisa mekhatlo lipakeng tsa mabaka ana a kotsi le ts'ebetso ea voxel ea sehlohlolong sa "accumbens".

Setšoantšo sa 4.
Setšoantšo sa 4.

Tšebelisano lipakeng tsa "nucleus" ea "voxel" ea sehlohlolong sa leqele le s-IATsex, HBI, nako e sebelisitsoeng litšoantšong tsa bootsoa li sebelisoa ka h / khoeli (NakoPU) le lintlha tse felletseng tsa TSMQ nakong ea tebello (moleng o kaholimo, NAcc [-6 8 -4]) le mohato oa phano (mola o ka tlase, NAcc [-8 14 -8]) oa Ts'ebetso ea Ts'ebetso ea Ts'ebetso ea thobalano (N = 73)

Tlhaloso: Leqephe la Lithethefatsi tsa Boitšoaro JBA 2021; 10.1556/2006.2021.00018

Puisano

Morero oa pele oa tlaleho ena e ne e le ho etsa lipatlisiso ka ts'ebetso ea kelello e amanang le moputso nakong ea tebello le karolo ea phumants'o ea VSS ka sampole e kholo eo e seng ea bongaka e sebelisang SIDT. Re fumane hore tlhahiso ea livideo tsa bootsoa hammoho le tlhahiso ea livideo tsa bootsoa tse tlileng pele ho moo e ne e amahanngoa le ts'ebetso e phahameng ea boko libakeng tse boletsoeng esale pele tse amanang le moputso (NAcc, amygdala, OFC, putamen, nucleus, insula, thalamus le dACC) ha e bapisoa le tlhahiso ea livideo tsa ho silila kapa li-cue tse fetileng tsa livideo tsa ho silila, ka ho latellana. Liphetho tsa rona li tsamaellana le se fumanoeng ke Sescousse et al. (2015, 2010), ea ileng a bapisa karabelo ea methapo ea kutlo ho VSS le tse seng tsa VSS (mona ke tsa chelete) tse susumetsang mohlala oa banna ba phetseng hantle nakong ea ts'ebetso ea ho chechisa. Mabapi le likarabo tsa boko ho li-cSS cues, ba fumane ts'ebetso e phahameng ho ventral striatum ka matla a eketsehang a moputso. Nakong ea ho pepa, ba fumane le ts'ebetso e ikhethileng ea boko ho VSS ka karolo ea OFC le ho amygdala ea linaha tse peli. Ntle le moo, ba supile libaka tse neng li kentse letsoho ho sebetsong ha mefuta e 'meli ea meputso (ventral striatum, midbrain, ACC, anterior insula).

Boitsebiso bo mabapi le boits'oaro bo bonts'itse hore linako tsa karabelo li ne li potlake haholo ho tsepamisa mohopolo maemong a hlahisang lits'oants'o tsa bootsoa ho fapana le maemo a nang le lits'oants'o tsa taolo tse sa phatlalatseng video ho hang. Sena se supa hore tebello ea VSS e kenya tšebetsong sistimi ea makoloi, e totobatsang boleng bo phahameng ba tšusumetso ba VSS.

Morero oa bobeli e ne e le ho lekola likamano lipakeng tsa likarabo tsa neural ho VSS hammoho le lintlha le lisosa tsa kotsi tsa CSBD. Lintho tse lekantsoeng tsa kotsi li bonts'a likamano tse amanang tsa matla a mahareng hara tse ling, ho bonts'a ho tšoana le likarolo tse eketsang tsa se aha. Ha ho lipotso tse lekanyang PPU (HBI le s-IATho kopanela liphate), Kapa nako eo u e qetang litšoantšong tsa bootsoa, ​​kapa tšusumetso ea thobalano (TSMQ) li ne li amana haholo le mesebetsi ea boko ea libaka tsa boko tse amanang le moputso nakong ea pelehi le tebello ea maikutlo a thobalano.

Ho bua ka nepo mabapi le kamano e sieo lipakeng tsa lisosa tsa kotsi tsa CSBD le likarabo tsa methapo ea kutlo ho VSS, ho bohlokoa ho bala lingoliloeng tse teng tsa lithuto tse ka bapisang likarabo tsa methapo ea CSBD le bankakarolo ba taolo (mokhoa oa papiso ea sehlopha) kapa ba sekaseka kamano ea lisosa tsa kotsi bakeng sa CSBD le likarabo tsa NAcc ho VSS (mokhoa oa khokahano). Kamora ho latela mokhoa oa papiso ea sehlopha, lithuto tse ling li fumane likarabo tse kholo tsa neural ho VSS ho ventral striatum le libakeng tse ling tse amanang le moputso ho barupeluoa ba nang le PPU ha ba bapisoa le bankakarolo ba taolo (Gola et al., 2017; Seok & Sohn, 2015; Voon et al., 2014). Sephetho sa bohlokoa sa thuto ka Gola et al. (2017) e ne e le hore lintlha tse neng li bolela esale pele VSS li ne li amahanngoa le ts'ebetso e phahameng ea ho ts'oara barupeluoa ba CSBD ho feta lithutong tse phetseng hantle. Ha a ntse a Gola et al. (2017) o ile a batlisisa mokhoa o kopaneng oa ho khothaletsa thobalano le chelete ho etsa paradigm e nang le litšoantšo tsa basali ba hlobotseng joalo ka lintlha, Klucken le al. (2016) e lekotse paradigm ea boemo ba ho khotsofatsa e nang le lintlha tsa jiometri. Ka lebaka leo, ba fumane ts'ebetso e eketsehileng ea amygdala nakong ea boemo ba CS + (ho bolela esale pele VSS) khahlanong le CS- (ho bolela esale pele letho) ho barupeluoa ba nang le CSBD ha ba bapisoa le barupeluoa ba taolo, empa ha ho na phapang pakeng tsa ventral striatum. Ka lehlakoreng le leng, ka paradigm ea boemo ba ho khotsofatsa ea Banca et al. (2016) Ho ne ho se na litlamorao tsa sehlopha lipakeng tsa barupeluoa ba CSBD le barupeluoa ba laolang mabapi le likarabo tsa methapo ea kutlo ho mekhoa e fapaneng (mekhoa e mebala e bolelang esale pele VSS, meputso ea chelete kapa letho).

Liphuputso tse latelang mokhoa oa khokahano li senotse sephetho se sa lumellaneng mabapi le kamano pakeng tsa lisosa tsa kotsi tsa CSBD le likarabo tsa methapo ea kutlo ho VSS: Kühn le Gallinat (2014) o fumane kamano e fosahetseng lipakeng tsa nako e sebelisitsoeng ho litšoantšo tsa bootsoa le ts'ebetso ho putamen ea leqele, Brand et al. (2016) ha ea tlaleha lipalo-palo tsa bohlokoa tsa likarabo tsa ventral striatum le nako e tloaelehileng e sebelisitsoeng litšoantšong tsa bootsoa. Leha ho le joalo, ba fumane hore ts'ebetso ea ventral striatum e ne e amana hantle le boemo ba PPU e itlhahloba (e lekantsoe ke s-IATho kopanela liphate). Ntle le moo, ho e 'ngoe ea lithuto tsa rona tsa pele re ne re sitoa ho fumana tšusumetso ea bohlokoa ea nako eo re e qetang ho sheba litšoantšo tsa bootsoa kapa ho ba le tšusumetso ea thobalano ho karabelo ea methapo ea kutlo ho VSS (Stark et al., 2019). Ka hona, lipatlisiso tsa hajoale mabapi le ts'ebetso ea VSS lihloohong tse nang le maemo a fapaneng a likotsi tsa CSBD li bonahala li sa lumellane. Ho fapana le moo liphuputso tse ts'oanang tsa lithuto tse sebelisang mokhoa oa papiso ea sehlopha empa liphetho tse sa lumellaneng tsa lithuto tsa khokahano li ka fana ka maikutlo a hore ts'ebetso ea neural ea VSS ho CSBD e fapane haholo le ea mehlala e metle. Tlhahiso ena, leha ho le joalo, e khahliloe ke leseli la Khopolo ea Khothatso ea Khothatso ea Robinson le Berridge (1993) e fanang ka maikutlo a ho eketsa likarabo tsa methapo ea kutlo nakong ea ntlafatso ea bokhoba ba tahi. Ho fihlela joale, ho ntse ho sa hlaka hore na mohopolo ona o sebetsa ho CSBD mme haeba ho joalo, hore na likarabo tse ntseng li eketseha tsa methapo ea kutlo ho VSS li fetoha ka boholo kapa hore na boemo bo mahlonoko ba boits'oaro bo tlameha ho fetisoa.

Ho khahlisang ke hore le litlamong tse amanang le lithethefatsi liphetho tse mabapi le Khopolo ea Khothatso ea Khothatso ha li lumellane. Liphuputso tse 'maloa tsa meta li bonts'itse ts'ebetso e eketsehileng ea ts'ebetso ea ts'ebeliso tsamaisong ea moputso (Chase, Eickhoff, Laird, & Hogarth, 2011; Kühn & Gallinat, 2011b; Schacht, Anton, & Myrick, 2012), Empa lithuto tse ling li sitiloe ho netefatsa liphuputso tsena (Engelmann et al., 2012; Lin et al., 2020; Zilberman, Lavidor, Yadid, & Rassovsky, 2019). Hape bakeng sa ho lemalla boitšoaro boitšoaro bo phahameng bo fumanehang marang-rang a meputso ea lithuto tse lemalloang ha li bapisoa le lithuto tse phetseng hantle bo fumanoe feela lithutong tse fokolang joalo ka ha ho akaretsoa tlhahlobisong ea morao-rao ke Antons le ba bang. (2020). Ho latela kakaretso ena, ho ka etsoa qeto ea hore ho ts'oaroa ha bokhoba ba tahi ho hlophisitsoe ke lintlha tse 'maloa tse kang lintlha ka bomong le lintlha tse ikhethileng tsa ho ithuta (Jasinska et al., 2014). Liphetho tsa rona tsa zero mabapi le likamano lipakeng tsa ts'ebetso ea bokhachane le lisosa tsa kotsi tsa CSBD le tsona li ka bakoa ke taba ea hore le sampole ea rona e kholo re ka nahana feela ka likhetho tse nyane tse ka susumetsang. Ho hlokahala lithuto tse ling tse kholo ho etsa toka ho tse ngata. Mabapi le moralo, mohlala, mokhoa oa kutlo oa maikutlo kapa ho khetholla likhopolo ho ka ba bohlokoa (Jasinska et al., 2014).

Ho latela boholo ba sampole ea rona (ho fapana le lithuto tse ling) ho ka etsahala hore khaello ea matla a lipalo e bakile liphetho tse sa sebetseng mabapi le khokahano ea lisosa tsa kotsi tsa CSBD le likarabo tsa methapo ea kutlo ho VSS le lintlha tsa VSS. Ho feta moo, boleng ba VSS bo susumetsoang ke ho iphetola ha lintho bo etsa hore libaka tsa boko tse amanang le moputso li lumellane ka mokhoa o ts'oanang li siea sebaka se fokolang bakeng sa liphapang tsa motho ka mong (siling effect). Khopolo-taba ena e tšehetsoa ke lithuto tse bontšang hore ha ho na liphapang tsa thobalano mabapi le ts'ebetso ea VSS marang-rang a meputso (Poppl et al., 2016; Stark et al., 2019; Wehrum et al., 2013). Leha ho le joalo, mabaka a ho se lumellane lipakeng tsa lithuto a hloka ho senoloa ke lithuto tse ling.

Meeli le likhothaletso bakeng sa lipatlisiso tse ling

Ho na le meeli e mengata e lokelang ho tsotelloa. Thutong ea rona re ile ra hlahloba feela setso sa Bophirimela, banna ba bong bo fapaneng. Ho pheta-pheta ha thuto ka sampole e fapaneng ka ho fetesisa ka bong, maikutlo a tsa thobalano, le maemo a setso le setso ho bonahala ho hlokahala ho netefatsa bonnete ba tikoloho. Ntle le moo, tlhaiso-leseling e nkiloe sampoleng e seng ea bongaka, lithuto tsa nako e tlang li tla tlameha ho nahana ka mehlala e nang le matšoao a CSBD a amanang le bongaka. Lintlha tse sebelisitsoeng thutong ena li hlalositsoe e le lintlha tse sa nke lehlakore ntle le boiphihlelo bo fapaneng ba pejana. Leha ho le joalo, theko ea ts'ebetso ena e nang le matla a holimo a kahare e kanna ea ba ho haelloa ke matla a kantle ho tloha ha litšoantšo tsa bootsoa bophelong ba letsatsi le letsatsi li ikhethile haholo.

Moeli o mong ke mokhoa oa karabelo o feto-fetohang (ka letsatsi / ka beke / ka khoeli) mabapi le tlhahlobo ea ts'ebeliso ea litšoantšo tsa bootsoa. Ho latela Schwarz le Oyserman (2001) likarabo tsa potso e ts'oanang li na le papiso e lekanyelitsoeng ha sebopeho sa karabelo se bua ka linako tse fapaneng tsa nako. Lebaka le ka sehloohong la ho khetha mokhoa ona oa karabelo e ne e le hore boholo ba litšoantšo tse manyala tse hlephisang boitšoaro li sebelisoa ka mehlala li ka fapana haholo (ho tloha lihora tse 'maloa ka selemo ho isa ho lihora tse' maloa ka letsatsi). Ntle le moo, ho ne ho bonahala ho le bohlokoa hore mokhoa o hlophisitsoeng oa karabelo o kanna oa beha tloaelo ea hore na litšoantšo tsa bootsoa li sebelisa boemo bofe. Ka hona, re nkile qeto ea ho sebelisa sebopeho se arabelloang habonolo bakeng sa potso ena e haufi-ufi, leha e ne e le bofokoli bo tsebahalang.

Ho feta moo, laboratori e emela boemo ba maiketsetso, kaha litšoantšo tse manyala tse hlephisang boitšoaro li sebelisoa bophelong ba letsatsi le letsatsi hangata li tsamaea le ho ipholla litho tsa botona kapa botšehali. Ka hona, ho lula ho sa tsejoe hore na moputso o tsoa ho ipholla litho tsa botona kapa botšehali kapa / kapa ho tsoa litšoantšong tsa bootsoa ka botsona. Gola et al. (2016) a pheha khang ea hore ts'usumetso ea thobalano e ka ba lintlha le meputso. Haeba lifilimi tsa bootsoa le tsona li hlalosoa e le lintlha, lithuto tsa nako e tlang li ka lumella ho ipholla litho tsa botona kapa botšehali ho fihlela karolo ea 'nete ea ho tsamaisa. Leha ho le joalo, mathata a boits'oaro le mahlale a morao-rao a hloka ho tsotelloa ho etsa thuto e joalo. Ho utloisisa ntlafatso ea CSBD, lithuto tse koahelang matšoao a CSBD (a phetseng hantle, a subclinical, a bongaka) lia hlokahala.

Nahanisisa

Phuputso ea rona e ile ea hlahloba ho sebetsoa ha likhakanyo le VSS ho sebelisa SIDT ka sampole e kholo eo e seng ea bongaka. Ho feta moo, SIDT ea rona e fetotsoeng e ntlafatsa SIDT e fetileng ka ho sebelisa likotoana tsa lifilimi ho fapana le lits'oants'o tse sa fetoheng, ka ho sebelisa livideo tsa ho silila e le boemo ba taolo ho fapana le litšoantšo tse qhekellang, le ka ho sebelisa lintlha tse se nang litaba tsa thobalano. Re atlehile ho pheta liphetho tse bonts'ang ho nka karolo ha sistimi ea moputso nakong ea ts'ebetso ea li-cue le tsa VSS. Ho fapana le monahano oa rona, re sitoa ho supa litlamorao tsa litšobotsi tsa botho tse nahanoang e le lisosa tsa kotsi bakeng sa nts'etsopele ea CSBD likarabong tsa methapo ea kutlo ho ROI efe kapa efe e hokahantsoeng le sistimi ea moputso. Patlisiso ea nako e tlang e lokela ho lekola matšoao a CSBD ho utloisisa hamolemo hore na litšoantšo tse manyala tse hlephisang boitšoaro li sebelisa boits'oaro joang mme ke lintlha life tse ka bolelang tsoelo-pele ena.