LITABA: Tlhatlhobo ea litsebi tsa tahi e phethela ka hore ts'ebeliso ea ts'ebeliso ea litšoantšo tsa bootsoa ke boemo bo ka ho fumanoa u le karolo ea ICD-11 "mathata a mang a boletsoeng ka lebaka la boits'oaro". Ka mantsoe a mang, tšebeliso e mpe ea litšoantšo tsa bootsoa e shebahala joalo ka tse ling tse lemalloang tsa boits'oaro, tse kenyeletsang ho becha le mathata a lipapali. Lintlha tse qotsitsoeng pampiring:
Hlokomela hore ha re khothaletse ho kenyeletsoa ha mathata a macha ho ICD-11. Empa, re ikemiselitse ho totobatsa hore mekhoa e meng e ka lemalloang e tšohloa lingoliloeng, tseo hajoale li sa kenyellelitsoeng e le mathata a ikhethileng ho ICD-11, empa a ka lumellanang le "mathata a mang a boletsoeng ka lebaka la boits'oaro" mme ka lebaka leo e ka ngoloa ka lebitso la 6C5Y ts'ebetsong ea bongaka. (khatiso e fanoe)…
Motheong oa bopaki bo hlahlojoang mabapi le mekhoa e meraro ea meta e hlahisitsoeng, re fana ka maikutlo a hore ts'ebeliso ea ts'ebeliso ea litšoantšo tse litšila tse tsosang takatso ke boemo bo ka fumanoang ka sehlopha sa ICD-11 "mathata a mang a boletsoeng ka lebaka la boits'oaro bo bobebe" bo thehiloeng moleng o meraro Mekhoa ea bothata ba lipapali, e fetotsoeng mabapi le ho sheba litšoantšo tsa bootsoa (Moetso, Blycker, et al., 2019) ....
Ho fumanoa ha bothata ba tšebeliso ea litšoantšo tsa bootsoa joalo ka bokuli bo bong bo boletsoeng ka lebaka la boits'oaro bo ka ba bo lekaneng ho batho ba nang le bothata ba ho shebella litšoantšo tse manyala tse hlephisang boitšoaro (maemong a mangata a tsamaeang le ho ipholla litho tsa botona kapa botšehali).
Mona re fana ka karolo e mabapi le ts'ebeliso e mpe ea litšoantšo tsa bootsoa:
Bothata ba tšebeliso ea litšoantšo tsa bootsoa
Tlokotsi e kopanetsoeng ea boitšoaro ba thobalano, joalo ka ha e kentsoe sehlopheng sa ICD-11 ea mathata a laoloang ke tšusumetso, e ka kenyelletsa boitšoaro bo bongata bo amanang le thobalano ho kenyelletsa ho shebella litšoantšo tse litšila tse tsosang takatso tse nang le ketsahalo e loketseng (Moetso, Blycker, & Potenza, 2019; Kraus et al., 2018). Phatlalatso ea karohano ea khatello ea boitšoaro bo tiileng ba thobalano e tšoeroe (Derbyshire & Grant, 2015), ha bangoli ba bang ba fana ka maikutlo a hore sebopeho sa tšebeliso ea litheko se nepahetse (Gola le Potenza, 2018), e ka bang boemo bo khethehileng ho batho ba nang le mathata a amanang le tšebeliso ea litšoantšo tse litšila tse tsosang takatso eseng tse tsoang liketsong tse ling tsa thobalano kapa tse susumetsang.Gola, Lewczuk, & Skorko, 2016; Kraus, Martino, & Potenza, 2016).
Tataiso ea tlhahlobo ea boloetse ba lipapali e arolelana likarolo tse 'maloa le ba nang le khatello ea boitšoaro bo khothalletsoang ba thobalano mme e ka amoheloa ka ho fetola "papali" ho "ts'ebeliso ea litšoantšo tsa bootsoa." Likarolo tsena tse tharo tsa mantlha li nkuoe e le karolo ea ts'ebeliso e mpe ea ts'ebeliso ea litšoantšo tsa bootsoa.Moetso, Blycker, et al., 2019) mme e hlahelle e lekana ka nepo mehopolo ea mantlha (Feie. 1). Boithuto bo 'maloa bo bontšitse bohlokoa ba tleliniki (litekanyetso 1) tsa ts'ebeliso e mpe ea litšoantšo tsa bootsoa, tse lebisang ho senyeha hoa ts'ebetso bophelong ba letsatsi le letsatsi ho kenyelletsa ho senya mosebetsi le likamano tsa motho, le ho lokafatsa kalafo (Gola le Potenza, 2016; Kraus, Meshberg-Cohen, Martino, Quinones, & Potenza, 2015; Kraus, Voon, & Potenza, 2016). Liphuputsong tse 'maloa le lingoloa tsa tlhahlobo, mehlala e tsoang lipatlisisong tsa bokhoba ba litekanyetso (2) e sebelisitsoe ho fumana litlatsetso le ho hlalosa sephetho (Moetso, Antons, Wegmann, & Potenza, 2019; Khoebo, Wegmann, et al., 2019; Brand, Young, et al., 2016; Stark et al., 2017; Wéry, Deleuze, Kanale, & Billieux, 2018). Tlhahiso-leseling e tsoang tlalehong ea boits'oaro, boits'oaro, electrophysiological, le neuroimaging e bonts'a ho kenya letsoho ha lits'ebetso tsa kelello le lithuto tsa motheo tsa neural tse fumanoeng lipatlisiso le ho theoleloa maemong a fapaneng a likhathatso tsa tšebeliso ea lithethefatsi le mathata a papali ea chelete (temana ea 3). Lits'oants'o tsa lihlahisoa tse hlokometsoeng lithutong tsa pejana li kenyelletsa ho etsa mosebetsi o mongata le ho lakatsa ho tsamaea le ts'ebetso e eketsehileng libakeng tsa boko tse amanang le moputso, khethollo ea kelello, ho etsa liqeto tse kotsi, le (taolo e tobileng) taolo ea thibelo (mohlala, Antons & Brand, 2018; Antons, Mueller, et al., 2019; Antons, Trotzke, Wegmann, & Brand, 2019; Bothe et al., 2019; Moetso, Snagowski, Laier, & Maderwald, 2016; Gola et al., 2017; Klucken, Wehrum-Osinsky, Schweckendiek, Kruse, & Stark, 2016; Kowalewska le al., 2018; Mechelmans et al., 2014; Stark, Klucken, Potenza, Brand, & Strahler, 2018; Voon et al., 2014).
Motheong oa bopaki bo hlahlojoang mabapi le mekhoa e meraro ea meta e hlahisitsoeng, re fana ka maikutlo a hore ts'ebeliso ea ts'ebeliso ea litšoantšo tse litšila tse tsosang takatso ke boemo bo ka fumanoang ka sehlopha sa ICD-11 "mathata a mang a boletsoeng ka lebaka la boits'oaro bo bobebe" bo thehiloeng moleng o meraro Mekhoa ea bothata ba lipapali, e fetotsoeng mabapi le ho sheba litšoantšo tsa bootsoa (Moetso, Blycker, et al., 2019). E le 'ngoe conditio sine qua e seng bakeng sa ho nahana ka ts'ebeliso e mpe ea tšebeliso ea litšoantšo tse litšila tse tsosang takatso ka har'a sehlopha sena e ka ba hore motho eo o hlokofatsoa ka ho khetheha taolong ea tšebeliso ea litšoantšo tsa bootsoa (matsatsing ana litšoantšo tsa bootsoa tsa inthaneteng maemong a mangata), tse sa tsamaelaneng le boits'oaro bo hatelletseng ba thobalano (Kraus et al., 2018). Ho feta moo, boitšoaro bo lokela ho nkuoa e le ts'ebetso ea ho lemalla ha feela e amana le ho senyeha hoa ts'ebetso le ho ba le litlamorao tse mpe bophelong ba letsatsi le letsatsi, joalo ka ha ho le joalo bakeng sa bokuli ba lipapali (Billieux et al., 2017; Mokhatlo oa Lefatše oa Bophelo, 2019). Leha ho le joalo, re boetse rea hlokomela hore bothata ba tšebeliso ea litšoantšo tse litšila tse tsosang takatso hajoale bo ka tšoaetsoa lefu la hona joale la ICD-11 la ts'oaetso ea thobalano e qobelloang, ka lebaka la ho shebella litšoantšo tse litšila tse tsosang takatso (hangata ho ipholla litho tsa botona kapa tsa botšehali empa ho ka etsahala hore ho be le thobalano e kopaneng). Finyella litekanyetso tsa tlhekefetso ea boitšoaro bo bobe ba thobalanoKraus le Sweeney, 2019). Tlhahlobo ea bofebe e qobelloang ea boitšoaro ba thobalano e kanna ea lekana batho ba sa sebeliseng litšoantšo tse litšila tse tsosang takatso feela, empa ba nang le bothata bo bong bo amanang le boitšoaro bo bobe ba thobalano bo amanang le thobalano. Tlhahlobo ea bokhopo ba tšebeliso ea litšoantšo tsa bootsoa joalo ka bokuli bo bong bo hlalositsoeng ka lebaka la boits'oaro bo bobebe e ka ba e lekaneng bakeng sa batho ba nang le bothata ba ho shebella litšoantšo tsa bootsoa feela (maemong a mangata a tsamaeang le thobalano). Hore na phapang pakeng tsa tšebeliso ea litšoantšo tsa bootsoa inthaneteng le ntle le inthanete e ka ba molemo hajoale ho ntse ho ngangisanoa, ho joalo le ka papali ea marang-rang / ntle le inthanete (Király & Demetrovics, 2017).
J Behav Lekhoba. 2020 Pherekhong 30.
inahaneloang
Background
Ho becha le mathata a ho bapala a kenyelelitsoe e le "mathata a bakoang ke boitšoaro bo lemalloang" ho Kemiso ea Machaba ea Maloetse (ICD-11). Boitšoaro bo bong bo nang le mathata bo ka nkuoa e le "mathata a mang a boletsoeng ka lebaka la boitšoaro bo lemalloang (6C5Y)."
mekhoa
Tlhahlobo e phetoang, maikutlo a litsebi.
Results
Re fana ka maikutlo a litekanyetso tse latelang tsa boemo ba meta bakeng sa ho nahana ka boits'oaro bo ka bang teng e le ho phethahatsa sehlopha sa "mathata a mang a boletsoeng ka lebaka la boits'oaro":
1. Tlameho ea bongaka: Bopaki bo matla bo tsoang lithutong tse ngata tsa mahlale bo bonts'a hore boits'oaro bo ka bang teng bo ka lemalloang ke ba bongaka mme batho ka bomong ba ba le litlamorao tse mpe le ho holofala ts'ebetsong bophelong ba letsatsi le letsatsi ka lebaka la boitšoaro bo nang le mathata le bo ka bang lemallo.
2. Khokahano ea khopolo: Likhopolo-taba tsa morao-rao le mefuta ea likhopolo-taba ea lefapha la lipatlisiso ka boitšoaro bo lemalloang li hlalosa le ho hlalosa ka nepo ka ho fetisisa moelelo oa motho ea ka bang le boits'oaro.
3. Bopaki bo matlafatsang: Lintlha tse ipapisitseng le litlaleho tsa hau, lipuisano tsa bongaka, lipatlisiso, liteko tsa boits'oaro, 'me, haeba li le teng, lipatlisiso tsa baeloji (neural, physiological, genetic) li fana ka maikutlo a hore mekhoa ea kelello le neurobiological e amehang mekhoeng e meng e lemalloang ea sebetsa. bakeng sa ketsahalo ea mokhethoa. Mefuta e fapaneng ea tšehetso bakeng sa mefuta e nang le mathata ea litšoantšo tse manyala tse hlephisang boitšoaro e sebelisa, ho reka le ho ea mabenkeleng, le ts'ebeliso ea marang-rang. Maemo ana a kanna a lekana sehlopha sa "mathata a mang a boletsoeng ka lebaka la boits'oaro".
fihlela qeto e
Ho bohlokoa hore re se ke ra fetelletsa boitšoaro ba bophelo ba letsatsi le leng le le leng ha ka nako e 'ngoe re sa nyenyefatse maemo a bohlokoa kliniking le a tšoaneloang ke tlhokomelo ea bophelo ba sechaba. Litekanyetso tsa boemo ba meta tse reriloeng li ka thusa ho tataisa boiteko ba lipatlisiso le boits'oaro ba bongaka.
- PMID: 32634114
- DOI: 10.1556/2006.2020.00035
Selelekela
Mathata a ho becha le a lipapali a khethiloe e le "mathata a bakoang ke boitšoaro bo lemalloang" khatisong ea leshome le motso o mong ea Kemiso ea Machaba ea Maloetse (ICD-11) (Mokhatlo oa Lefatše oa Bophelo, 2019). Le ha ho bile le ngangisano e kholo mabapi le hore na ho nepahetse ho kenyelletsa boloetse ba papali ho ICD-11 (Dullur & Starcevic, 2018; van Rooij et al., 2018), lingaka le bafuputsi ba bangata ba lemalloang kelello le neuroscience ba ts'ehetsa ho kenyeletsoa (Khoebo, Rumpf, et al., 2019; Fineberg et al., 2018; King et al., 2018; Rumpf et al., 2018; Stein et al., 2018). Kaha ho na le mathata a bakoang ke ts'ebeliso ea lithethefatsi le boits'oaro bo lemalloang a kentsoe ho ICD-11, lebitso le bitsoa "mathata a mang a boletsoeng ka lebaka la boits'oaro" (a ngolisitsoeng ka 6C5Y) a tiisa lipuisano tse ling tse thehiloeng bopaking. Tlhaloso ena e bonts'a maikutlo a hore mekhoa e meng e sa laoloang hantle le e nang le mathata e ka nkoang e le mathata ka lebaka la boitšoaro bo hlephileng (ntle le papali ea chelete le papali) e tšoaneloa ke tlhokomelo (Potenza, Higuchi, & Brand, 2018). Leha ho le joalo, ha ho na tlhaloso ea boits'oaro bo itseng kapa litekanyetso. Re pheha khang ea hore ho bohlokoa ho ba le boits'oaro bo lekaneng ha re nahana ka ho kenyeletsoa ha mathata a ka bang teng sehlopheng sena ho qoba ho fetelletsa boitšoaro ba bophelo ba letsatsi le letsatsi (Billieux, Schimmenti, Khazaal, Maurage, & Heeren, 2015; Starcevic, Billieux, & Schimmenti, 2018). Mona re etsa tlhahiso ea litekanyetso tsa boemo ba meta bakeng sa ho nahana ka boits'oaro bo nang le mathata joalo ka mathata a mang a boletsoeng ka lebaka la boits'oaro le ho tšohla bonnete ba litekanyetso mabapi le maemo a mararo a ka bang teng: ts'ebeliso ea ts'ebeliso ea litšoantšo tsa bootsoa, bothata ba ho reka le ho sebelisa marang-rang ho hloka taolo.
Litekanyetso tsa boemo ba meta ba ho nahana ka boits'oaro bo lemalloang joalo ka mathata a mang a boletsoeng ka lebaka la boits'oaro
Joalo ka mekhoa e meng e ka lemalloang e ka nkuoang bakeng sa lebitso la 6C5Y, lipapali tse sa sebetseng hangata li tsamaisoa inthaneteng. Litataiso tse tharo tsa tlhahlobo ea lefu la lipapali ho ICD-11 li kenyelletsa taolo e sa sebetseng lipapaling, ho eketsa bohlokoa ba (le ho ameha haholo ka) papali, le tsoelo-pele kapa kholo ea papali le ha e na le litlamorao tse mpe (Mokhatlo oa Lefatše oa Bophelo, 2019). Ntle le moo, mokhoa oa boits'oaro o tlameha ho lebisa ho senyeheng ho hoholo bathong, lelapeng, sechabeng, thutong, mosebetsing, kapa libakeng tse ling tsa bohlokoa tsa bophelo. Litaelo tsena tsa tlhatlhobo le tsona li lokela ho sebelisoa ho boits'oaro bo ka bang teng kamora bothata ba papali (le bothata ba papali ea chelete, bo arolelanang litataiso tsa tlhahlobo le boloetse ba papali). Ntle le litataiso tsena tsa tlhatlhobo, re fana ka maikutlo a litekanyetso tse tharo tsa boemo ba meta ho latela pono ea mahlale bakeng sa ho nahana ka boits'oaro bo ka bang teng e le ho phethahatsa sehlopha sa ICD-11 "mathata a mang a boletsoeng ka lebaka la boits'oaro". Re etsa tlhahiso ea litekanyetso tsena tsa meta molemong oa ho thusa ho tataisa boiteko ba lipatlisiso le boits'oaro ba bongaka.
Bopaki ba mahlale ba bohlokoa ba bongaka
Morero oa 1: Bopaki bo matla bo tsoang lithutong tse ngata tsa mahlale, ho kenyelletsa le tse amang batho ba batlang kalafo, bo bonts'a hore boits'oaro bo ka bang teng bo ka lemalloang litleleniking mme batho ka bomong ba ba le litlamorao tse mpe le ho senyeha ho sebetsang bophelong ba letsatsi le letsatsi ka lebaka la boits'oaro bo ka bang teng.
Mabaka: Bofokoli bo sebetsang ke sesupo sa mantlha mathateng a mangata a kelello, ho kenyeletsoa le mathata a papali le a papali ea chelete (Billieux et al., 2017; Mokhatlo oa Lefatše oa Bophelo, 2019). Ka hona, lithuto tsa mahlale li lokela ho bonts'a hore boits'oaro bo ka bang teng ba ho lemalla li amana le ho holofala ho sebetsang ho lumellang kalafo (Stein et al., 2010). Ketsahalo ena e lokela ho ba e tobileng, ho bolelang hore mathata a hlahang bophelong ba letsatsi le leng le le leng e tlameha ho ba litlamorao tse bakoang ke boits'oaro bo itseng bo ka lemalloang eseng ka lebaka la boits'oaro bo fapaneng bo fapaneng kapa bo hlalositsoeng ke mathata a mang a kelello (mohlala, ka lebaka la ketsahalo ea manic ).
Ho kenella ka mohopolo
Mothati oa 2: Likhopolo-taba tsa morao-rao le mehlala ea thuto e mabapi le boits'oaro bo hlalosang li hlalosa le ho hlalosa ka nepo ka ho fetisisa moelelo oa motho ea ka bang le boits'oaro.
Mabaka: Haeba ts'ebetso ea boits'oaro e nkuoa e le bokuli ka lebaka la boits'oaro, likhopolo tsa (methapo ea kutlo) tse hlalosang boits'oaro bo lokelang ho ba teng li lokela ho sebetsa bakeng sa ketsahalo ea mokhethoa. Ho seng joalo, ho ne ho ke ke ha utloahala ho re ketsahalo eo ke bokhoba, empa mohlomong ke bothata ba ho laola maikutlo kapa bokuli bo qobelloang. Likhopolo tsa morao-rao tse nkoang li sebetsa ka kotloloho ka hara mathata a ts'ebeliso ea lithethefatsi le lipatlisiso tsa lithethefatsi li kenyelletsa khopolo ea khothatso ea ts'usumetso (Robinson le Berridge, 2008), ho sitisoa ke karabelo ea karabelo le boits'oaro ba salience (iRISA)Goldstein le Volkow, 2011), lefu la khaello ea moputso (Blum et al., 1996), mekhoa e habeli ea ho lemalla bokhoba (Bechara, 2005; Everitt le Robbins, 2016ho kenyeletswa le tse tsepamisitseng maikutlo hodima tsebo e totobetseng (Stacy le Wiers, 2010; Wiers & Stacy, 2006), le mefuta e ikhethileng ea litlolo tsa boitšoaro. Sehlopha sena sa ho qetela se kenyelletsa mefuta e joalo ka mohlala oa pele oa mathata a ts'ebeliso ea inthanete ea Davis (Davis, 2001), mofuta oa boits'oaro ba boits'oaro ba papali ea lipapali (Dong & Potenza, 2014), mofuta oa likarolo tse tharo oa bothata ba lipapali (Wei, Zhang, Turel, Bechara, & He, 2017), Le tšebelisano-'moho ea mofuta oa motho o amang tšebetso-ts'ebetso (I-PACE) ea mathata a itseng a ts'ebeliso ea Marang-rang (Brand, Young, Laier, Wölfling, & Potenza, 2016) le boitšoaro bo lemalloang ka kakaretso (Khoebo, Wegmann, et al., 2019). Lingoliloeng tsa mahlale tse buang ka ketsahalo ea mokhethoa, likhopolo tsa boits'oaro bo lokelang ho sebelisoa li lokela ho sebetsa mme lithuto li lokela ho bonts'a hore lits'ebetso tsa mantlha tse tlatselletsang boits'oarong le tsona li kentse letsoho ketsahalong ea likhetho (bona moelelo o latelang). Boemo bona bo bohlokoa molemong oa ho latela mokhoa o tsamaisoang ke likhopolo le maikutlo a ho lekola ho fapana le ho bua feela ka likamano tse itseng tse ka bang teng tsa boits'oaro.
Bopaki bo matla ba mekhoa ea motheo
Mothati oa 3: Lintlha tse ipapisitseng le litlaleho tsa hau, lipuisano tsa bongaka, lipatlisiso, liteko tsa boits'oaro, 'me, haeba li teng, lipatlisiso tsa baeloji (neural, physiological, genetic) li fana ka maikutlo a hore mekhoa ea kelello (le neurobiological) e amehang mekhoeng e meng e lemalloang ea boitšoaro (cf., Potenza, 2017) li sebetsa hape bakeng sa ketsahalo ea mokhethoa.
Mabaka: Re pheha khang ea hore ho bohlokoa ho ba le tlhaiso-leseling ho tsoa lipatlisisong tse ngata tse sebelisitseng mekhoa e fapaneng ho lekola lits'ebetso tse ikhethileng tsa mokhethoa pele motho a ka nka tlhophiso ea boemo ba boits'oaro e le pherekano ka lebaka la boits'oaro bo lemalloang. Lithuto li lokela ho netefatsa hore mehopolo ea thuto ea boits'oaro bo lemalloang e bonahala e nepahetse bakeng sa ketsahalo ea mokhethoa. Sena se boetse se bolela hore ha hoa lekana ha feela lithuto tse fokolang haholo, ka mohlala ho sebelisa sesebelisoa se secha sa tlhahlobo, li rarollotse boitšoaro bo bocha bo ka bang teng ho sebelisa poleloana "ho hloka taolo ka lebaka la boitšoaro bo lemalloang." Ntle le moo, lithuto li tlameha ho kenyelletsa mekhoa e lekaneng le e thata mabapi le mehlala le lisebelisoa tsa tlhahlobo (Rumpf et al., 2019). Ke ha feela data e tšepahalang le e nepahetseng e tsoang liphuputsong tse ngata (le ho tsoa lihlopheng tse fapaneng tse sebetsang) - joalo ka ha ho nkuoe e le tekanyetso ea ts'epahalo ea lisebelisoa tsa ho lekola lebaleng (King et al., 2020) - li teng tse bonts'ang likhopolo-taba tse susumetsoang ke likhopolo ka likarolo tse itseng tsa boits'oaro bo netefalitsoeng, moelelo o fapaneng oa hore ke boitšoaro bo lemalloang o kanna oa nepahala. Sena se bohlokoa hape mabapi le ho qoba ho itšoara hampe ka ho fetelletseng ka boitšoaro ba bophelo ba letsatsi le letsatsi e le bokhoba (Billieux, Schimmenti, et al., 2015) joalo ka ha ho boletsoe kaholimo karolong ea litšitiso tsa ts'ebetso Kakaretso ea litekanyetso tse tharo tsa boemo ba meta tse hlahisitsoeng, ho kenyeletsoa mokhatlo o hlophisitsoeng le lipotso tse lokelang ho arajoa ha ho nahanoa ka tlhophiso ea ketsahalo ea mokhethoa e le "bothata bo bong bo boletsoeng ka lebaka la boits'oaro" Feie. 1.
Kakaretso ea litekanyetso tsa boemo ba meta tse reriloeng bakeng sa ho nahana ka tlhophiso ea ketsahalo ea mokhethoa e le "bothata bo bong bo boletsoeng ka lebaka la boits'oaro".
Tlhaloso: Tlaleho ea Bokhoba ba Boitšoaro J Behav Addict 2020; 10.1556/2006.2020.00035
Tlhatlhobo ea bopaki ba mahlale bo tšehetsang ho nepahala ha mefuta e itseng ea tahi ea boits'oaro kahare ho sehlopha sa ICD-11 sa "mathata a mang a boletsoeng ka lebaka la boits'oaro"
Mefuta e fapaneng ea tšehetso bakeng sa mefuta e nang le mathata ea litšoantšo tse manyala tse hlephisang boitšoaro e sebelisa, ho reka le ho ea mabenkeleng, le ts'ebeliso ea marang-rang. Bopaki bo tla akaretsoa likarolong tse latelang. Hlokomela hore ha re khothaletse ho kenyeletsoa ha mathata a macha ho ICD-11. Ho fapana le moo, re ikemiselitse ho totobatsa hore mekhoa e meng e ka lemalloang e tšohloa lingoliloeng, tseo hajoale li sa kenyellelitsoeng e le mathata a ikhethileng ho ICD-11, empa a ka lumellanang le "mathata a mang a boletsoeng ka lebaka la boits'oaro" mme ka lebaka leo e ka ngoloa ka lebitso la 6C5Y ts'ebetsong ea bongaka. Ka ho hlalosa ka nepo moelelo oa ho nahana ka mekhoa ena e meraro e ka lemalloang, re boetse re ikemiselitse ho bontša hore bakeng sa liketsahalo tse ling, ho kanna ha se be le bopaki bo lekaneng ba ho li bitsa boitšoaro bo "lemalloang".
Bothata ba tšebeliso ea litšoantšo tsa bootsoa
Tlokotsi e kopanetsoeng ea boitšoaro ba thobalano, joalo ka ha e kentsoe sehlopheng sa ICD-11 ea mathata a laoloang ke tšusumetso, e ka kenyelletsa boitšoaro bo bongata bo amanang le thobalano ho kenyelletsa ho shebella litšoantšo tse litšila tse tsosang takatso tse nang le ketsahalo e loketseng (Moetso, Blycker, & Potenza, 2019; Kraus et al., 2018). Phatlalatso ea karohano ea khatello ea boitšoaro bo tiileng ba thobalano e tšoeroe (Derbyshire & Grant, 2015), ha bangoli ba bang ba fana ka maikutlo a hore sebopeho sa tšebeliso ea litheko se nepahetse (Gola le Potenza, 2018), e ka bang boemo bo khethehileng ho batho ba nang le mathata a amanang le tšebeliso ea litšoantšo tse litšila tse tsosang takatso eseng tse tsoang liketsong tse ling tsa thobalano kapa tse susumetsang.Gola, Lewczuk, & Skorko, 2016; Kraus, Martino, & Potenza, 2016).
Tataiso ea tlhahlobo ea boloetse ba lipapali e arolelana likarolo tse 'maloa le ba nang le khatello ea boitšoaro bo khothalletsoang ba thobalano mme e ka amoheloa ka ho fetola "papali" ho "ts'ebeliso ea litšoantšo tsa bootsoa." Likarolo tsena tse tharo tsa mantlha li nkuoe e le karolo ea ts'ebeliso e mpe ea ts'ebeliso ea litšoantšo tsa bootsoa.Moetso, Blycker, et al., 2019) mme e hlahelle e lekana ka nepo mehopolo ea mantlha (Feie. 1). Boithuto bo 'maloa bo bontšitse bohlokoa ba tleliniki (litekanyetso 1) tsa ts'ebeliso e mpe ea litšoantšo tsa bootsoa, tse lebisang ho senyeha hoa ts'ebetso bophelong ba letsatsi le letsatsi ho kenyelletsa ho senya mosebetsi le likamano tsa motho, le ho lokafatsa kalafo (Gola le Potenza, 2016; Kraus, Meshberg-Cohen, Martino, Quinones, & Potenza, 2015; Kraus, Voon, & Potenza, 2016). Liphuputsong tse 'maloa le lingoloa tsa tlhahlobo, mehlala e tsoang lipatlisisong tsa bokhoba ba litekanyetso (2) e sebelisitsoe ho fumana litlatsetso le ho hlalosa sephetho (Moetso, Antons, Wegmann, & Potenza, 2019; Khoebo, Wegmann, et al., 2019; Brand, Young, et al., 2016; Stark et al., 2017; Wéry, Deleuze, Kanale, & Billieux, 2018). Tlhahiso-leseling e tsoang tlalehong ea boits'oaro, boits'oaro, electrophysiological, le neuroimaging e bonts'a ho kenya letsoho ha lits'ebetso tsa kelello le lithuto tsa motheo tsa neural tse fumanoeng lipatlisiso le ho theoleloa maemong a fapaneng a likhathatso tsa tšebeliso ea lithethefatsi le mathata a papali ea chelete (temana ea 3). Lits'oants'o tsa lihlahisoa tse hlokometsoeng lithutong tsa pejana li kenyelletsa ho etsa mosebetsi o mongata le ho lakatsa ho tsamaea le ts'ebetso e eketsehileng libakeng tsa boko tse amanang le moputso, khethollo ea kelello, ho etsa liqeto tse kotsi, le (taolo e tobileng) taolo ea thibelo (mohlala, Antons & Brand, 2018; Antons, Mueller, et al., 2019; Antons, Trotzke, Wegmann, & Brand, 2019; Bothe et al., 2019; Moetso, Snagowski, Laier, & Maderwald, 2016; Gola et al., 2017; Klucken, Wehrum-Osinsky, Schweckendiek, Kruse, & Stark, 2016; Kowalewska le al., 2018; Mechelmans et al., 2014; Stark, Klucken, Potenza, Brand, & Strahler, 2018; Voon et al., 2014).
Motheong oa bopaki bo hlahlojoang mabapi le mekhoa e meraro ea meta e hlahisitsoeng, re fana ka maikutlo a hore ts'ebeliso ea ts'ebeliso ea litšoantšo tse litšila tse tsosang takatso ke boemo bo ka fumanoang ka sehlopha sa ICD-11 "mathata a mang a boletsoeng ka lebaka la boits'oaro bo bobebe" bo thehiloeng moleng o meraro Mekhoa ea bothata ba lipapali, e fetotsoeng mabapi le ho sheba litšoantšo tsa bootsoa (Moetso, Blycker, et al., 2019). E le 'ngoe conditio sine qua e seng bakeng sa ho nahana ka ts'ebeliso e mpe ea tšebeliso ea litšoantšo tse litšila tse tsosang takatso ka har'a sehlopha sena e ka ba hore motho eo o hlokofatsoa ka ho khetheha taolong ea tšebeliso ea litšoantšo tsa bootsoa (matsatsing ana litšoantšo tsa bootsoa tsa inthaneteng maemong a mangata), tse sa tsamaelaneng le boits'oaro bo hatelletseng ba thobalano (Kraus et al., 2018). Ho feta moo, boitšoaro bo lokela ho nkuoa e le ts'ebetso ea ho lemalla ha feela e amana le ho senyeha hoa ts'ebetso le ho ba le litlamorao tse mpe bophelong ba letsatsi le letsatsi, joalo ka ha ho le joalo bakeng sa bokuli ba lipapali (Billieux et al., 2017; Mokhatlo oa Lefatše oa Bophelo, 2019). Leha ho le joalo, re boetse rea hlokomela hore bothata ba tšebeliso ea litšoantšo tse litšila tse tsosang takatso hajoale bo ka tšoaetsoa lefu la hona joale la ICD-11 la ts'oaetso ea thobalano e qobelloang, ka lebaka la ho shebella litšoantšo tse litšila tse tsosang takatso (hangata ho ipholla litho tsa botona kapa tsa botšehali empa ho ka etsahala hore ho be le thobalano e kopaneng). Finyella litekanyetso tsa tlhekefetso ea boitšoaro bo bobe ba thobalanoKraus le Sweeney, 2019). Tlhahlobo ea bofebe e qobelloang ea boitšoaro ba thobalano e kanna ea lekana batho ba sa sebeliseng litšoantšo tse litšila tse tsosang takatso feela, empa ba nang le bothata bo bong bo amanang le boitšoaro bo bobe ba thobalano bo amanang le thobalano. Tlhahlobo ea bokhopo ba tšebeliso ea litšoantšo tsa bootsoa joalo ka bokuli bo bong bo hlalositsoeng ka lebaka la boits'oaro bo bobebe e ka ba e lekaneng bakeng sa batho ba nang le bothata ba ho shebella litšoantšo tsa bootsoa feela (maemong a mangata a tsamaeang le thobalano). Hore na phapang pakeng tsa tšebeliso ea litšoantšo tsa bootsoa inthaneteng le ntle le inthanete e ka ba molemo hajoale ho ntse ho ngangisanoa, ho joalo le ka papali ea marang-rang / ntle le inthanete (Király & Demetrovics, 2017).
Bothata ba ho reka
Bothata ba ho reka le ho reka bo 'nile ba hlalosoa ka ho ameha haholo ka ho reka, ho fokotsa taolo ea ho reka ka mokhoa o feteletseng, oo hangata o sa hlokeng le ho sa sebelisoe, le boits'oaro bo sa khaotseng ba ho reka. Lintlha tsa mantlha (joalo ka ha ho hlahisitsoe ho Feie. 1) ho ka nkuoa ho phethahetse ha ho fanoa ka taolo e fokotsehileng ea ho reka-ho reka, ho eketsa bohlokoa ba ho reka le ho tswela pele kapa ho nyoloha ha ho reka-mabenkele ho hlalositsoe e le likarolo tsa mantlha tsa bothata ba ho reka-ho reka (Guerrero-Vaca et al., 2019; Weinstein, Maraz, Griffiths, Lejoyeux, & Demetrovics, 2016). Mokhoa oa boits'oaro o lebisa mathateng le ho holofala ho hoholo libakeng tsa bohlokoa tsa ts'ebetso (moelelo oa 1) ho kenyelletsa phokotso e matla ea boleng ba bophelo le likamano tsa batho le pokello ea mokoloto (cf., Müller, Brand, et al., 2019). Lihloohong tsa morao-rao tse mabapi le bothata ba ho reka, ho sebelisoa likhopolo le mohopolo oa lipatlisiso tsa bokhoba ba taeo (tekanyetso ea 2), ho kenyeletsoa, mohlala, mekhoa ea tšebetso e habeli e kenyelletsang ho ts'oaroa le ho lakatsa le ho fokotsa taolo ea holimo-tlase le ho etsa liqeto tse mpe. (Khoebo, Wegmann, et al., 2019; Kyrios et al., 2018; Trotzke, Brand, & Starcke, 2017). Bopaki ba bonnete ba mehopolo ea lipatlisiso tsa bokhoba ba tahi (tekanyetso 3) ho bothata ba ho reka-mabenkeleng bo tsoa lithutong tse kholo (Maraz, Urban, & Demetrovics, 2016; Maraz, van den Brink, & Demetrovics, 2015), lithuto tsa liteko (Jiang, Zhao, & Li, 2017; Nicolai, Darancó, & Moshagen, 2016), lithuto tse lekolang batho ba batlang kalafo ba nang le boits'oaro le boits'oaro (Derbyshire, Chamberlain, Odlaug, Schreiber, le Grant, 2014; Granero et al., 2016; Müller et al., 2012; Trotzke, Starcke, Pedersen, Müller, le Brand, 2015; Voth et al., 2014), likarabo tsa boits'oaro ba letlalo ho mekhoa ea ho reka (Trotzke, Starcke, Pedersen, & Brand, 2014), le thuto e le 'ngoe ea neuroimaging (Raab, Elger, Neuner, & Weber, 2011). Ho ipapisitsoe le bopaki bo hlahlojoang mabapi le litekanyetso tse tharo tsa meta tse hlahisitsoeng, re fana ka maikutlo a hore bothata ba ho reka le ho reka bo ka nkuoa e le "bothata bo bong bo boletsoeng ka lebaka la boits'oaro" (Müller, Brand, et al., 2019), ho fihlela e ka nkuoa e le setho sa eona ntlafatsong e tlang ea ICD. Kaha ho boetse ho na le bopaki ba phapang ea ts'ebetso pakeng tsa boits'oaro ba ho reka le ho reka ka marang-rang (Müller, Steins-Loeber, et al., 2019; Trotzke, Starcke, Müller, le Brand, 2015), Ha bothata ba ho reka le ho reka bo fumanoa e le bo lemalloang, ho ka ba molemo ho khetholla pakeng tsa bothata ba ho reka-ho reka, haholo-holo kantle ho naha kapa inthaneteng, ho lumellana le ho becha le mathata a lipapali ho ICD-11, leha mokhoa ona o ngangisana, joalo ka ha ho boletsoe kaholimo (Király & Demetrovics, 2017).
Bothata ba ts'ebeliso ea marang-rang
Ho nahanoa ha ts'ebeliso e nang le mathata a marang-rang le lits'ebetso tse ling tsa puisano e le boemo bo ka lumellanang le maemo a "mathata a mang a boletsoeng ka lebaka la boitšoaro bo hlephileng" hoa nepahala ebile ho nakong. Ho fokotsa taolo ea ts'ebeliso ea marang-rang, ho eketsa bohlokoa ba ts'ebeliso ea marang-rang, le tsoelo-pele ea ts'ebeliso ea marang-rang leha ho na le litlamorao tse mpe (mehopolo ea mantlha ho Feie. 1) li nkuoe e le likarolo tsa mantlha tsa ts'ebeliso e thata ea marang-rang (Andreassen, 2015), leha bopaki bo matla bo mabapi le likarolo tse itseng tsa ts'ebeliso ea marang-rang e nang le mathata bo tsoakane ebile bo ntse bo fokola ha bo bapisoa le, mohlala, bothata ba lipapali (Wegmann le Brand, 2020). Kholofalo e sebetsang bophelong ba letsatsi le letsatsi ka lebaka la boits'oaro (moelelo oa 1) e ntse e ngotsoe ka mokhoa o tlase ho feta litlamong tse ling tsa boitšoaro. Liphuputso tse ling li tlaleha litlamorao tse mpe libakeng tse fapaneng tsa bophelo tse bakoang ke tšebeliso e mpe ea taolo e mpe ea lits'ebeliso tsa puisano, joalo ka libaka tsa marang-rang tsa sechaba, ke batho ba bang (Guedes, Nardi, Guimarães, Machado, & King, 2016; Kuss le Griffiths, 2011). Ho latela litlhahlobo tsa meta, litlhahlobo tse hlophisehileng, le lithuto tse emelang naha ka bophara, ts'ebeliso e fetelletseng ea liwebosaete tsa marang-rang li ka amahanngoa le mathata a bophelo bo botle ba kelello, khatello ea maikutlo le phokotso ea bophelo (Bányai et al., 2017; Frost le Rickwood, 2017; Marino, Gini, Vieno, & Spada, 2018). Le ha litlamorao tse mpe tsa ts'ebeliso e mpe ea marang-rang e ka ba bohlokoa 'me ea hokahanngoa le ho senyeha ha tšebetso (Karaiskos, Tzavellas, Balta, & Paparrigopoulos, 2010), lithuto tse ngata li sebelisitse mehlala e bonolo 'me li hlalositse litlamorao tse mpe ho latela lintlha tse khaotsoeng tsa lisebelisoa tsa ho hlahloba. Ho kenella ka mohopolo (tekanyetso ea 2), leha ho le joalo, ho pharalla le moralo oa bokhoba ba tahi (Billieux, Maurage, Lopez-Fernandez, Kuss, le Griffiths, 2015; Turel le Qahri-Saremi, 2016; Wegmann le Brand, 2019). Lithuto tse 'maloa tsa neuroimaging le boits'oaro (moelelo oa 3) li bonts'a ho tšoana lipakeng tsa ts'ebeliso e fetelletseng ea libaka tsa marang-rang le ts'ebeliso ea lithethefatsi, papali ea chelete le mathata a lipapali (cf., Wegmann, Mueller, Ostendorf, & Brand, 2018), Ho kenyeletsoa liphuputso tse tsoang liphuputsong tsa liteko tsa cue reactivity (Wegmann, Stodt, & Brand, 2018), taolo ea thibelo (Wegmann, Müller, Turel, & Brand, 2020), le khethollo ea tlhokomelo (Nikolaidou, Stanton, & Hinvest, 2019Le liphetho tsa pele tse tsoang sampoleng ea bongaka (Leménager et al., 2016). Ka lehlakoreng le leng, lithuto tse ling li tlalehile lintlha tsa pele tse tšehetsang tšebetso e bolokiloeng ea lobe e ka pele ho batho ba bonts'ang tšebeliso e fetelletseng ea marang-rang (Eena, Turel, & Bechara, 2017; Turel, He, Xue, Xiao, & Bechara, 2014). Leha ho na le bopaki bo fokolang bo hlakileng le tse ling tse fapakaneng (mohlala, lithuto tsa methapo ea kutlo), ho ka etsahala hore mekhoa ea mantlha e kenyelletsang ts'ebeliso ea ts'ebeliso ea marang-rang ea marang-rang e kanna ea tšoana le ba amehang bothateng ba lipapali, leha sena se hloka lipatlisiso tse tobileng. Bopaki bo mabapi le bofokoli bo sebetsang bophelong ba letsatsi le letsatsi le liphuputso tse tsoang lithutong tse ngata tsa mekhoa e kenyeletsang lisampole tsa kliniki ha ho pelaelo hore ha li kholisehe ha li bapisoa le bothata ba ts'ebeliso ea litšoantšo tsa bootsoa le bothata ba ho reka. Leha ho le joalo, sehlopha sa ICD-11 "mathata a mang a boletsoeng ka lebaka la boits'oaro bo hlephileng" hajoale se ka ba molemo bakeng sa ho fumana motho eo ts'ebeliso ea hae ea marang-rang e leng mohloli o ka sehloohong oa mahlomola a kelello le ts'oaetso ea ts'ebetsong, haeba kholofalo ea ts'ebetso ka bo mong e amana ka kotloloho le tšebeliso e mpe ea taolo ea marang-rang. Leha ho le joalo, lithuto tse ling, tse kenyeletsang mehlala ea bongaka, lia hlokahala pele tumellano ea hoqetela e ka fihlelleha mabapi le bonnete ba sehlopha sa 6C5Y bakeng sa ts'ebeliso e sa laoloang ea liwebosaete.
fihlela qeto e
Ho theha litekanyetso tseo ho lumellanoeng ka tsona bakeng sa ho hlahloba hore na ke boits'oaro bofe bo ka fumanoang e le "mathata a mang a boletsoeng ka lebaka la boits'oaro bo lemalloang" ho thusa molemong oa lipatlisiso le tsa bongaka. Ke habohlokoa hore u se ke ua fetelletsa boitšoaro ba bophelo ba letsatsi le letsatsi (Billieux, Schimmenti, et al., 2015; Kardefelt-Winther et al., 2017) ha ka nako e le 'ngoe ho ntse ho nahanoa ka maemo a ka bang teng a amanang le bofokoli (Billieux et al., 2017). Ka lebaka lena, mona re nahanne ka maemo a lumellanang le sehlopha sa ICD-11 se ngolisitsoeng ka 6C5Y mme ha a so hlahise mathata a macha. Mebuso ho potoloha le lefatše e kanna ea nka qeto ka bo eona hore na e sebelisa ICD-11 joang ka hona e ka bonts'a ho ngolisoa ha mathata ka har'a likaroloana tse ikhethileng tsa ICD-11. Bakeng sa lipatlisiso, ho bohlokoa ho fihlela tumellano ea machabeng mabapi le ho nahanisisa ka mathata a itseng. Ka hona re etsa tlhahiso ea litekanyetso tsena tsa boemo ba meta bakeng sa ho nahana ka mathata a ka lumellanang le sehlopha sa 6C5Y. Hape, re pheha khang ea hore ho bohlokoa ho ba le mokhoa o lekaneng oa ho boloka mekhoa e metle ha u sebelisa poleloana "boitšoaro bo hlephileng," e bolelang ho sebelisa lentsoe lena feela bakeng sa liketsahalo tsa boits'oaro tse nang le bopaki bo tiileng ba mahlale. Maemong ohle, ho bohlokoa ho nahana ka bofokoli bo sebetsang ka hloko bophelong ba letsatsi le letsatsi, ho khetholla boits'oaro ba boits'oaro khafetsa ho tsoa mokhoeng oa boits'oaro o fihlellang litekanyetso tsa mathata ka lebaka la boits'oaro. Sena ke sa bohlokoa ka ho khetheha molemong oa hore re se ke ra nyenyefatsa maemo a bohlokoa kliniking le a lokelang tlhokomelo ea bophelo ba sechaba. Re khothaletsa boits'oaro ba lithuto tse tsoelang pele ka maemo a nahannoeng ka mehlala ea baemeli ka mehato e utloahalang ea maemo a fapaneng le ts'ebeliso ea liteko tse utloahalang tsa bofokoli le bohlokoa ba kliniki. Ntle le moo, re fana ka tlhahiso ea lipatlisiso tse ling tse bapisang ka kotloloho lits'ebetso tsa kelello le methapo ea kutlo tse ka bang teng mefuteng e fapaneng ea boits'oaro bo hlahisitsoeng.
Likhohlano tsa lithahasello
JB, ZD, NAF, DLK, SWK, KM, MNP, le HJR e bile litho tsa WHO kapa marang-rang a mang, lihlopha tsa litsebi kapa lihlopha tsa boeletsi mabapi le boitšoaro bo hlephileng, ts'ebeliso ea Marang-rang le / kapa CSBD.AM, JB, MB, SRC, ZD, NAF, DLK, MNP, le HJR ke litho kapa bashebelli ba COST Action 16207 "European Network for Mathata Tšebeliso ea Marang-rang". AEG, NAF, le MNP ba amohetse lithuso / lichelete / tšehetso ho tsoa mekhatlong ea meriana, ea molao kapa e meng e amehang (ea khoebo), ho kenyeletsoa le boeletsi.
Menehelo ea bangoli
MB le MNP ba ngotse buka e ngotsoeng ka letsoho. Bangoli bohle bao ba sebelisaneng le bona ba kentse maikutlo ho moralo. Litaba tse ngotsoeng ka letsoho li ile tsa buisanoa le bona le ho amoheloa ke bangoli bohle ba kopanetsoeng.
lumela hore baa fokolaSengoloa sena / sengoliloeng sena se ipapisitse le mosebetsi o tsoang ho COST Action CA16207 "European Network for Mathata ea Ts'ebeliso ea Marang-rang", e ts'ehetsoeng ke COST (European Cooperation in Science and Technology), www.cost.eu/.
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