Ho kopanela liphate ka autism: boitšoaro ba ho kopanela liphate le li-paraphilic ho basali le banna ba nang le bothata bo boholo ba autism spectrum (2017)

Dialogues Clin Neurosci. 2017 Dec; 19 (4): 381-393.

PMCID: PMC5789215

Daniel Schöttle, MD^*

Daniel Schöttle, Lefapha la Psychiatry le Psychotherapy, Setsi sa Bongaka sa Bongaka Hamburg-Eppendorf, Hamburg, Jeremane;

Lithane Briken, MD

Peer Briken, Setsi sa Patlisiso ea Thobalano le Forensic Psychiatry, Setsi sa Bongaka sa Bongaka Hamburg-Eppendorf, Hamburg, Jeremane;

Oliver Tüscher, MD

Oliver Tüscher, Lefapha la Psychiatry le Psychotherapy, Setsi sa Bongaka sa Medical Mainz, Mainz, Jeremane;

Daniel Turner, MD, PhD

Daniel Turner, Setsi sa Patlisiso ea Thobalano le Forensic Psychiatry, Setsi sa Bongaka sa Bongaka Hamburg-Eppendorf, Hamburg, Jeremane; Lefapha la Psychiatry le Psychotherapy, Setsi sa Bongaka sa Medical Mainz, Mainz, Jeremane;

inahaneloang

Joalo ka batho ba baholo ba sa boneng, batho ba nang le likotsi tsa autism spectrum (ASD) ba bonts'a mefuta eohle ea boitsoaro. Leha ho le joalo, ka lebaka la matšoao a mantlha a bokhutšoaane ba pherekano, ho kenyelletsa le bofokoli ba bokhoni ba sechaba, hypo- hypersensitivities, le boits'oaro bo pheta-phetoang, batho ba bang ba ASD ba ka ba le mekhoa e mengata ea boits'oaro le lithahasello tsa thobalano tse sa tloaelehang. Kamora ho hlahloba lingoliloeng tse amanang le thobalano ho batho ba sebetsang ka mokhoa o phahameng oa ASD, re hlahisa lintho tse fumanoeng khafetsa mabapi le boits'oaro bo tloaelehileng ba boitšoaro ba thobalano le tse mabapi le tlhahlobo ea maikutlo le boits'oaro ba boits'oaro ho batho ba ASD ho tsoa thutong ea rona. Batho ba nang le ASD ho bonahala ba e-na le litoro le boits'oaro bo bongata ho feta lithuto tse akaretsang. Leha ho le joalo, ho se lumellane hona ho susumetsoa haholo ke ketso ea barupeluoa ba banna ba nang le ASD. Sena se ka bakoa ke taba ea hore basali ba nang le ASD hangata ba ikamahanya le maemo sechabeng mme ba bonts'a matšoao a ASD a fokolang. Litšobotsi tsa boitšoaro ba thobalano ho bakuli ba ASD li lokela ho tsotelloa ka bobeli thutong ea thobalano le ka mekhoa ea phekolo.

Keywords: Asperger syndrome, autism, boloetse bo bong bo fapaneng, Hypersexourse, paraphilia, lefu la paraphilic, Ho kopanela liphate

Selelekela

Litla-morao tsa Autism spectrum (ASD) ke mathata a methapo ea methapo e kopanyang sehlopha sa maemo a phahameng, a bonts'ang liphokotso mokhoeng oa puisano le puisano, hammoho le lithahasello le boits'oaro bo bobe.¹ Sekhahla sa ho ata ha litekanyetso se nyolohile haholo lilemong tse mashome tsa morao tjena (ho fihla ho 1% ea bophelo bohle), ha batho ba baholo ba bangata ba fumanoa ba na le ASD.² Ho nahanoa hore karo-karolelano ea monna le mosali e pakeng tsa 3 le 4 ho 1,³ hape ho na le phapang e fapaneng ea bong ho ASD.⁴ Leha hoo e batlang e le halofo ea batho ba nang le ASD ba sa holofala kelellong mme ba e-na le tsebo e tloaelehileng ea ho ithuta le puo (joalo ka batho ba nang le ts'ebetso e phahameng ea autism kapa lefu la Asperger), ts'ebelisano 'moho le bofokoli ba puisano le mathata a ho bona pono ea batho ba bang le ho utloisisa ka mokhoa o hlakileng e seng oa tlhaho. litloaelo sechabeng ke litšitiso tse patiloeng molemong oa likamano tsa lerato le tsa thobalano.^5,6 Mathata a amanang le thobalano a ka hlaha, haholo-holo qalong ea bocha, nako eo nts'etsopele ea boiphihlelo ba batho ba ASD e ke keng ea tsamaisana le litlhoko tse ntseng li eketseha tsa sechaba, mme mathata a ho theha likamano tsa lerato le tsa thobalano a bonahala haholo.⁷

Boithuto mabapi le thobalano ho batho ba nang le ASD

Hoo e ka bang lilemo tsa 10 ka mor'a ho kenngoa semmuso ha autism khatisong ea boraro ea Buka ea Tlhahlobo le Tlaleho ea Bofokoli ba Kelello (DSM-III) ho 1980, lithuto tsa pele tse hlophisitsoeng mabapi le thobalano ea bakuli ba nang le ASD li phatlalalitsoe.^8-11 Boemo ba hajoale ba lipatlisiso mabapi le boiphihlelo ba thobalano, boits'oaro ba thobalano, maikutlo a thobalano, kapa tsebo ea thobalano ea batho ba ASD bo kopantsoe, lithutong tse ling ho fumana phapang ho tsoa taolong e phetseng hantle (HCs) ha ba bang ba sa e etse. Leha ho le joalo, ka lebaka la sebopeho se sa bonahaleng sa bothateng ba pherekano le mokhoa o fapaneng oa lithuto, sena ha se makatse. Lithuto tse fetileng li na le: (i) kenyelletsa bakuli ba basali le / kapa ba banna libakeng tsa bolulo tse nang le mathata a ho feta a monyetla le menyetla e fokolang ea boiphihlelo ba thobalano; (ii) tsepamisitse maikutlo ho batho ba nang le mathata a kelello kapa boiphihlelo bo bong ba ntlafatso ea mororbid, ka hona e lebisang ho litlamorao tse mpe; (iii) o sebelisitse lipatlisiso tsa inthanete moo ho neng ho nkile karolo batho ba sebetsang kaholimo ho moo; (iv) a itshetlehile ka litlaleho tse tsoang ho ba lelapa le bahlokomeli kapa ho tsoa ho bakuli ka bobona; le (v) ho hlahlobe batho ba nang le ASD ka lilemo tse fapaneng.

Lithuto tsena li fana ka maikutlo a hore batho ba bangata ba nang le ASD ba batla likamano tsa thobalano le maikutlo a lerato a tšoanang le a batho ba seng ASD^12,13 mme o be le pono e felletseng ea boiphihlelo ba bootsoa le boits'oaro.^12-18 Leha ho le joalo, ho sa na le litumelo le litumelo tse ngata tse mabapi le batho ba nang le ASD, ba li buang e le ba sa tsotelleng likamanong tsa kahisano le batho ba ratanang hape e le batho ba matla.^10,19,20 Lethathamo I e fana ka kakaretso ea lithuto tse hlahlobang likarolo tse fapaneng tsa thobalano ho batho ba baholo le ba baholo ba nang le ts'ebetso e phahameng ea ts'ebetso, motheong oa lipotso tsa boits'oaro.^{11,12,15,21-33} Re tsepamisitse maikutlo holima tlhahlobo ea lingoliloeng lithutong tsena hobane mokhoa oa tsona o lumellana le mokhoa oa lipatlisiso o sebelisitsoeng thutong e hlahisitsoeng mona. Lithuto tse hlahisitsoeng Lethathamo I netefatsa hore likamano tsa botona le botšehali li na le taba ho batho ba ASD, mme ho hlakile hore karolo eohle ea boiphihlelo le boits'oaro ba thobalano e emeloa sehlopheng sena.^{11-13,15,20-31}

Tlhatlhobo ea lingoliloeng. Tlhokomeliso: Ho sebelisitsoe mantsoe a latelang patlo e hlophisitsoeng ea lingoliloeng: "thobalano," "thobalano," "boitšoaro ba thobalano," "thobalano," "likamano tsa thobalano," ...

Boholo ba lipatlisiso tse teng ho fihlela joale li shebile ho banna, 'me ke liphuputso tse fokolang tse seng li rarolotse litaba tse mabapi le bong mabapi le maemo a bophelo, maikutlo, le kelello,' me ke lithuto tse fokolang tse leng teng tse amanang le thobalano ka boithaopo ho banna le basali ba nang le ASD.^12,13,20,32 Litlhahlobo tse 'maloa tsa kliniki³² le tlhahlobo e nyane ea lithuto tse hlophisehileng li bonts'a hore basali ba nang le ASD ba ka hlahisa liphoso tse sa hlaloseheng tsa sechaba le tsa puisano mme ba na le lithahasello tse ikhethileng tse lumellanang le lithahasello tsa lihlopha tsa bona.^33-36 Ntle le moo, basali ba nang le ASD ba bonahala ba sebelisa maano a ho sebetsana le ona, joalo ka ho etsisa bokhoni ba metsoalle ea bona bao e seng ba ASD, ka lebaka leo ba le botsoalle sechabeng.³⁴ Mabapi le litaba tse amanang le thobalano, basali ba nang le ASD ho bonahala ba na le maemo a fokolang a ts'ebetso ea thobalano ka kakaretso, ba ikutloa ba le betere likamanong tsa thobalano ho feta banna ba nang le ASD, hape ba kotsing e kholo ea ho ba mohlaseluoa oa tlhekefetso ea thobalano kapa tlhekefetso.³⁷ Banna ba nang le ASD ba fumanoe ba etsa liketso tse ngata tsa thobalano,^11-14,18,37 hammoho le ho ba le takatso e matla ea likamano tsa thobalano le maikutlo a lerato²⁰; empa ho na le bopaki bo bong ba hore basali ba nang le ASD, leha ba na le takatso e tlase ea thobalano, hangata ba kopanela likamanong tsa dyadic.¹³

Leha batho ba nang le ASD ba batla boiphihlelo ba likamano tsa botona le botšehali le likamano, nts'etsopele le tlhokomelo ea likamano tsa lerato le tsa thobalano li angoa haholo ke likhaello tsa tsebo ea sechaba le puisano le mathata a ho utloisisa likamano tse sa bueheng kapa tse poteletseng le ka kelello (ho bolelang ho khona ho utloisisa le maemo a kelello a ba bang, mohlala, maikutlo, litakatso, likakanyo tse fumanoang ke batho ba joalo.⁶ Ntle le moo, batho ba bangata ba nang le ASD ha ba fuoe thuto ea thobalano e nkang boits'oaro ba bona, mme ha ba na monyetla oa ho fumana leseli ka litaba tsa thobalano ho tsoa mehloling ea sechaba.^5,22,38

Ntlha e 'ngoe eo u lokelang ho e nahana ke lithahasello tse khutliselitsoeng le tse phetoang, tse ka bang tsa morao bongoaneng empa li ka fetoha' me tsa fella ka boitšoaro ba thobalano le bootsoa ho ba motho e moholo. Ho feta moo, maikutlo a atisang ho hlalosoa a ka re lebisa ho ho fetelletseng kapa bokhobong ba maikutlo a susumetsang mohopolong oa boiphihlelo ba thobalano.³⁹ Ho batho ba nang le khatello e matla ea maikutlo, ho ama 'mele butle ho ka utloahala e le ho sa thabiseng; ka lehlakoreng le leng, batho ba nang le boitšoaro bo botle ba 'mele ba ka ba le mathata a ho ts'oaroa le ho fihlella boits'oaro ka boitšoaro bo bobe ba thobalano.²⁰ Ha re kopantsoe hammoho, matšoao a mantlha a ASD a kopaneng le tsebo e fokolang ea thobalano le sebaka se fokolang sa ho ba le maikutlo a lerato le thobalano li ka etsa hore batho ba bang ba nang le ASD ba qale ho ba le boits'oaro bo bobebe kapa bo bobe ba ho etsa thobalano,^22,38 jwaloka boitshwaro bo feteletseng ba boitshwaro bo bobe le ho khopisa.

Ho sebelisitsoe mantsoe a fapaneng ho hlalosa boitšoaro ba thobalano bo kaholimo ho kenyelletso ho kenyelletsa ts'ebetso ea thobalano, ho qobelloa ka thobalano, takatso ea botona kapa ea botšehali. Sehloohong sena, re tla sebelisa mantsoe hypersexual kapa hypersexourse e buang ka litabatabelo tsa khafetsa tsa thobalano, takatso ea thobalano le boits'oaro.^40,41 Leha ho le joalo, motho o lokela ho hlokomela hore boteng ba boitšoaro bo bobe bo kaholimo ho mahareng ha bo na tokelo ea ho fuoa tlhahlobo ea mafu a kelello (joalo ka khatello ea maikutlo kapa khatello ea boitšoaro bo amanang le thobalano). Kafka o ile a etsa tlhahiso ea hore ho kenyeletsoe mekhoa ea tekanyetso ea tlhahlobo ea mafu a amanang le khatello ea maikutlo DSM-5. ⁴⁰ Litekanyetso tsena li hlalosa ho hloka taolo ha hypersexual e le litoro tsa morao-rao le takatso e matla ea thobalano, khothatso, kapa boits'oaro ba botona le botšehali nako e fetang bonyane likhoeli tsa 6, ho baka khatello e kholo ea bongaka, mme hoo ha ho bakoe ke lintho tse ling kapa maemo a bongaka; hape, motho ka mong o tlameha ho ba le bonyane lilemo tsa 18.^40,42 Leha Reid le basebetsi-mmoho ba bonts'itse hore khatello ea tšoaetso ea kelello e ka hlahlojoa ka nepo le ka ts'ebeliso e nepahetseng ka ts'ebeliso ea mekhoa ena ea tlhahlobo, American Psychiatric Association leha ho le joalo e hanne tšebeliso e joalo ka lebaka la boemo bo ntseng bo sa lekana ba lipatlisiso, e kopa lithuto tse ling mabapi le tlhahlobo ea setso bothata bona, bakeng sa lithuto tsa baemeli ba mafu a amanang le lefutso, le lithuto tse mabapi le etiology le likarolo tse amanang le tsona.⁴³

Bakeng sa khatiso ea leshome le motso o mong e boletsoeng Sehlopha sa Machaba sa Tsamaiso ea Mafu (ICD-11), Tlhaloso e latelang bakeng sa ho khetholla lefu le qobelloang la boitšoaro ba thobalano⁴¹ e ntse e nahanoa:

Boloetse ba boitšoaro bo hlephileng ba ho kopanela liphate bo khetholloa ke litabatabelo tsa thobalano tse phehellang le tse pheta-phetoang kapa litabatabelo tse nang le boiphihlelo e le tse ke keng tsa hanyetsoa kapa tse sa laoleheng, tse lebisang ho boits'oaro bo pheta-phetoang ba thobalano, mmoho le lits'oants'o tse ling tse joalo ka liketso tsa thobalano e ba tsona tse ka sehlohlolong bophelong ba motho ho isa ntlheng ea ho se tsotelle bophelo bo botle. tlhokomelo ea botho kapa mesebetsi e meng, boiteko bo sa atleheng ba ho laola kapa ho fokotsa boits'oaro ba thobalano, kapa ho tsoelapele ho etsa boits'oaro bo pheta-phetoang ba thobalano leha ho bile le litlamorao (mohlala, ho senyeha hoa likamano, litlamorao mosebetsing, litlamorao tse mpe ho bophelo bo botle). Boiphihlelo ba motho ka mong bo ile ba eketsa tsitsipano kapa ho tsosa maikutlo hanghang pele ho thobalano, le phomolo kapa ho qhala ha tsitsipano kamora moo. Mokhoa oa litakatso le boits'oaro ba thobalano o baka khatello ea maikutlo kapa ho holofala ho hoholo, ka lapeng, sechabeng, thutong, mosebetsing kapa likarolong tse ling tsa bohlokoa tsa ts'ebetso.

Mabapi le paraphilias, the DSM-5 joale e khetholla lipakeng tsa likhathatso tsa ho hlaseloa ke paraphilias le paraphilic, ka hona e shebane le litakatso tsa litakatso tsa thobalano tse sa pheleng le boits'oaro bo sa bakeng khatello kapa ho senyeha ho motho eo kapa ho utloisa ba bang bohloko.⁴² ka DSM-5, paraphilias e hlalosoa e le "lithahasello tsa thobalano tse matla le tse tsoelang pele ntle le lithahasello tsa thobalano ho tsoalo ea botona kapa ho itokisetsa ho ratana le batho ba tloaetseng ho hola, ba holileng tsebong, ba lumelang balekane" lebokose 1 bakeng sa lenane la mathata a paraphilic a kenyellelitsoeng ho DSM-5). ⁴⁴ Leha mekhoa e khothalletsoang ea mathata a paraphilic ho ICD-11 tšoana le ba DSM-5, Phapang e le 'ngoe e kholo lipakeng tsa libuka tsena tse peli tsa tlhahlobo ea mafu ke ho tlosoa ha mafu a paraphilic a tšoaelitsoeng haholo motheong oa litloaelo tse sa lumellaneng le tsona ka lebaka la khatello ea maikutlo kapa ts'ebetso ea ts'ebetso. Sena se ile sa lebisa ho ICD-11 kenyelletso ea fetishistic, pono e tsosang takatso ea botona kapa botšehali, le lefu la ho fetela,^41,45 boits'oaro bo tlalehiloeng ho batho ba ASD.

Lebokose 1. Kakaretso ea mathata a paraphilic a kenyellelitsoeng libukeng tsa hona joale tsa tlhahlobo ea mafu.

Bofokoli bo hlalosang

• Ho tsosa takatso ea thobalano ka ho pepesa litho tsa botona kapa tsa botšehali ho motho ea sa tsotelleng.

Moferefere oa bongoana *

• Ho tsosa takatso ea thobalano ka ho bapala ka lintho tse sa pheleng.

Moferefere oa bofutsana

• Ho tsosa takatso ea thobalano ka ho hohla litho tsa botona kapa tsa botšehali ho motho ea sa tsotelleng.

Boloetse ba ho hlaseloa ka likamano tsa botona le botšehali *

• Ho tsosa takatso ea botona kapa ea botšehali ka ho tlangoa, ho shapuoa kapa ho etsoa lintho tse ling tse utloisang bohloko 'meleng kapa ho tlotloloha.

Boloetse ba ho hlonama ka tsa thobalano

• Ho tsosa takatso ea botona kapa ea botšehali ka ho utloisa bohloko maikutlong kapa 'meleng kapa bohloko ho molekane oa thobalano.

Boloetse ba lefu la Transvestic *

• Ho tsosa takatso ea botona kapa ea botšehali ka ho apara le ho tloaela ho etsa setaele kapa mokhoa o amanang le batho ba bong bo fapaneng.

Boloetse ba Voyeuristic

• Ho tsosa takatso ea botona kapa ea botšehali ho sheba ba bang ha ba hlobotse kapa ha ba kopanela liketsong tsa thobalano.

Boloetse ba Pedophilic

• Ntho ea pele kapa e ikhethang e khahlang ea thobalano ho bana ba preubescent.

* Ho bonts'a maemo a ipapisitseng le boits'oaro bo lumellang 'me hangata ha bo kenyelle ho se tsotelle batho ba bang ebile ha bo kopane le khatello ea maikutlo kapa ts'ebetso ea ts'ebetso. Sehlopha sa Ts'ebetso mabapi le Classified ea Mathata a Thobalano le Bophelo bo Botle ba thobalano se khothalelitse ho tlosa maemo ana ho ICD-11.

Ho fihlela hajoale, ke lithuto tse fokolang feela tse ileng tsa lekola boitšoaro ba hypersexual kapa paraphilic ho batho ba nang le ASD, mme boholo ba eona ke litlaleho tsa linyeoe tse tlalehang ka batho ba ASD ba bontshang ho ipholla litho ho feta tekano,^46-50 boits'oaro bo bonts'ang⁵¹ litoro kapa boitšoaro,^52,53 litoro kapa boitšoaro,^54,55 sadomasochism,⁵⁰ kapa mefuta e meng ea paraphilias.⁵⁶ Le ha ho le joalo, tsebong ea rona, lithuto tsohle tse fetileng mabapi le boits'oaro bo botle ba boitšoaro le sebopeho li entsoe ho banna le maemong a mangata ka batho ba nang le bothata ba ASD ba nang le ts'oaetso.

Kamora ho hlahloba lingoliloeng, re ne re ikemiselitse ho etsa lipatlisiso tsa boitsoaro bo botle le litabatabelo tsa paraphilic mohlaleng o moholo oa bakuli ba ASD ba batona le ba batšehali ha ba bapisoa le li-HC tse lumellanang le bong, lilemo, le boemo ba thuto.

mekhoa

barupeluoa ba

Ho fumana tlhaiso-leseling e tobileng ho tsoa ho batho ba nang le ASD le ho ithuta sampole e sa rateheng, re kenyelletsa feela batho ba baholo ba nang le ASD ntle le bofokoli ba thuto. Taba ea ho kenyelletsa feela batho ba nang le ts'ebetso e phahameng ea Autism kapa Asperger syndrome e ne e le ho fokotsa phello e mpefatsang ea ho holofala kelellong mme ka hona, ba ithute ka kotlolloho phello ea ASD litabeng tsa thobalano. Motheong oa boithati, bakuli bohle ba ile ba fumanoa ke ngaka ea mafu a kelello kapa setsebi sa kelello (n= 90, Asperger syndrome; n = 6, atypical autism); lilemo tse boleloang tseo bakuli ba fumaneng tlhahlobo ea bona ea ASD e ne e le lilemo tsa 35.7 (ho kheloha ho tloaelehileng [SD] = lilemo tsa 9.1; mefuta = 17 ho lilemo tsa 55). Sehlopha sa bakuli ba ASD (bolela alama [M] = 26.7; SD = 4.9) se ne se na le lintlha tse phahameng haholo ho feta HCs (M = 6.4; SD = 3.3) ho mofuta oa Jeremane oa Autism Spectrum Quotient Short form (AQ-SF; P⁵⁷ Bakuli bohle ba ASD 'me ha ho le ea mong oa HC ea fumaneng holimo ka boleng bo khaotsoeng ba lintlha tsa 17.⁵⁷ Barupeluoa lihlopheng tsena ka bobeli ba ne ba etselitsoe bong, lilemo. le lilemo tsa thuto (Tafole ea II).

Litšobotsi tsa bankakarolo. ASD, Autism spectrum disorder; Li-HC, taolo e phetseng hantle; n, palo; SD, ho kheloha ho emeng

Tsamaiso

Boto ea tlhahlobo ea melao ea boitšoaro ea Hamburg Medical Council e amohetse protocol. Bakeng sa ho hira batho ba fumanoeng ba na le ASD, lihlopha tsa boithati ho pholletsa le Jeremane li ile tsa ikopanya mme tsa botsoa hore li tsamaise bukana ea thuto har'a barupeluoa ba bona. Barupeluoa ba bang ba ile ba hloa setsi sa bongaka sa bongaka sa bophelo sa bongaka Univesithing ea Bongaka ea Bongaka Hamburg-Eppendorf, Jeremane. Li-HC li ile tsa hapuoa ka lipapatso Univesithing ea Bongaka ea Bongaka Hamburg-Eppendorf le University Medical Center Mainz ea Jeremane, mabenkeleng a mabenkele a lehae, le ka mabitso a bafuputsi ka bo bona.

Mehato

Autism Spectrum Quotient Short Foromo, Sejeremane

Mofuta oa Jeremane oa lipotso tsa Autism Spectrum Quotient Short Form (AQ-SF)⁵⁷ e sebelisitsoe bakeng sa tlhahlobo ea matšoao a autistic ho bohle ba nkang karolo. Sekhechana sa phallo ea 17 se fumanoe e le boleng bo botle ba ho khaola sepheo sa ho hlahlobeloa mme se hlahisitse maikutlo a 88.9% le tlhaiso-leseling ea 91.6% e nang le sebaka se katlasehong ea moamoheli litšobotsi tsa ts'ebetso ea 0.92 ho sampole ea netefatso ea Jeremane.⁵⁸

Hypersexual Behaeve Inventory (HBI-19)

Hypersexual Behaeve Inventory (HBI-19)^58,59 e na le lintho tsa 19 mme e lekola boitšoaro ba hypersexual. Lintho tsohle li tlameha ho arajoa ka tekanyo ea Likert ea 5 'me li ngotsoe ka bong ka ho se lekane. Barupeluoa ba nang le lintlha ka holimo 49 hangata ba khetholloa e le hypersexual. Phetolelo ea Sejeremane ea lipotso tse hlahisitsoeng e hlahisitse mokhoa o ts'oanang oa ho lekana oa α = 0.90 bakeng sa kakaretso kaofela.⁶⁰

Potso ea lipotso mabapi le boiphihlelo ba thobalano le bo-behaviors (QSEB)

Potso ea lipotso mabapi le liphihlelo tsa thobalano le bo-behaviors (QSEB)⁶¹ e na le lintho tsa 120 mme e lekola tlhaiso-leseling e mabapi le semelo sa lelapa, boits'oaro ba thobalano, boits'oaro ba thobalano le litloaelo tse fapaneng tsa thobalano. Ho feta moo, lipotso li hlahloba tlhaiso-leseling ka menahano le boits'oaro ba thobalano (ho kenyeletsoa menahano le boits'oaro ba botona le botšehali). Lintho tse ngata li bua ka nako ea ho shebella ea likhoeli tsa 12; linthong tse amanang le tliliniki, lipotso li botsa barupeluoa ho bolela hore na matšoao a kliniki a bile teng neng. Bakeng sa thuto ea hona joale, ho hlahlobisisitsoe feela lintho tse amanang le khafetsa ea ho ipholla litho le liketselletso tsa thobalano, hammoho le litoro le boits'oaro bo botle.

Lipatlisiso tsa sethathamo

Phapang ea sehlopha e ile ea hlahlojoa ho sebelisoa Χ ² liteko ka li-variative tsa mekhahlelo, le tLiteko tsa sampole tse ikemetseng bakeng sa lintho tse tsoelang pele tse sa fetoheng. Hobane liteko tse ngata tsa lipalo li ile tsa etsoa ho data e ts'oanang, re ile ra laola boemo ba bohlokoa ba ho bokella phoso ea mofuta-I ka ts'ebeliso ea sekhahla sa phihlello ea bohata (FDR) ho latela mokhoa o ntlafalitsoeng ke Benjamin! le llochberg.⁶² Ho laola liteko tse ngata ho lebisa phokotsong ea PMorero oa nako. Thutong ea hona joale, tse lokisitsoeng PKotlo eavalval e ne e le 0.0158, ho bolelang hore feela PLitaelo tse ka tlase ho cutoff ena li lokela ho nkuoa e le tsa bohlokoa. Ka hona, FDR ha e tsotellehe ho feta tloaelo ea Bonferroni e neng e sebelisoa ka tloaelo; leha ho le joalo, haufinyane tjena, ho ile ha khothaletsoa hore FDR e lokela ho fumana khetho ho feta mokhoa oa Bonferroni, haholo lithutong tsa bophelo bo botle le tsa bongaka.⁶³

Results

Boemo ba kamano

Ho batho ba nang le ASD, basali ba bangata haholo (n = 18; 46.2%) ho feta banna (n = 9; 16.1%) ba ne ba le kamanong (P<0.01). Ha ho phapang e kholo e fumanoeng palong ea basali (n = ll; 27.5%) le banna (n = 8; 14.3%) le ASD ba tlalehileng ba na le bana ba bona. Ha re bapisa batho ba ASD le li-HC, re hlokometse hore basali ba bangata ba HC (n= 31; 79.5%; P> 0.01) le banna ba bangata ba HC (n= 47; 82.4%; (P> 0.01) ho feta batho ba nang le ASD ba ne ba le kamanong hona joale. Ha ho liphapang tse bonoeng palong ea bankakarolo ba nang le bana ba bona (HCs: n= 7; 7.3%).

Boitšoaro bo bobe ba thobalano le bo-daadic

Tse tšehali

Joalokaha ho bontšitsoe ho Tafole ea III, ha ho liphapang tse fumanoeng pakeng tsa barupeluoa ba basali khafetsa ea ho ipholla litho.P> 0.05). Leha ho le joalo, li-HC tsa basali li bonts'a thobalano khafetsa ho feta bakuli ba basali ba ASD (P<0.05). Mokhoa o tšoanang o fumanoe mabapi le potso ea hore na "o lakatsa ho etsa thobalano hangata hakae," ho bontša hore basali ba HC ba na le takatso e kholo ea thobalano ho feta balekane ba bona ba ASD (P

Batona

Mabapi le khafetsa ea ho ipholla litho ho banna, barupeluoa ba ASD ba banna ba tlalehile khafetsa ho ipholla litho ho feta li-HC tsa banna (P<0.01). Ha ho bapisoa khafetsa ea thobalano, mokhoa o fapaneng o fumanoe, ha li-HC li tlaleha makhetlo a phahameng a thobalano ho feta batho ba ASD. Banna ba ASD ba tlalehile takatso e kholo ea thobalano ho feta balekane ba bona ba HC (P<0.05, Tafole ea III).

Boitšoaro ba thobalano le bo-daadic ka har'a bakuli ba sebetsang ka mokhoa o phahameng ha bo bapisoa le taolo e ntle. ASD, Autism spectrum disorder; Li-HC, taolo e phetseng hantle; ns, ha e bohlokoa

Boitšoaro ba kelello

Ho HBI, bakuli ba ASD (HBI)_kakaretso= 35.1; SD = 13.7) e ne e e-na le kakaretso ea palo e phahameng haholo ho feta ea li-HC (HBI)_kakaretso= 29.1; SD = 8.7; P<0.001), mme batho ba bangata ba ASD ba ne ba le kaholimo ho boleng ba lintlha tse 49 mme ka hona ba ka hlalosoa e le hypersexual (P<0.01). Joalokaha ho bontšitsoe ho Lethathamo IV, banna ba nang le tlhahlobo ea ASD ba tlaetse boitšoaro bo eketsehileng ba hypersexual, athe ho ne ho se na phapang e joalo pakeng tsa bakuli ba basali ba nang le ASD le HC ea basali. Ntle le moo, athe banna ba 17 ba nang le ASD ba fumane lintlha tse kaholimo ho boleng ba 49 mme ka hona e ka hlalosoa e le hypersexual, ke li-HC tse peli feela tsa banna tse fumanehileng kaholimo ho li-cutoff tse hlahisitsoeng (P<0.001). Ha ho phapang e fumanoeng lipakeng tsa bakuli ba basali ba ASD le li-HC ka sekhahla sa bosodoma.

Matšoao a hypersexuality le paraphilias ho bakuli ba sebetsang ba Autism e phahameng ha a bapisoa le taolo e phetseng hantle. ASD, Autism spectrum disorder; Li-HC, taolo e phetseng hantle; HBI = Hypersexual Behaeve Inventory; max, boholo; n / A, ha e sebetse. *P-mela e ntse e le teng ...

Litoro le boitšoaro ba Paramente

Ka kakaretso, litakatso le boits'oaro bo bobe ba botona le botšehali bo tlalehiloe khafetsa ho bakuli ba banna ba nang le ASD ho feta ho li-HC tsa banna. Kamora ho khalemela liteko tse ngata, phapang e kholo e ne e ntse e le teng ka palo ea batho ba tlalehang litoro tsa menahano, litoro tse nyarosang, litoro le boits'oaro bo hlephileng, litoro le boits'oaro bo bobe, le litoro tse amanang le bana ba basali (bona Lethathamo IV). Bakuli ba basali ba nang le ASD ha baa ka ba bontša phapang khafetsa ea menahano kapa boits'oaro ba ho bapisa le balekane ba bona ba HC, ntle le khafetsa ea boits'oaro ba mahlo, moo HC ea basali e bonts'ang boits'oaro bo botle ho feta bakuli ba ASD.

Puisano

Ho tsebo ea rona, ena ke thuto ea pele ea ho hlahloba likarolo tse ikhethileng tsa bong ka litoro le boits'oaro ba paraphilic ka har'a sehlopha sa batho ba sebetsang ka matla le ASD ha ba bapisoa le sehlopha se laoloang. Liphetho tsa rona tsa mantlha ke hore batho ba nang le ASD ba bonts'a litoro le boits'oaro bo fetisisang ho feta ma-HC.

Patlisiso e fetileng e khothalelitse hore ho batho ba nang le ASD, leha boholo ba bona ba nkoa e le batho ba bong bo fapaneng,¹⁸ ho bile le litheko tse phahameng (ho fihla ho 15% ho 35%) ea batho ba ratanang le ba bong bo tšoanang kapa ba batho ba sa ratanang le ba ASD.^14,64 Phuputsong ea hona joale hape, ke batho ba fokolang ba nang le ASD ba tlalehileng ho ratana le balekane ho feta li-HC; leha ho le joalo, ho tlameha ho hlokomeloe hore li-HC tsohle e ne e le batho ba bong bo fapaneng mme ka hona ha li tšoane le bongata ka kakaretso. Thutong ea Lefapha la Thobalano ea Botona le Botšehali ea lefatše ka bophara, karolo e akaretsang ea 10% ea barupeluoa e bontšitse hore ke basodoma.⁶⁵ Ho bile le maikutlo a fapaneng mabapi le mefuta e pharalletseng ea likamano tsa botona le botšehali ho baahi ba ASD. Mohlomong bong ha bo tšoanelehe ha motho a khetha molekane, ka lebaka la phihlello e lekanyelitsoeng ea likamano tsa lerato kapa tsa thobalano le boiphihlelo bo fokolang le phapanyetsano ea batho ba bong bo fapaneng le balekane ba bona. Ho kopantsoe le tsebo e fokolang ea thobalano, sena se ka lebisa kutloisisong e lekanyelitsoeng ea likamano tsa botona le botšehali kapa khetho.^33,35,37 Ntle le moo, ho na le bopaki ba hore batho ba ASD ba ka khona ho mamella likamano tsa bong bo tšoanang,¹⁵ mme ho ka etsahala hore batho ba ASD ba khethe litakatso tsa bona tsa thobalano ka boithatelo ho feta se amoheloang sechabeng kapa se batloang, mohlomong ka lebaka la maikutlo a tlase litloaelong tsa sechaba kapa karolo ea bong.¹⁵

HC tse ngata haholo ho feta batho ba nang le ASD li tlalehiloe li le kamanong le liphapang tse hlakileng tsa balekane. Basali ba bangata ho feta banna ba nang le ASD ba ne ba le kamanong. Liphetho tsa lithuto tse ling tse hlahlobang phapang ea bong maemong a kamano ha li ikhethang, empa ho na le bopaki ba hore le ha banna ba lakatsa likamano tsa banna le basali ho feta basali, basali ba ASD hangata ba kamanong ea lerato le thobalano.^11,31 Sena se ka bakoa ke bokhoni ba basali ba ASD ba ho letsetsa mekhoa e tsoetseng pele ea ho sebetsana le boemo (mohlala, ho etsisa litsebo tsa boiketlo ba lithaka tsa bona tseo e seng tsa ASD), ho lebisang ho senyeheng ho fokolang ts'ebetsong ea sechaba.^33-36 Mabapi le khafetsa ea boitšoaro ba thobalano, basali ba nang le ASD ba tlaleha ba le bang ho feta boits'oaro bo khahlisang batho ba ho etsa thobalano le takatso e fokolang ea ho ba le likamano tsa botona le botšehali le balekane ba bona ho feta balekane ba bona bao e seng ba ASD. Mokhoa o tšoanang o fumanoe ho banna ba ASD, e tsamaellanang le lithuto tse ling.^12,23,24,33

Leha ho le joalo, ho hlokomoloha litloaelo tsa maemo a bophelo hammoho le boiphihlelo bo fumanehang bo atamelaneng ba sechaba le maikutlo a ho ferekanya kelello kapa hypersensitivities le tsona li ka eketsa kotsi ea ho etsa boits'oaro bo seng bobebe kapa bo boholo ka hofeta-bohareng.^22,38 Ha re hlokomela monahano ona, re fumane hore mekhoa ea boitšoaro bo fetelletseng e tlalehiloe hangata ho batho ba ASD ho feta li-HC; leha ho le joalo, liphapang tsena li ne li tsamaisoa haholo ke bakuli ba ASD ea banna, 'me ha ho liphapang pakeng tsa lihlopha tsa basali tse ileng tsa bonoa. Motheong oa ts'ebetso e nepahetseng ea boits'oaro bo matla, lithuto tse fetileng li fumane likhakanyo tsa ho ata ho tloha ho 3% ho 12% bakeng sa lithuto tsa banna tse phetseng hantle.^66-68 Phuputsong e fumanehang marang-rang ea banna ba Jeremane ba ka bang 9000, Klein le basebetsi-'moho ba fumane ts'oaetso ea boits'oaro bo matla (bo hlalositsoeng e le li-orgasms tse fetang tse supileng ka beke nakong e fetang ea khoeli ea 1) ea 12%.⁶⁹ Ho hlakile hore sena se bontša hore lithuto tsa ASD tsa banna tse ngata lithutong tsa rona tsa boitšoaro bo fetisisang ho feta likhakanyo tse thehiloeng ho baahi. Ho fihlela hajoale, ke Fernandes feela le basebetsi-'moho ba ileng ba lekola boitšoaro ba hypersexual ho batho ba ASD mme ba fumane litheko tse tlase ho feta kamoo re neng re le ka teng.⁷⁰ Bakeng sa 55 e sebetsanang le banna ba ASD e hlahlobiloeng, 7% e tlalehiloe ka boits'oaro bo hlalositsoeng, bo hlalositsoeng e le liketsahalo tse fetang tse supileng tsa thobalano ka beke, mme 4% e ne e etsa liketso tsa thobalano nako e fetang hora ea 1 ka letsatsi, e hlakileng ka tlase ho lipalo. e fumanehang thutong ea hona joale. Leha ho le joalo, Fernandes et al ha aa ka a bolela hore na ba hlalosa liketso tsa thobalano joang, mme ho ka etsahala hore barupeluoa thutong ea bona ba lekanyetse feela liketso tsa thobalano tsa dyadic, a hlalosa palo e tlase ea boits'oaro bo hlekefetsang.⁷⁰ Lisosa tse ka bang tsa litheko tse phahameng tsa khatello ea maikutlo ho banna ba ASD li lula li sa hlaka, empa ho ka nahanoa hore ke karolo ea mekhoa e pheta-phetoang kapa e susumetsoang ke litšobotsi tsa maikutlo. Hobane ha re a khetholla lipakeng tsa boits'oaro ba boits'oaro ba batho ba boits'oaro le boits'oaro, tekanyo e phahameng ea boits'oaro ho banna ba ASD e kanna ea eba polelo ea ho ipholla litho tse ngata, tse fumanoeng lithutong tse ling le litlaleho tsa linyeoe. Ho khothalelitsoe hore boitšoaro bo feteletseng ba ho bonts'a takatso ea ho pholla litho tsa botona kapa botšehali bo ka bonts'a takatso ea ho ba le thobalano leha ba sa khone ho fihlela sena ka lebaka la mathata a ho kopanela likamanong tsa botona le botšehali ka lebaka la bokhoni bo fokolang ba sechaba.^14,46-48,52 Mabapi le basali, ho entsoe lipatlisiso tse fokolang mabapi le boitšoaro ba maqhubu a hanyane ka hanyane, 'me ka lebaka la boholo ba sampole e nyane, likhakanyo tsa tšoaetso li tloha ho 4% ho 40% ka bongata.⁶⁰ Phuputsong e netefalitsoeng ea Jeremane ea HBI, 4.5% ea basali ba batlang ba le 1000 ba kenyellelitsoe ka holimo ho sepheo sa hypersexuality cutoff.⁵⁹ E le karolo ea DSM-5 liteko tsa tšimo bakeng sa khatello ea kelello, ho fumanoe hore 5.3% ea bakuli bohle ba batlang thuso setsing se khethehileng sa tlhokomelo ea kantle e ne e le basali,⁴³ ho bonts'a hore tekanyo ea boits'oaro bo matlafatsang e ka ba e tlase haholo ho basali ho feta ho banna. Ha bakuli ba ASD ba basali ba bonahala ba fetoha le maemo sechabeng 'me hangata ba bonts'a matšoao a ASD a seng a bitsitsoe (mohlala, mekhoa e fokolang e phetoang), ha ho makatse hore boits'oaro bo akaretsang lithutong tse teng le bona bo fumanoe bo sa ateloe hangata ho basali ho feta ho banna ba ASD.

Ho fihla joale, ha ho na lithuto tse hlophisehileng tse mabapi le paraphilias ho baahi ba ASD^64,70; boholo ba leseli bo tsoa lithutong tsa linyeoe. Ho feta moo, hoo e batlang e le lithuto tsohle tse buang ka boits'oaro ba batho ba ASD ba nang le mofuta o itseng oa ho lemala; ka hona, ho bapisoa le se fumaneng thutong ea hona joale ho na le moeli. Thutong ea Fernandes le basebetsi mmoho (ho tsebo ea rona feela thuto e fetileng e neng e bua ka paraphilias ho banna ba sebetsang ba ASD), lipapatso tse fumanoang hangata e ne e le voyeurism le fetishism.⁷⁰ Litoro le boits'oaro bo khahlisang e ne e le tse ling tsa litšoantšo tse atisang ho fumanoa ke banna le basali ba ASD thutong ea kajeno. Ho feta moo, liketsahalo tse tlalehiloeng khafetsa e ne e le litoro le boits'oaro bo bobe. Hape, sena e ka ba sesupo sa hyposensitivity e boletsoeng ho baahi ba ASD, e bonts'a hore batho ba joalo ba hloka ho khothatsoa ka nako e telele ho hlekefetsoa ka thobalano. Ho feta moo, Fernandes et al o fumane hore ho hlaha ha paraphilia ho ne ho amana le matšoao a eketsehileng a ASD, maemo a tlase a bokhoni ba kelello, le litekanyetso tse tlase tsa ts'ebetso e sebetsang, a bontša hore bokhoni ba kelello bo tlase bo bonahala e le karolo ea bohlokoa ho etiology ea paraphilic fantasies le boits'oaro ho ASD.⁷⁰ Ho ka fetisoa taba ea hore tlhokomeliso ea maemo a sechaba le boits'oaro bo botle e tlase le ho batho ba ASD ba nang le mathata a kelello, ba hlalosang sekhahla se phahameng sa boits'oaro. Leha batho ba bangata ba ASD thutong ea morao-rao ba ne ba e-na le litoro tse makatsang, batho ba fokolang haholo ba hlile ba bonts'a boits'oaro bo fetisisang, ba ts'ehetsa tlhahiso ea hore batho ba sebetsang ba phahameng ba ASD ba ka ba le boits'oaro bo phahameng ho feta bakuli ba ASD ba nang le mathata a kelello. Tlhahisoleseling mabapi le paraphilias ho bongata ka kakaretso e boetse e haella, ha liphuputso tse ngata tse kenyeletsang banna, li hloahloa haholo maemong a bongaka kapa a mafu a morao-rao.⁷¹ Ho bongata ka kakaretso, tekanyo ea ho ata ha paraphilia efe kapa efe e nahanoa hore e pakeng tsa 0.4% le 7.7%. ^72-75 Hape, ho sebelisa QSEB, Ahlers et al e fumane sekhahla sa 59% bakeng sa litoro leha e le life tsa paraphilic le sekhahla sa 44% bakeng sa boitšoaro bofe kapa bofe ba paraphilic mohlaleng oa bona o akaretsang oa banna ba Majeremane a 367, ka litoro tse tloaelehileng tsa paraphilic ho ba voyeuristic (35 %), fantishistic (30%), le fantisi (22%) litoro.⁶¹ Phuputsong e teng hona joale, haholo-holo bakeng sa banna ba ASD ea banna, litekanyetso tsa menahano le boits'oaro bo ts'oanang li ne li phahame ho feta likhakanyo tsa tlhahlobo e fumanoeng lithutong tse ngata tsa kakaretso ea batho. Hape, re fumane liphapang tse hlalositsoeng ka botona le botšehali khafetsa ea menahano le boits'oaro bo bongata ho batho ba ASD. Tlhaloso e ka bang teng bakeng sa phapang ena e ka ba hore moreropo o matla oa thobalano ho banna ba ASD o ka kopanya boteng ba litšoantšo tse tšoanang ka matla a maholo ho phethahatsa litabatabelo tsa bona tsa thobalano kapa hore ba nang le thobalano e phahameng ba tloaetse ho etsa lintho tse itseng habonolo, ka ho etsa joalo. ho lwela mesebetsi e meng e meng.^71,76,77 Ho feta moo, tšibollo ea maikutlo e ka boela ea lebisa ho nyatseng ea tlase ea thobalano kapa ho khelohela litoro kapa litloaelo tse hlakisang kamano lipakeng tsa boemo bo phahameng ba hypersexual, hammoho le boits'oaro.⁷⁷

Liphetho tsa boithuto ba rona li na le meeli hobane li thehiloe feela ho itlaleha, 'me motho a ke ke a ba le bonnete ba hore barupeluoa bohle ba fumanoe ke setsebi sa kelello kapa setsebi sa kelello. Leha ho le joalo, barupeluoa bohle ba ASD ba ile ba natefeloa ke boleng ba mofuta oa Jeremane oa AQ, ba netefatsa hore ba bonts'a matšoao a ASD. Ntle le moo, bohle ba neng ba nkile karolo ba ile ba hapuoa ka lihlopha tse thusang ka ASD kapa litsi tsa tlhokomelo tsa malapeng tsa ASD, ho bonts'a hore ho ikopanya ha bona le tsamaiso ea bongaka ho bakiloe ke matšoao a bona. Liphetho tsa rona tsa ho ithuta li boetse li fokotsoa ke monyetla oa hore batho ba nang le thahasello e phahameng litabeng tse amanang le thobalano, mme mohlomong hape ba nang le mathata a mangata a thobalano, ba ne ba ka khona ho ithaopa ho nka karolo, ka hona, ba ama bongata ba lipatlisiso. Sena se kanna sa lebisa ho tebello e fetisisang ea litekanyetso tsa boits'oaro bo matla le boitshwaro bo hlasimolohileng sehlopheng sa ASD. Leha ho le joalo, haeba ke 'nete, sena se kanna sa tlameha ho ba se etsahetse sehlopheng sa HC.

Boithuto ba hona joale ke ba pele ba ho hlahloba menahano le boits'oaro bo bobebe mohlaleng o moholo oa batho ba sebetsang haholo ba ASD ha ba bapisoa le sehlopha se laoloang, ho bonts'a hore le ha batho ba ASD ba na le tjantjello e phahameng ea boitšoaro ba thobalano, ka lebaka la liphokotso tsa bona tse tobileng tšebetsong ea sechaba le ea baratani, ba bangata ba bona ba tlaleha litšobotsi tse ling tsa thobalano.

lumela hore baa fokola

Re batla ho leboha Stefanie Schmidt ea entseng mosebetsi o motle ho ts'ehetsa ho hira barupeluoa. Ntle le moo, re batla ho leboha lihlopha tsohle tsa batho ba neng ba ikemiselitse ho aba memo ea bona ea ho ithuta har'a litho tsa bona. Ha ho thuso ea chelete ea kantle e fumanoeng bakeng sa thuto.

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