2021 Apr 2.
- I-PMID: 33822748
- I-DOI: 10.1556/2006.2021.00018
abstract
Ingemuva futhi ihlose
Ukusetshenziswa kwezithombe zobulili ezingcolile, kuyilapho kungenabungozi kwabaningi, kungakhula kube isimilo esifana nokulutheka esesimeni saso esibi kakhulu esibizwa njengokuphazamiseka kokuziphatha ngokocansi ku-ICD-11 (WHO, 2018). Inhloso yalolu cwaningo bekungukuphenya ukuphinda kusebenze ngokuqondene nokulutha okuthile ukuze kutholakale ukuqonda kangcono izindlela ezisisisekelo ekwakhiweni kwalesi sifo.
izindlela
Sisebenzise i-Sexual Incentive Delay Task elungiselelwe ukutadisha ubuchopho emiklomelweni ehambisana nezindawo zobuchopho ngesikhathi sesigaba sokulindela (ngemikhondo ebikezela amavidiyo angcolile, lawula amavidiyo noma awekho amavidiyo) kanye nesigaba sokulethwa esihambisanayo emadodeni aphilile. Ukuhlobana nezinkomba zokusetshenziswa kwezithombe zobulili ezingcolile okunenkinga, isikhathi esichithwe ekusetshenzisweni kwezithombe zobulili ezingcolile, kanye nokuziphatha kocansi kwahlaziywa.
Imiphumela
Imiphumela yamadoda we-74 ikhombisile ukuthi izindawo zobuchopho ezihlobene nomvuzo (i-amygdala, i-dorsal cingate cortex, i-orbitofrontal cortex, i-nucleus accumbens, i-thalamus, i-putamen, i-caudate nucleus, ne-insula) zenziwa zasebenza kakhulu ngamavidiyo wezithombe zobulili ezingcolile kanye nezimpawu zocansi kunoku lawula amavidiyo nezinkomba zokulawula, ngokulandelana. Kodwa-ke, asibutholanga ubudlelwano phakathi kwalezi zinto ezenziwayo nezinkomba zokusebenzisa izithombe zobulili ezingcolile eziyinkinga, isikhathi esichithwe ekusetshenzisweni kwezithombe zocansi, noma ngezisusa zobulili.
Ingxoxo neziphetho
Umsebenzi owenziwa ezindaweni zobuchopho ezihlobene nomvuzo kuzo zombili izinto ezibukwayo zocansi kanye nezinkomba kubonisa ukuthi ukwenziwa komsebenzi we-Sexual Incentive Delay Task kube yimpumelelo. Ngokusobala, izinhlangano eziphakathi komsebenzi wobuchopho obuhlobene nomvuzo nezinkomba zokusetshenziswa kwezithombe zobulili ezingcolile ezinenkinga noma zezifo kungenzeka zivele kuphela kumasampuli anamazinga akhuphukile hhayi kusampula enempilo esetshenziswe esifundweni samanje.
Isingeniso
Ukusetshenziswa kwezithombe zobulili ezingcolile kuyi-Internet kuyinto esabalele emphakathini (IBlais-Lecours, Vaillancourt-Morel, Sabourin, & Godbout, 2016; IBőthe, iTóth-Király, iPotenza, i-Orosz, neDemetrovics, i-2020; IMartyniuk, i-Okolski, ne-Dekker, i-2019). Ngenkathi iningi likhombisa ukusetshenziswa kwezithombe zocansi ezingenangqondo, kubantu abambalwa lihambisana nosizi, ukungabi namandla kokulawula, kanye nokwehluleka ukwehlisa isimilo naphezu kwemiphumela emibi (cishe i-8%, kuye ngemibandela esetshenzisiwe; Cooper, Scherer, Boies, & Gordon, 1999; IGola, i-Lewczuk, ne-Skorko, i-2016; I-Grubbs, Volk, Exline, nePargament, 2015). Ukusetshenziswa kwezithombe zobulili ezingcolile okuhambisana nokushaya indlwabu kuyindlela yokuziphatha eyinkinga kakhulu kubantu abanokuziphatha okuphoqelela ngokocansi (IKraus, Voon, & Potenza, 2016; Reid et al., 2012; IZwiecha et al., 2018). Ngokokuqala ngqa, i- I-World Health Organization (WHO) ichaze izindlela ezithile zokuxilonga zalezi zimpawu ku-11th edition ye-International Classification of Disorders (ICD-11) ngaphansi kwegama Ukucindezeleka kokuziphatha ngokocansi (I-CSBD, Inhlangano Yezempilo Yomhlaba, i-2018). Ukuqonda kangcono ukusetshenziswa kokuzithokozisa nokunenkinga kokusebenzisa i-porn, izisekelo zayo ze-neurobiological kufanele zicaciswe.
Yize ukuhlukaniswa okulungile kokusetshenziswa okuyizinkinga kwezithombe zobulili ezingcolile kuyisihloko esinokuphikisana, okutholwe yi-neuroscientific kusikisela ukusondela kwayo ezinkingeni zokulutha (Uthando, i-Laier, i-Brand, i-Hatch, ne-Hajela, i-2015; Stark, Klucken, Potenza, Brand, & Strahler, 2018). URobinson noBerridge bachaze kwi-Incentive Sensitization Theory yabo yokuthuthukisa ukuluthwa ukuthi ukuvezwa kwezidakamizwa okuphindaphindwayo kuholela kanjani ekuguqulweni kwe-neuroadaptive ngaphakathi kwamasekethe womvuzo (URobinson neBerridge, ngo-1993, 2008). Ngesikhathi sokuthuthukiswa komlutha, impendulo ezinkomba ("ukufuna") iyanda ngenkathi umphumela oyifunayo wokudla izidakamizwa ("ukuthanda") ungancipha. Ngakho-ke, cue reactivity ehlanganisa ukuphendula okungokomzwelo, okokuziphatha, komzimba kanye nokuqonda kuzimo ezihlobene nokulutha (IBerridge & Robinson, 2016; UTiffany noWray, 2012) kuwumqondo obalulekile wokuchaza ushintsho kusuka ekusetshenzisweni kwesidakamizwa kwesinye isikhathi kusetshenziswe umlutha (UBrand et al., 2019; IKoob & Volkow, 2010; IVolkow, uKoob, noMcLellan, 2016).
Izifundo ezigulini ezinezinkinga ezahlukahlukene ezihlobene nokusetshenziswa kwezidakamizwa zithole ukwanda kokusebenza kabusha kwe-ventral striatum, i-dorsal striatum, i-anterior cingulate cortex (ACC), i-orbitofrontal cortex (OFC), i-insula kanye ne-amygdala kuya kwizimpawu ezihlobene nezidakamizwa (UJasinska, Stein, Kaiser, Naumer, & Yalachkov, 2014; IKühn & Gallinat, 2011a; UStippekohl et al., 2010; IZilverstand, iHuang, i-Alia-Klein, ne-Goldstein, i-2018). Ngokuphathelene nokulutha kokuziphatha, kunezibuyekezo eziningi ezibonisa umsebenzi owandisiwe ezifundeni ezihlobene nomvuzo kuzindlela ezihlobene nokulutha (Ama-Antons, Brand, & Potenza, 2020; Fauth-Bühler, Mann, & Potenza, 2017; I-Starcke, i-Antons, iTrotzke, neBrand, i-2018; UVan Holst, van den Brink, uVeltman, noGoudriaan, 2010). Ukuthi izinqubo ezibandakanyeka ku-CSBD zifana nalezo zokuphazamiseka kokusetshenziswa kwezidakamizwa nokulutha kokuziphatha kuseyimpikiswano yesayensi.
Ukubuyekezwa okuningana kubonisa umsebenzi owandayo we-ventral kanye ne-dorsal striatum, i-OFC, i-ACC, i-insula, i-caudate nucleus, i-putamen, i-amygdala, i-thalamus, ne-hypothalamus kubahlanganyeli abanempilo lapho bebheka izinto ezibonakalayo zocansi (VSS) uma kuqhathaniswa nezimo ezingathathi hlangothi (IGeorgiadis neKringelbach, 2012; I-Poeppl, i-Langguth, i-Laird, ne-Eickhoff, i-2014; UStoléru, uFonteille, uCornélis, uJoyal, noMoulier, ngo-2012). Ngaphezu kwalokho, kunezifundo zezimpendulo ze-neural ezinkomba ezibikezela i-VSS kepha zingenakho okuqukethwe kocansi (isb. I-Banca et al., 2016: amaphethini anemibala; IKlucken, Wehrum-Osinsky, Schweckendiek, Kruse, & Stark, 2016: izikwele ezinemibala; I-Stark et al., I-2019: amagama achaza isigaba). Ubuchopho buphendula kulezi zinkomba ezandulele i-VSS (UBanca et al., 2016; UKlucken et al., 2016; UStark et al., 2019) bezifana nezimpendulo ku-VSS (ventral striatum, OFC, occipital cortex, insula, putamen, thalamus). Ngaphezu kwalokho, abantu abanezinkinga zokusebenzisa izithombe zobulili ezingcolile (PPU) uma kuqhathaniswa nababambiqhaza bokulawula babonise ukwanda kwe-amygdala reactivity kumanani wejometri ahambisana ne-VSS (Klucken et al., 2016). Usebenzisa i-VSS njengezinkomba, Voon et al. (I-2014) ithole izimpendulo eziphakeme ku-dorsal anterior cingate, ventral striatum kanye ne-amygdala yabantu abane-PPU. Lokhu okutholakele kokuphindaphindeka kokusebenza ngokuya kwezinkomba zokubikezela i-VSS kubantu abane-PPU kuhambisana nokulindelwe okuthathwe kwi-Incentive Sensitization Theory.
Ukutadisha ukuthuthukiswa kokulutha, i-Monetary Incentive Delay Task (MIDT) iyithuluzi elisunguliwe lokuphenya izimpendulo ze-neural eziguqukile kuzinkomba nakushukumisayo (IBalodis nePotenza, 2015). I-MIDT iqala ngesigaba sokulindela lapho izinkomba zikhomba khona ukuthi ukuwina noma ukulahlekelwa kwemali kungenzeka ngesikhathi sokulethwa esilandelayo. Ekuqaleni, lo msebenzi wawusetshenziselwa ukuhlola ukuzwela okujwayelekile komvuzo ngokulutha, noma kunjalo, imiphumela engahambelani maqondana nesikhathi sokulindela nesigaba sokulethwa (IBalodis & Potenza, 2015; U-Beck et al., 2009; UBustamante et al., 2014; UJia et al., 2011; INestor, Hester, neGaravan, 2010). Ukuhlola ukwenziwa kabusha kwe-cue ku-PPU, inguqulo eguquliwe ye-MIDT esunguliwe (IKnutson, iFong, i-Adams, iVarner, neHommer, i-2001; IKnutson, iWestdorp, iKaiser, neHommer, 2000) kwahlongozwa: Umsebenzi Wokuncipha Kokukhuthazwa Kocansi (SIDT) usebenzisa izinkomba zocansi nemivuzo. Izifundo ezintathu zisebenzise imisebenzi yokubambezeleka yokukhuthaza ngezimpawu zocansi nemivuzo kuze kube manje (UGola et al., 2017; ISescousse, Li, & Dreher, 2015; ISescousse, Redouté, & Dreher, 2010). AbakwaSescousse nozakwabo baphenye amaphethini womsebenzi owehlukile maqondana nemivuzo evusa inkanuko neyemali kubantu abadala abanempilo futhi bakhomba ingxenye engemuva ye-OFC kanye ne-amygdala njengezifunda ezenziwa ngokukhethekile yimivuzo evusa inkanuko (Sescousse et al., 2010). UGola nozakwabo (2017) kuqhathaniswa amadoda ane-PPU nokulawula amadoda maqondana nomsebenzi wobuchopho bawo ku-MIDT / SIDT exubile. Ngenkathi ababambiqhaza be-PPU bekhombisa ukwanda komsebenzi ku-ventral striatum yezinkomba ezibikezela imivuzo yezocansi, bezingafani nezezilawuli eziphathelene nomsebenzi wobuchopho nemivuzo yezocansi. Ngokuhambisana ne-Incentive Sensitization Theory, ababhali baphikisana nokwanda "kokufuna" kwemivuzo yezocansi kubahlanganyeli be-PPU ngenkathi "ukuthanda" izinkanuko zocansi kuhlala kungathinteki.
Yize izifundo zangaphambilini ezisebenzisa i-SIDT zithembisa kakhulu maqondana nokuhlolwa kokutholwa kokutholwa kwezindlela zokuya ocansini nemivuzo kubantu abaphilile nabantu abane-PPU, kunezici ezithile zendlela okufanele kuxoxwe ngazo. Ngokuphathelene nokusebenza kwangaphandle, izifundo zangaphambilini bezisebenzisa izithombe ezimile esikhundleni samavidiyo, yize lezi zokugcina ziyindlela esetshenziswa kakhulu yezithombe zocansi (ISolano, i-Eaton, ne-O'Leary, i-2020). Ngokuphathelene nesimo sokulawula, izifundo zangaphambili zazisebenzisa izinhlobo ze-VSS eziqhekekile njengezimo zokulawula (UGola et al., 2017; USescousse et al., 2010, 2015). Ngenxa yalokho, izimo zokuhlola nezokulawula zehluka maqondana nezici ezithile (ukusethwa kwemvelo kuqhathaniswa namaphethini angaqondakali, ukulungiswa kwesithombe, ukuvezwa kwabantu kuqhathaniswa nokuboniswa okungebona abantu). Akungabazeki ukuthi ngabe lezi zinto ezishukumisayo zimelela isikhuthazi sokulawula esifanelekile. Ngaphezu kwalokho, abacwaningi basebenzise ama-pictograms wabesifazane abanqunu njengezinkomba. Ngale ndlela izinkomba azikwazanga ukuba nenani lokuqagela kuphela, kepha futhi zimele okuqukethwe kwezocansi. Ngaphezu kwalokho, kungasiza ukuphenya ngethonya lezinto ezinobungozi ekwakhiweni kwe-CSBD, lapho okulandelayo kubukeka njengokufanele kakhulu: izinkinga ezizibikayo eziphathelene nokusetshenziswa kwezithombe zocansi (Umkhiqizo, uSnagowski, uLaier, noMaderwald, 2016; ILaier, iPawlikowski, iPekal, iSchulte, neBrand, 2013), isikhathi esichithwa ukubuka izithombe ezingcolile (UKühn noGallinat, 2014) kanye nokuziphatha kocansi (IBaranowski, iVogl, neStark, i-2019; Kagerer et al., 2014; UKlucken et al., 2016; UStark et al., 2018; I-Strahler, i-Kruse, i-Wehrum-Osinsky, i-Klucken, ne-Stark, i-2018).
Ngakho-ke, izinhloso zesifundo samanje yilezi ezilandelayo: (1) Besifuna ukusungula i-SIDT eyenziwe kahle sisebenzisa iziqeshana zefilimu esikhundleni sezithombe ezimile. Besilindele ukuthi amaphethini womsebenzi ngesikhathi sesigaba sokulindela nesigaba sokulethwa sifane nemiphumela ezifundweni zangaphambili ezibonisa ukubandakanyeka kwe-ACC, OFC, thalamus, insula, amygdala, nucleus accumbens (NAcc), caudate, ne-putamen. (2) Sifuna ukuphenya ukuthi zingakanani izinto ezinobungozi ze-CSBD (i-PPU eyazibika yona, isikhathi esichithwa ekusetshenzisweni kwezithombe zobulili ezingcolile, kanye nokuziphatha kocansi) ezixhunywe emisebenzini ye-neural ngesikhathi sesigaba sokulindela kanye nesigaba sokulethwa kungasebenzi isampula. Ngokwe-Incentive Sensitization Theory ye I-Robinson ne-Berridge (i-1993), silindele ukuthi umsebenzi we-neural wezindawo zobuchopho ezishiwo ngenhla ngesikhathi sesigaba sokulindela se-SIDT uhambisane kahle nalezi zinto ezinobungozi. Ngokuya ngocwaningo lwe UGola et al. (2017), silindele ukuthi umsebenzi we-neural walezi zifunda ezibalulwe ngenhla ngesikhathi sesigaba sokulethwa ungahlobene nalezi zinto ezinobungozi.
izindlela
Abahlanganyeli
Amadoda ayisikhombisa ayisishiyagalombili nesishiyagalombili aphilile phakathi kweminyaka eyi-18 nengama-45 aqashwe ngezinhlu zamakheli, okuthunyelwe kanye nokukhishwa kwabezindaba. Abahlanganyeli ababili kudingeke bakhishwe ngenxa yobunzima bezobuchwepheshe, ababili ngenxa yezithombe ezenziwe ngobuciko futhi oyedwa ngenxa ye-neuroanatomy engajwayelekile. Isampula lokugcina lalinamadoda angama-73 aneminyaka yobudala engama-25.47 (SD = 4.44). Iningi labahlanganyeli (n = 65; 89.04%) kwakungabafundi. Abahlanganyeli abangama-45.21 (36%) babengabodwana, abangu-49.32 (5.48%) bahlala ebudlelwaneni bezothando kanti ababambiqhaza abane (32.88%) babeshadile. Abangu-XNUMX (XNUMX%) ababambe iqhaza bazichaze njengabakholwayo (“Ingabe uthi uyinkolo noma ihlelo elithile?” “Yebo” / “cha”). Kusetshenziswe imibandela elandelayo yokufakwa: ukungabi bikho kwezifo zamanje ze-somatic / zengqondo, akukho ukwelashwa kwamanje kwe-psychotherapeutic / kwemithi, akukho ukusetshenziswa okuyingozi kotshwala / i-nicotine, akukho okuphikisana nenkomba ye-fMRI, nokushelela ngolimi lwesiJalimane.
Inqubo
Ekungeneni kokufunda, ababambiqhaza basayine idokhumenti yemvume enolwazi. Isampula yamanje ivela ocwaningweni olukhulu oluphenya ngemiphumela yokuxineka okukhulu ekusetshenzisweni kwe-VSS ngokuqhathanisa isimo sokucindezeleka nesimo sokulawula. Olunye ucwaningo olusebenzisa idatha evela kule phrojekthi lushicilelwe kuze kube manje. UKlein et al. (2020) ihlolisise ithonya lokukhetha ngakunye ekusebenzeni kwe-neural ku-VSS. Ukuhlaziywa kubonise ukuthi izindawo eziningana zobuchopho ezihlobene nomvuzo zihambisana kahle nesilinganiso ngasinye se-VSS nokuthi lokhu kuhlangana kuhambisana kahle nezinga le-PPU. Ayikho idatha ebikwe lapha eyashicilelwa ngaphambilini. Ababambiqhaza kusukela ekuhlaziyweni kwamanje babelwa ngokungahleliwe esimweni sokulawula futhi bathola inguqulo ye-placebo engacindezeli yeTrier Social Stress Test (i-placebo TSST, i-15 min, Het, Rohleder, Schoofs, Kirschbaum, & Wolf, ngo-2009) ngaphambi kokuskena kwe-MRI. Lokhu kuhlolwa kuqukethe imisebenzi emibili elula yengqondo (inkulumo ekhululekile kanye nezibalo ezilula zengqondo) ezingabangeli ukukhathazeka kwengqondo okukhulu noma izinguquko zomzimba ezibonakalisiwe kubahlanganyeli, ithonya ku-SIDT elandelayo ngakho-ke akulindelekile. Ngokulandela i-placebo TSST, ababambiqhaza babamba iqhaza kwi-SIDT. Ngemuva kokushiya isithwebuli, ababambiqhaza balinganise iziqeshana zefilimu bebodwa egumbini elihlukile ukuqinisekisa ubumfihlo nokusebenza kwesilinganiso. Ingxenye yemininingwane yemibuzo yezenhlalo yabantu kanye nengabandakanyi ezocansi ibivele iqoqiwe ngaphambi kokuthi i-TSST iqale (isikhathi esingaba yimizuzu engama-45) kusetshenziswa ipulatifomu ye-SoSci Survey ese-inthanethi. Ngemuva kokuskena kwe-MRI, ababambiqhaza banikezwa isikhathi sokukala iziqeshana zefilimu nokugcwalisa eminye imibuzo (cishe ama-60 min).
Izindlela
Umsebenzi Wokubambezeleka Kwezikhuthazo Zocansi
Sisebenzise i-SIDT etholakala ku-MIDT esunguliwe (Knutson et al., 2001). Imivuzo yemali ithathelwe indawo kulolu cwaningo ngamabhayisikobho amafilimu awamasekhondi ayisithupha anikezwe ngaphandle komsindo futhi akhombisa i-VSS (VSS isiqeshana), amavidiyo wokubhucungwa okungewona owocansi (lawula isiqeshana) noma isikrini esimnyama (none). Ukusetshenziswa kwamavidiyo wokuhlikihla kuqinisekiswe ukuqhathaniswa kwezinto ezibukwayo (ukuxhumana nabantu, ubunqunu obuncane, ukunyakaza kwesigqi, njll.) Eziqeshini zefilimu ezibonisa i-VSS. Ocwaningweni lokuqala, zonke iziqeshana zamafilimu zilinganiswe maqondana nobumnandi (kusuka ku- “1” = “kubi kakhulu” kuya ku- “9” = “kumnandi kakhulu”) nokuvuka kocansi (kusuka ku- “1” = “akuvusi nhlobo ucansi” kuya ku- “9” = “kuvusa inkanuko yobulili”) yisampula ezimele yamadoda angama-58 angewona ongqingili. Amanani angaphezu kuka-5 ahunyushelwa phezulu. Iziqeshana ze-21 VSS ezisetshenziswe ocwaningweni lwangempela zithole amaphuzu aphakathi we-valence ephezulu (M = 6.20, SD = 1.12) nokuvuka okuphezulu kocansi (M = 6.29, SD = 1.34 esifundweni sangaphambi kokufunda, kanti amaphuzu aphakathi nendawo kuya phezulu we-valence (M = 5.44, SD = 0.97) nezikolo eziphansi zokuvusa ucansi (M = 1.86, SD = 0.81) kwabikwa ngeziqeshana zokulawula ezingama-21. Isiqeshana sefilimu ngasinye sethulwe kanye kuphela ngesikhathi somsebenzi. Ukuhlolwa kutholakale ngephakheji yesoftware yePrezentheshini (Inguqulo engu-17.0, iNeurobehavioral Systems, Inc, e-USA) futhi yathatha cishe imizuzu engama-20. I-SIDT ifake izilingo ezingama-63 ezibandakanya isigaba sokulindela nesigaba sokulethwa esinemibandela emithathu (21 × VSS, 21 × ukulawula, 21 × none).
Ngesikhathi sesigaba sokulindela, kwethulwe izibalo ezintathu ezehlukene zejometri, njengezikhombo ezimemezela isiqeshana se-VSS (CueVSS), isiqeshana sokulawula (CueControl) noma isikrini esimnyama (CueNone, bona futhi I-Fig. 1). Ukunikezwa kwezibalo zeJiyomethri emiphumeleni engahle ibe khona (isiqeshana se-VSS, isiqeshana sokulawula, akukho) senziwa ngokungahleliwe kubo bonke ababambiqhaza. Sisebenzise izibalo zejometri njengezindlela zokuqinisekisa ukuthi azikho izinhlangano ezedlule phakathi kwalezi zinkomba ne-VSS. Abahlanganyeli bazisiwe mayelana nezinhlangano eziphakathi kwezinkomba namavidiyo ngaphambi kocwaningo lwe-fMRI. Lezi zinhlangano zaqeqeshwa ekuhlolweni kokuzivocavoca okungama-21 ngaphandle kwesithwebuli. Ngemuva kokuthi enye yezinkomba ibonakele kuma-4 s, isiphambano sokulungiswa silandelwe isikhawu se-interstimulus esiguqukayo esingu-1-3 s. Ngemuva kwalokho isisusa sokukhomba (isikwele esimhlophe, i-200 × 200 pixel) sakhonjiswa phakathi kwe-16 ms (ubuncane) kanye no-750 ms (esiphezulu). Kungakhathalekile ukuthi kukhonjisiwe ngaphambili, imiyalo bekufanele iphendule ilitshe ngokushesha okukhulu ngangokunokwenzeka ngokucindezela inkinobho. Uma uCueVSS noma CueControl kwavela futhi ababambiqhaza bacindezela inkinobho ngenkathi i-stimulus yethagethi ibonakala, ababambiqhaza "bawine" isiqeshana sefilimu. Okuqondiwe kulandelwe ukwethulwa kwesinye isiphambano sokulungiswa kwesikhawu se-interstimulus esiguqukayo esingu-0-2 s. Ngemuva kwalokho, ababambiqhaza bakhonjiswa isiqeshana se-VSS, isiqeshana sokulawula noma isikrini esimnyama isikhathi sama-6 s. Izilingo zokuzivocavoca ngaphambi kokuskena zaphinde zasebenza ukubala izikhathi ezijwayelekile zokuphendula (meanRT) nokuphambuka okujwayelekile (SDRT) ukunquma izikhathi zokwethulwa kwesisusa sokukhomba (win: meanRT+2 × SDRT; akukho ukunqoba: KushoRT–2 × i-SDRT). AmaWins ahlelelwe cishe i-71% ye-VSS kanye nezilingo zokulawula (izilingo eziyi-15 kwezingu-21), kanti akukho lutho lokulingwa olungakaze luhlanganiswe nokunqoba. Izilingo ezintathu zokuqala zanikeza uCueControl, KubeVSS, noCueNone ngokulandelana okungahleliwe. Lezi CueControl noCueVSS izivivinyo zazihlale zihlelwa njengezilingo zokuwina. Ngemuva kwezilingo ezintathu zokuqala, kwakhiwa izivivinyo ezingaphansi kwezivivinyo ze-6 (2 × CueUkulawula, 2 × UkuqagelaVSS kanye ne-2 × CueNone). Phakathi kwezilingo zokuwina (izivivinyo zokuwina i-VSS noma izilingo zokuwina) azikho ngaphezu kokunye ukuhlolwa okungu-5 (ezinye izilingo zokuwina noma ezinye izilingo) ezivunyelwe. Isimo esifanayo singethulwa izikhathi eziphakeme ezi-2 zilandelana. Ukwethulwa kwesikhuthazi okuhlosiwe kwalungiswa ku-inthanethi ngokususwa noma ngokufakwa kwama-20 ms ngakunye uma ababambiqhaza bewinile ezivivinyweni ezingahlelwanga noma bengaphumelelanga ezivivinyweni ezihleliwe ukuqinisekisa izinga lokuqiniswa ezivivinyweni ezizayo. Izilingo ze-VSS nezilingo zokulawula, ezingazange ziholele emiphumeleni njengoba bekuhleliwe, zaphindaphindwa kuzilingo ezihleliwe nesikhathi esisha sokwethulwa kwethagethi.
Umsebenzi Wokubambezeleka Kwezikhuthazo Zocansi. Ngesikhathi sesigaba sokulindela, ababambiqhaza babona ukubonwa (isibalo sejiyometri). Ngemuva kwesikhawu sesikhathi esiguqukayo, kwethulwe isikhangiso isikhathi esifushane, lapho ababambiqhaza bacelwa ukuthi basabele ngokushesha okukhulu ngokucindezela inkinobho. Uma umkhondo esigabeni sokulindela bekuyi-CueVSS noma i-CueControl, ividiyo ehambisanayo ingatholakala ngokusabela ngokushesha kulokho okubhekiswe kukho (bona futhi UKlein et al., 2020)
Isikhombo: Ijenali Yezidakamizwa Zokuziphatha JBA I-2021; 10.1556/2006.2021.00018
Ukuhlolwa kwedatha ye-psychometric
Ngemuva kwe-SIDT, ababambiqhaza balinganise izinga labo lamanje lokuvusa ucansi esikalini se-Likert esikalini esingu-9 ngenkathi besengaphakathi kwesithwebuli. Iziqeshana zefilimu zilinganiswe kusetshenziswa izikali ze-Self-Assessment-Manikin (UBradley noLang, 1994i-valence (kusuka ku-1 = ayimnandi neze kuye ku-9 = kumnandi kakhulu) nokuvuka kocansi (kusuka ku-1 = kungavusi ucansi kuya ku-9 = kuvusa kakhulu ucansi) ngemuva kokushiya isithwebuli egumbini elihlukile.
Isikhathi esichithwe ekubukeni i-VSS empilweni yansuku zonke kuhlolwe ngento ethi "Uchithe isikhathi esingakanani usebenzisa izithombe zobulili ezingcolile, impendulo yakho uyisekela ngenyanga edlule?". Abahlanganyeli bakwazile ukukhetha amahora neminithi “ngenyanga”, “ngeviki” noma “ngosuku” ukucacisa impendulo yabo. Ngaphambi kokuhlaziywa, amafomethi wezimpendulo ahlukile aguqulwa aba “amahora ngenyanga”.
I-PPU yalinganiswa ngezinguqulo zaseJalimane ze-Internet Internet Addiction Test (s-IAT) (IPawlikowski, Altstötter-Gleich, neBrand, 2013) iguqulelwe i-cybersex (s-IATsex; Laier et al., 2013) nange-Hypersexual Behavior Inventory (HBI; Reid, Garos, & Umbazi, 2011). Ukuthembeka kwangaphakathi kwedatha yemibuzo eqoqwe kwabalwa isampula yamanje. Into ngayinye kweziyishumi nambili ze-s-IATsex kukalwe esikalini se-Likert samaphoyinti ama-5 kusuka ku-1 (ungalokothi) ku-5 (ngokujwayelekile). Amaphuzu aphelele (s-IATsex isamba, Izinto eziyi-12, ezakwaCronbach ɑ = 0.90) isukela ku-12 kuye ku-60. Imixhaso emibili ingabalwa ngokungeziwe: ukulahleka kolawulo (izinto ezi-6, iCronbach's ɑ = 0.89) nokulangazelela (izinto eziyi-6, iCronbach's ɑ = 0.73). I-HBI inezinto eziyi-19 ezilinganiselwe kusuka ku-1 (ungalokothi) ku-5 (ngokujwayelekile) ngamaphuzu aphelele (i-HBIisamba, Izinto eziyi-19, ezakwaCronbach ɑ = 0.89) kusuka ku-19 kuye ku-95. Imixhaso emithathu ingabalwa: ukulawula (izinto eziyi-8, iCronbach's ɑ = 0.89), ukubhekana (nezinto eziyi-7, iCronbach's ɑ = 0.84) nemiphumela (izinto ezi-4, iCronbach's ɑ = 0.76). Ukungaguquguquki kwangaphakathi kwakwamukelekile kumabanga amahle esifundweni samanje (bona idatha ngenhla).
Isikhuthazo sezocansi silinganiswe yi-Trait Sexual Motivation Questionnaire (TSMQ; I-Stark et al., I-2015). I-TSMQ inezinto ezingama-35 ezilayishwa kuma-subscales ama-4: ucansi oluyedwa (izinto eziyi-10, ICronbach's ɑ = 0.77), ukubaluleka kocansi (izinto eziyi-15, iCronbach's ɑ = 0.89), ukufuna ukuzibandakanya ocansini (izinto ze-4, iCronbach's ɑ = 0.92), nokuqhathanisa nezinye (izinto eziyi-6, iCronbach's ɑ = 0.86). Ngaphezu kwalokho, inkomba ejwayelekile yokukhuthazwa kwezocansi (TSMQKusho) kungabalwa njengokusho kwazo zonke izinto ezingama-35 (Cronbach's ɑ = 0.91). Into ngayinye ikalwe esikalini se-Likert samaphoyinti ayi-6 kusuka ku-0 (lutho neze) ku-5 (kakhulu). Abahlanganyeli bayalelwa ukuthi bahlobanise izitatimende zabo kule minyaka emihlanu edlule. Igama elithi “isisusa socansi” elisetshenziswe kulesi sikali lifaka phakathi imisebenzi yezocansi nomlingani wakho kanye nemisebenzi yocansi eyedwa. Amanani aphezulu akhombisa isikhuthazo sezocansi.
Imininingwane yokuziphatha
Isikhathi sokuphendula sichazwe njengesikhathi phakathi kokuqala kwethagethi nokuqala kokuphendula. Idatha yesikhathi sokuphendula ihlolwe abathengisa ngaphandle ngaphandle kwedatha engaphansi kwe-100 ms noma ngaphezulu kusho + 1.5 × SD ngesimo ngasinye ngokuya ngamanani esampula wezibalo. Ngokusho kwalokhu, kwakukhona abathengisi abathathu ngaphakathi kwesampula sonke (eyodwa ngesimo ngasinye). Izibalo ezichazayo zabalwa ngaphandle kwama-outliers namanani alahlekile kudatha. Amanani alahlekile aqukethe ukusabela sekwephuze kakhulu noma akukho ukusabela esiphambanweni sokulungiselela. Umehluko kubalamedi bezikhathi zokuphendula ezivivinyweni eziphumelele zahlaziywa kusetshenziswa ukuhlolwa kukaKruskal-Wallis noDunn-Bonferroni. Ekugcineni, ukuhlangana kukaPearson phakathi kwezikhathi zokuphendula zalezi zimo ezintathu nezici eziyingozi ze-CSBD kwabalwa.
Ukutholwa kwedatha ye-fMRI nokuhlaziywa kwezibalo
Izithombe ezisebenzayo nezokwakheka zitholwe kusetshenziswa i-3 Tesla body-body MR tomograph (Siemens Prisma) enekhoyili yekhanda engu-64. Ukutholwa kwesithombe kuhlanganisa izingcezu ze-sagittal ezinesisindo se-176 T1 (ubukhulu besilayidi 0.9 mm; I-FoV = 240 mm; TR = 1.58 s; TE = 2.3 s). Ekucabangeni okusebenzayo, ingqikithi yezithombe ezingama-632 zarekhodwa kusetshenziswa ukulandelana kwe-T2-weighted gradient echo-planar imaging (EPI) ngokulandelana ngezingcezu ezingama-36 ezimboza bonke ubuchopho (voxel size = 3 × 3 × 3.5 mm; gap = 0.5 mm; ukwehla kocezu ukutholwa; TR = 2 s; TE = 30 ms; flip angle = 75; FoV = 192 × 192 mm2; usayizi we-matrix = 64 × 64; I-GRAPPA = 2). Inkambu yokubuka ibimiswe ngokuzenzakalela ngokuhlobene nolayini we-AC-PC ngokuma kwe -30 °. I-Statistical Parametrical Mapping (SPM12, Wellcome Department of Cognitive Neurology, London, UK; 2014) isetshenziswe eMatlab Mathworks Inc., eSherbourn, MA; 2012) isetshenziselwe ukucubungula idatha eluhlaza, kanye nokuhlaziywa kwezinga lokuqala nelesibili.
Ukulungiswa kwangaphambili kwezithombe ze-EPI kufaka phakathi ukubhaliswa kwethempulethi yaseMontreal Neurological Institute (MNI), ukuhlukaniswa, ukuqondiswa kabusha nokungavinjelwa, ukulungiswa kwesikhathi sesilayidi, ukujwayela indawo ejwayelekile ye-MNI kanye nokwenza bushelelezi nge-kernel yeGaussian ku-6 mm FWHM. Idatha esebenzayo yahlaziywa ngokwamanani aphesheya kusetshenziswa indlela yamahhala yokusabalalisa yedatha eboshiwe (USchweckendiek et al., 2013). Ivolumu ngayinye ephumayo kamuva yamodelwa ngaphakathi kwemodeli ejwayelekile yomugqa (i-GLM) njenge-regressor engenantshisekelo. Isimo ngasinye sokuhlola (CueVSS, CueControl, CueNone, DeliveryVSS, AkukhoDeliveryVSS, UkulethwaControl, AkukhoDeliveryControl, AkukhoDeliveryNone futhi umgomo) yenziwe njenge-regressor yenzalo. Onke ama-regressors ahlanganiswa nomsebenzi wokuphendula we-canonical hemodynamic. Imingcele yokunyakaza eyisithupha ifakwe njengama-covariate ngaphezu kwama-regressor amavolumu angaphandle akhonjiwe. Uchungechunge lwesikhathi luhlungwe ngesihlungi esiphakeme sokuphasa (isikhathi esiqhubekayo = 128 s).
Ezingeni leqembu, kuhlolwe izinto ezimbili: CueVSS-QaphelaControl kanye nokulethwaVSS-UkudilivaControl. Isampula elilodwa t-izivivinyo kanye nokuhlehla komugqa ngokuguquguqukayo okulandelayo njengoba izibikezelo zenziwa ngokuqhathanisa: s-IATsex, I-HBI, isikhathi esichithwa ekusetshenzisweni kwezithombe zocansi (amahora ngenyanga), kanye ne-TSMQ. Okwe-TSMQ kanye ne-HBI, ukuhlehliswa okuningi okuqukethe konke okuxhaswayo ngasikhathi sinye kwenziwa. Sisebenzise ukuhlehla okuhambisanayo kwesikhathi esichithwa ekusetshenzisweni kwezithombe zocansi kanye ne-s-IATsex.
Ukuhlaziywa kwe-ROI ezingeni le-voxel kwenziwa kusetshenziswa ukulungiswa kwevolumu encane (SVC) nge P <0.05 (kulungiswe iphutha lomndeni ngokuhlakanipha: Kulungiswe i-FWE). I-Caudate, i-NAcc, i-putamen, i-dorsal anterior cingate cortex (i-dACC), i-amygdala, i-insula, i-OFC, ne-thalamus bakhethwa njengama-ROI ngoba bake babikwa phambilini ezifundweni zokucutshungulwa kabusha kwe-cue kanye ne-VSS processing (URuesink & Georgiadis, 2017; UStoléru et al., 2012). Amamaski e-Bilateral anatomical ROI e-OFC ne-DACC adalwe eMARINA (U-Walter et al., 2003); wonke amanye amaski athathwe eHarvard Oxford Cortical Atlas (HOC). Izinhlobonhlobo ezingakwesokunxele nangakwesokudla ze-ROI zihlanganiswe kumaskhi owodwa. Kula ma-ROI ayisishiyagalombili, ukuhlaziywa ezingeni le-voxel kwenziwa P <0.05 kulungiswe i-FWE.
Sibhale ukuhlehliswa okuqondile kwemiphumela yemibuzo nokusetshenziswa kwezithombe zobulili ezingcolile kuCueVSS–QaphelaControl umehluko kanye nokulethwaVSSUkulethwaControl umehluko. Ama-voxels abalulekile kuphela (ama-SVC, alungiswe nge-FWE) avela kusampula eyodwa t-Ukuhlolwa ngaphakathi kwama-ROI lapho kusetshenziselwa khona i-SVC. Ngakho-ke, ama-ROI amancane asetshenziselwa ukuhlaziywa kokubuyela emuva. Ukuhlaziywa kobuchopho okuphelele (i-FWE-corrected) yenezela ukuhlaziywa kwe-ROI.
Ethics
Ucwaningo lwavunywa yikomidi lendawo yokuziphatha futhi lwenziwa ngokuhambisana nesimemezelo sango-1964 sikaHelsinki kanye nezichibiyelo zaso zakamuva. Bonke ababambiqhaza banikeze imvume enolwazi ngaphambi kwanoma ikuphi ukuhlolwa. Udokotela wezinzwa wayekhona ukuze acacise ukungajwayelekile okusolisayo kwe-neuroanatomical.
Imiphumela
Izici zesampula
Ithebula 1 ifingqa izibalo ezichazayo. Ukuhlangana kwe-bivariate phakathi kokwakhiwa kwemibuzo kuveze ukuhlangana okuqinile okukhombisa ukuthi konke okuqukethwe kudlulelwa kanye nokwabelana ngokwengeziwe kokwakhiwa okuhlukile (bona I-Fig. 2).
Ithebula 1.Izilinganiso zePsychometric nezilinganiso zamavidiyo wezocansi nokulawula asetshenziswa emsebenzini wokubambezeleka wezikhuthazo zocansi (N = 73)
| Kusho (i-SD) | Ibanga | ||
| I-IATsex | Ukulahlekelwa ukulawula | 10.56 (4.66) | 6.00-30.00 |
| ukunxanela | 9.60 (3.44) | 6.00-26.00 | |
| I-IATsex inani eliphelele | 20.16 (7.74) | 12.00-56.00 | |
| HBI | Control | 14.86 (6.28) | 8.00-39.00 |
| Ukukopisha | 17.92 (5.48) | 7.00-32.00 | |
| Imiphumela | 6.71 (2.81) | 4.00-20.00 | |
| HBIisamba | 39.49 (11.48) | 20.00-90.00 | |
| IsikhathiPU [h / ngenyanga] | 6.49 (7.21) | 0.00-42.00 | |
| I-TSMQ | Ubulili bodwa | 3.74 (0.68) | 1.80-5,00 |
| Ukubaluleka kocansi | 3.82 (0.74) | 1.27-5.00 | |
| Ukufuna ukuhlangana ngokocansi | 1.50 (1.40) | 0.00-4.75 | |
| Ukuqhathanisa nabanye | 1.73 (1.10) | 0.00-4.33 | |
| I-TSMQKusho | 2.70 (0.69) | 1.05-4.35 | |
| Izilinganiso zesimo socansi | I-Valencia | 6.35 (1.17) | 2.14-8.67 |
| Ukuvusa ngocansi | 6.63 (1.16) | 2.14-8.62 | |
| Izilinganiso zesikhuthazi sokulawula | I-Valencia | 5.51 (1.27) | 2.95-8.86 |
| Ukuvusa ngocansi | 2.01 (0.97) | 1.00-5.00 |
Qaphela: I-IATsex = inguqulo emfushane ye-Internet Addiction Test iguqulelwe i-cybersex (Laier et al., 2013), I-HBI = Inventory Yokuziphatha Ngokobulili Obufanayo (Reid et al., 2011), IsikhathiPU = Isikhathi esichithwa ekusetshenzisweni kwezithombe zocansi; I-TSMQ = Imibuzo Yemibuzo Yokukhuthaza Izocansi (I-Stark et al., I-2015).
Ukuhlanganiswa kwezici ezihlobene nokulutha (N = 73): s-IATsex ne-HBI = isamba semiphumela yokusetshenziswa kwezinkinga zobulili ezingcolile okunenkinga, IsikhathiPU = isikhathi esichithwa ezithombeni zobulili ezingcolile ngo-h / ngenyanga; I-TSMQ = inani elisho inkuthazo yezocansi
Isikhombo: Ijenali Yezidakamizwa Zokuziphatha JBA I-2021; 10.1556/2006.2021.00018
Ukuhlolwa kukaKruskal – Wallis kukhombise umehluko omkhulu phakathi kwezikhathi zokuphendula eziphakathi nokuphendula okuqondiwe ezimweni ezintathu (eCueNone, KubeControl, KubeVSS; Χ2(2) = 12.05, P <0.01). Ithebula 2 ifingqa izibalo ezichazayo zezikhathi zokuphendula ngesikhathi se-SIDT. Ukuhlolwa okwalandela kweposi (ukuhlolwa kukaDunn-Bonferroni) kuveze ukuthi isikhathi sokuphendula kulitshe elisesimweni seCueVSS ibishesha kakhulu kunesikhathi sokuphendula esimweni seCueControl (z = 2.68, P <0.05, Cohen's d = -0.65) nasesimweni esithi CueNone (z = 3.35, P <0.01, Cohen's d = -0.82). Ngokuphikisanayo, izikhathi zokuphendula kusisusa sokukhomba ezimeni zeCueControl nakuCueNone azange zihluke kakhulu komunye nomunye (z = 0.59, P = 0.56). Akukho ukuxhumana okuphawulekayo okutholakele phakathi kwezikhathi zokuphendula zezimo ezintathu nezici zobungozi ze-CSBD (konke r <0.1, P > 0.10). CueNone kwalandelwa izimpendulo ezingama-75 (4.89%) ezingekho, uCueControl kwalandelwa izimpendulo ezingekho ze-51 (3.33%), ne-CueVSS kwalandelwa izimpendulo eziyi-17 (1.11%) ezingekho kubo bonke ababambiqhaza.
Ithebula 2.Izibalo ezichazayo zezikhathi zokuphendula emsebenzini wokubambezeleka kwesikhuthazo socansi (N = 73)
| I-Median (SD) | |
| CueVSS | 235.11 (60.94) |
| CueControl | 296.63 (135.01) |
| CueNone | 314.42 (158.64) |
Qaphela: CueAmav = qaphela ukumemezela ividiyo yezocansi, CueControl = ukuqaphela ukumemezela ividiyo yokuhlikihla, CueNone = cue ememezela ukuthi ayikho ividiyo.
Izimpendulo ze-Hemodynamic
Ama-cues asayina i-VSS uma kuqhathaniswa nezimpawu zokukhonjiswa kokulawulwa kweziqeshana ziphakamise impendulo ephezulu yegazi-oxygenation-level (BOLD) e-NAcc, caudate, putamen, nase-insula (konke okwenziwa ngamazwe amabili), kanye nase-DACC elungile naku-thalamus. Impendulo ephakeme ye-BOLD nayo itholakele kwi-NAcc ne-OFC yangakwesobunxele, ku-bilate caudate, putamen, dACC, insula, amygdala, kanye ne-thalamus ngesikhathi sokulethwa kweziqeshana ze-VSS uma kuqhathaniswa nezilawuli (yonke imiphumela uyabona Ithebula 3 futhi I-Fig. 3).
Ithebula 3.Imiphumela ye-ROI ye-Cue ehlukileVSS–QaphelaControl kanye nokulethwaVSSUkulethwaControl (Isibonelo Esisodwa t-zivivinyo) ngosayizi weqoqo (k) kanye nezibalo (kulungiswe i-FWE; N = 73)
| Phawula umehluko owawukhona phakathi | Ukwakheka | side | x | y | z | k | Tmax | Pi-corr |
| CueVSS–QaphelaControl | I-NAcc | L | -6 | 8 | -4 | 77 | 8.71 | |
| R | 8 | 10 | -4 | 65 | 7.50 | |||
| ukhokho | L | -8 | 10 | 2 | 449 | 9.66 | ||
| R | 10 | 14 | 4 | 476 | 8.18 | |||
| putamen | L | -16 | 8 | -2 | 774 | 6.72 | ||
| R | 24 | 2 | 4 | 766 | 7.42 | |||
| i-DACC | R | 12 | 16 | 36 | 1,697 | 10.77 | ||
| i-insula | L | -34 | 14 | 6 | 592 | 9.43 | ||
| R | 38 | 14 | 4 | 604 | 8.65 | |||
| i-thalamus | R | 8 | -2 | 0 | 2,164 | 8.91 | ||
| DeliveryVSSUkulethwaControl | I-NAcc | L | -8 | 14 | -8 | 69 | 9.49 | |
| ukhokho | L | -12 | -6 | 18 | 56 | 4.24 | ||
| R | 16 | -16 | 22 | 71 | 5.32 | |||
| putamen | L | -18 | 12 | -10 | 314 | 6.58 | ||
| R | 32 | -12 | -10 | 63 | 7.28 | |||
| i-DACC | L | -2 | 20 | 28 | 953 | 5.43 | ||
| R | 4 | 4 | 32 | 953 | 9.19 | |||
| amygdala | L | -22 | -4 | -16 | 232 | 10.71 | ||
| R | 20 | -4 | -14 | 280 | 12.20 | |||
| i-insula | L | -36 | -4 | 14 | 517 | 9.52 | ||
| R | 38 | 2 | -16 | 476 | 9.19 | |||
| OFC | L | -6 | 44 | -18 | 2,825 | 17.45 | ||
| i-thalamus | L | -20 | -30 | -2 | 1,747 | 25.67 | ||
| R | 20 | -28 | 0 | 1,747 | 24.08 |
Umsebenzi we-ROI wokuqhathanisa CueVSS–QaphelaControl (A) kanye nokulethwaVSSUkulethwaControl (B). Imigqa esigaxeni se-sagittal ngasohlangothini lwesokudla ikhombisa izingcezu ze-coronal eziboniswe ngakwesobunxele. Izimpawu ezisayina i-VSS (CueVSS) uma kuqhathaniswa nezinkomba ezibonisa iziqeshana zokubhucungwa (i-CueControl) kuphakamise impendulo ephakeme ye-BOLD kuma-putamen, i-NAcc, i-caudate, ne-insula. Iziqeshana ze-VSS (DeliveryVSS) kuqhathaniswa neziqeshana zokubhucungwa (UkulethwaControl) kuphakamise impendulo ephakeme ye-BOLD ku-thalamus, insula, amygdala, putamen, ne-OFC. Kubonisiwe t-Izilinganiso zivinjelwe ku- t <5
Isikhombo: Ijenali Yezidakamizwa Zokuziphatha JBA I-2021; 10.1556/2006.2021.00018
Ukuhlaziywa okuphelele kobuchopho kuveze izimpendulo eziphakeme ze-hemodynamic kuqoqo eliqhubekayo kufaka phakathi izingxenye ezinkulu zobuchopho zeCue ehlukileVSS kuqhathaniswa noCueControl (Ubukhulu beqoqo k = 174,054 voxel) futhi futhi ngokulethwa okungafaniVSS kuqhathaniswa neDeliveryControl (k = 134,654)
Izici zobungozi ze-CSBD nezimpendulo ze-hemodynamic
Akukho okulungiswa okuhlaziya izixhumanisi eziphakathi kwezici zobungozi ze-CSBD (i-PPU eyazibika, isikhathi esichithwa ekusetshenzisweni kwezithombe zobulili ezingcolile, kanye nokuziphatha kocansi) kanye nomsebenzi we-neural wokubandlulula kunoma iyiphi i-ROI ngesikhathi sesigaba sokulindela (I-CueVSS–QaphelaControl) noma isigaba sokulethwa (UkulethwaVSSUkulethwaControlkube nemiphumela ebalulekile. Umfanekiso we-4 iveza ukuhlangana phakathi kwalezi zinto ezinobungozi nomsebenzi wesilinganiso se-voxel we-nucleus accumbens.
Ukuhlangana phakathi kwe-nucleus yesobunxele eqongelela umsebenzi we-voxel omkhulu kanye ne-s-IATsex, HBI, isikhathi esichithwa ekusetshenzisweni kwezithombe zobulili ezingcolile ngehora / ngenyanga (IsikhathiPU) nezikolo eziphelele ze-TSMQ ngesikhathi sesigaba sokulindela (irowu ephezulu, i-NAcc [-6 8 -4]) kanye nesigaba sokulethwa (irowu engezansi, i-NAcc [-8 14 -8]) ye-Sexual Incentive Delay Task (N = 73)
Isikhombo: Ijenali Yezidakamizwa Zokuziphatha JBA I-2021; 10.1556/2006.2021.00018
Ingxoxo
Inhloso yokuqala yalo mbiko ukuphenya ngomsebenzi wobuchopho ohlobene nomvuzo ngesikhathi sokulindela kanye nesigaba sokulethwa kwe-VSS kusampula enkulu engeyona eyemitholampilo kusetshenziswa i-SIDT. Sithole ukuthi ukwethulwa kwamavidiyo wezithombe zocansi kanye nokwethulwa kwama-cue ngaphambi kwamavidiyo wezithombe zocansi kuhlotshaniswa nomsebenzi ophakeme wobuchopho ezindaweni zobuchopho ezihlobene nomvuzo ezichazwe ngaphambilini (NAcc, amygdala, OFC, putamen, caudate nucleus, insula, thalamus, ne-DACC) uma kuqhathaniswa nokwethulwa kwamavidiyo wokubhucungwa noma izinkomba ezandulele zamavidiyo wokubhucungwa, ngokulandelana. Imiphumela yethu ihambisana nokutholakele kwe- USescousse et al. (2015, 2010), Oqhathanise impendulo ye-neural ne-VSS kanye ne-non-VSS stimuli (lapha yemali) ethinta isampula yamadoda aphilile ngesikhathi somsebenzi wokubambezeleka wokukhuthaza. Ngokuphathelene nezimpendulo zobuchopho kuzinkomba ze-VSS, bathole umsebenzi ophakeme ku-ventral striatum ngokukhula okulindelekile komvuzo. Ngesikhathi sokulethwa, bathole nomsebenzi wobuchopho oqondene nomvuzo ku-VSS engxenyeni ye-OFC kanye nase-amygdala yamazwe amabili. Ngokwengeziwe, bakhombe izifunda ezazibandakanyeka ekusebenzeni kwazo zombili izinhlobo zemivuzo (i-ventral striatum, i-midbrain, i-ACC, i-insula yangaphakathi).
Idatha yokuziphatha ikhombise ukuthi izikhathi zokuphendula bezishesha kakhulu ukukhomba intshisekelo esimweni esiveza izinkomba zocansi kunezi zimo ezinama-control cues noma ama-cues angamemezanga vidiyo nhlobo. Lokhu kukhombisa ukuthi ukulindelwa kwe-VSS kusebenze uhlelo lwezimoto, olugcizelela inani eliphakeme lokugqugquzela le-VSS.
Inhloso yesibili kwakuwukuhlola ubudlelwano phakathi kwezimpendulo ze-neural ku-VSS kanye nezimpawu nezici zobungozi ze-CSBD. Izici ezinobungozi ezilinganisiwe zikhombise ubudlelwane obuhambisanayo bamandla aphakathi komunye nomunye, okukhombisa ukufana kanye nezingxenye ezengeziwe zokwakhiwa. Ayikho imibuzo yokulinganisa i-PPU (HBI ne-s-IATsex), noma isikhathi esichithwa ezithombeni ezingcolile, noma isisusa socansi (TSMQ) sasihambisana kakhulu nemisebenzi yobuchopho yezindawo zobuchopho ezihlobene nomvuzo ngesikhathi sokulethwa nokulindelwa kwesikhuthazo sezocansi.
Ukuze uxoxe ngokufanele ngokuhlangana okungekho phakathi kwezici zobungozi ze-CSBD nezimpendulo ze-neural ku-VSS, kuyasiza ukubheka izincwadi ezikhona zezifundo ezingaqhathanisa izimpendulo ze-neural ze-CSBD nabahlanganyeli bokulawula (indlela yokuqhathanisa yeqembu) noma uhlaziye ukuhlangana kwezici zobungozi ye-CSBD enezimpendulo ze-NAcc ku-VSS (indlela yokuhlangana). Ukulandela indlela yokuqhathanisa yeqembu, ezinye izifundo zithole izimpendulo ezinkulu ze-neural ezibhekiswe ku-VSS ku-ventral striatum nakwezinye izindawo zobuchopho ezihlobene nomvuzo kubahlanganyeli abane-PPU uma kuqhathaniswa nababambiqhaza bokulawula (UGola et al., 2017; Seok & Sohn, 2015; IVoon et al., 2014). Umphumela obalulekile wesifundo ngo UGola et al. (2017) kwakungukuthi izinkomba ezazibikezela ukuthi i-VSS yayihlotshaniswa nomsebenzi ophakeme we-striatal kubahlanganyeli be-CSBD kunezifundo ezinempilo. Ngenkathi UGola et al. (2017) uphenye umbandela wokulibaziseka ocansini nowezimali ohlanganisiwe onama-pictograms wabesifazane abahamba nqunu njengezinkomba, UKlucken et al. (2016) ihlole ipharadayim yesimo sokuthakazelisa enezimpawu zejometri. Ngenxa yalokho, bathole umsebenzi owandisiwe we-amygdala ngesikhathi sokulungiswa kwe-CS + (qagela ukubikezela i-VSS) kuqhathaniswa ne-CS- (qagela ukubikezela lutho) kubahlanganyeli abane-CSBD uma kuqhathaniswa nababambiqhaza bokulawula, kepha akukho mehluko ku-ventral striatum. Ngokuphambene nalokho, kumbandela wesimo sokuthakazelisa se- Banca et al. (I-2016) bekungekho miphumela yeqembu phakathi kwabahlanganyeli be-CSBD kanye nababambiqhaza bokulawula maqondana nezimpendulo ze-neural ezinkomba ezihlukile (amaphethini anemibala abikezela i-VSS, imivuzo yemali noma lutho).
Izifundo ezilandela indlela yokuhlangana ziveze imiphumela engahambelani maqondana nokulungiswa phakathi kwezici zobungozi ze-CSBD nezimpendulo ze-neural ku-VSS: Ngenkathi UKühn noGallinat (2014) ithole ukuhlangana okungahambi kahle phakathi kwesikhathi esichithwe ezithombeni ezingcolile kanye nomsebenzi kuma-putamen angakwesobunxele, I-Brand et al. (I-2016) akabikanga ukuhlangana okuphawulekayo kwezibalo zezimpendulo ze-ventral striatum nesikhathi esivamile esichithwe ezithombeni ezingcolile. Kodwa-ke, bathole ukuthi umsebenzi we-ventral striatum ubuhlobene kahle nezinga le-PPU elizihlole (elinganiswa yi-s-IATsex). Ngaphezu kwalokho, kwesinye sezifundo zethu zangaphambilini asitholanga noma yiliphi ithonya elibalulekile lesikhathi esichithwa ezithombeni zobulili ezingcolile noma ukwenza isisusa sobulili ekuphenduleni kwe-neural ku-VSS (I-Stark et al., I-2019). Ngakho-ke, ucwaningo lwamanje mayelana nokusebenza kwe-VSS ezifundweni ezinamazinga ahlukahlukene ezingozi ze-CSBD kubonakala kungahambelani. Esikhundleni sokutholwa okufanayo kwezifundo ezisebenzisa indlela yokuqhathanisa yeqembu kepha imiphumela engahambelani evela ezifundweni ezihambisanayo ingahle iphakamise ukuthi ukucubungula kwe-neural kwe-VSS ku-CSBD kuhluke kakhulu kulokho kumasampula angaphansi. Lesi siphakamiso, nokho, sinentshisekelo ekukhanyeni kweTheory Yokukhuthaza Ukuzwela ye I-Robinson ne-Berridge (i-1993) okuphakamisa izimpendulo ze-neural ezikhulayo ezinkomba ngesikhathi sokulutha umlutha. Kuze kube manje, kusalokhu kungacaci ukuthi ngabe le mbono isebenza ku-CSBD futhi uma kunjalo, noma ngabe izimpendulo ezandayo ze-neural ku-VSS zishintsha ngobukhulu noma ngabe izinga eliphakeme lokuziphatha okuluthayo kufanele lidlulwe.
Kuyathakazelisa ukuthi futhi ekuluthweni okuhlobene nezidakamizwa imiphumela ephathelene neTheory Yokukhuthaza Ukuzwela ayihambisani. Ukuhlaziywa kwe-meta okuningana kubonise ukukhuphuka kokuphindaphindwa kokukhonjwa ohlelweni lomvuzo (Chase, Eickhoff, Laird, & Hogarth, 2011; UKühn & Gallinat, 2011b; USchacht, u-Anton, noMyrick, ngo-2012), kepha ezinye izifundo azikwazanga ukuqinisekisa lokhu okutholakele (U-Engelmann et al., 2012; ULin et al., 2020; UZilberman, uLavidor, uYadid, noRassovsky, 2019). Futhi ekuluthweni kokuziphatha ukuphakama okuphezulu kokusebenza kunethiwekhi yomvuzo wezihloko eziluthayo uma kuqhathaniswa nezihloko ezinempilo kutholakala kuphela kwizifundo ezimbalwa njengoba kufingqiwe ekubukezweni kwakamuva kakhulu U-Antons et al. (2020). Kusukela kulesi sifinyezo, kungaphethulwa isiphetho sokuthi ukucubungula kabusha kokulutha kuguqulwe yizici eziningana njengezici ezithile kanye nezici ezithile zokutadisha (UJasinska et al., 2014). Ukuthola kwethu okungu-zero maqondana nokuhlangana phakathi kwento ebusayo kanye nezici zobungozi be-CSBD kungenzeka futhi ukuthi kungenxa yokuthi nesampula sethu esikhulu singabheka kuphela ukukhetha okuncane kwezinto ezingaba nomthelela. Izifundo ezengeziwe ezinkulu ziyadingeka ukwenza ubulungiswa kokuningi. Ngokwendlela yokwakhiwa, isibonelo, isimo sezimpawu sezinzwa noma ukwenziwa kwezibonelo ezithile kungabalulekile (UJasinska et al., 2014).
Ngokuya ngosayizi wethu omkhulu wesampula (ngokungafani nezinye izifundo) akunakwenzeka ukuthi ukuntuleka kwamandla wezibalo kubangele ukutholwa okungenamqondo maqondana nokulungiswa kwezici eziyingozi ze-CSBD nezimpendulo ze-neural ku-VSS nezinkomba ze-VSS. Ngokunokwenzeka, inani eliqhutshwa ngokuziphendukela kwemvelo, inani eligqugquzela kakhulu le-VSS lenza kusebenze izindawo zobuchopho ezihambisana nomvuzo ngokufanayo zishiya isikhala esincane kuphela sokwehluka ngakunye (umphumela wophahla). Le hypothesis isekelwa yizifundo ezibonisa ukuthi akukho mehluko wobulili maqondana nokusebenza kwe-VSS kunethiwekhi yomvuzo (UPoeppl et al., 2016; UStark et al., 2019; Wehrum et al., 2013). Yize kunjalo, izizathu zokungahambelani phakathi kwezifundo zidinga ukwambulwa ngezifundo ezengeziwe.
Imikhawulo nezincomo zokuqhubeka nocwaningo
Ukulinganiselwa okuningana kufanele kubhekwe. Esifundweni sethu sihlole kuphela isiko lasentshonalanga, abesilisa abesilisa nabesifazane. Ukuphindaphindwa kwesifundo ngesampula ehluke kakhulu ngokobulili, ukuthambekela kwezocansi, nezici zenhlalo namasiko kubonakala kunesidingo ukuqinisekisa ubuqiniso bemvelo. Ngaphezu kwalokho, idatha ithathwe kusampula engeyona eyemitholampilo, izifundo ezizayo kuzodingeka futhi zibheke amasampula anezimpawu ezifanele zomtholampilo ze-CSBD. Izinkomba ezisetshenziswe kulolu cwaningo zichazwe njengezindlela ezingathathi hlangothi ngaphandle kokuhlangenwe nakho okwedlule okwehlukile. Kodwa-ke, intengo yale nqubo ngokusebenza okuphezulu kwangaphakathi kungaba ukuntuleka kokusebenza kwangaphandle ngoba izinkomba zocansi ezimpilweni zansuku zonke zenzelwe umuntu ngamunye.
Omunye umkhawulo ifomethi yokuphendula eguquguqukayo (ngosuku / ngeviki / ngenyanga) maqondana nokuhlolwa kokusetshenziswa kwezithombe zocansi. Ngokuvumelana ne USchwarz no-Oyserman (2001) izimpendulo zombuzo ofanayo zinokuqhathaniswa okulinganiselwe lapho ifomethi yokuphendula isho izikhathi ezahlukahlukene. Isizathu esiyinhloko sokukhetha le fomethi yokuphendula ukuthi ubukhulu bezithombe zobulili ezingcolile ezisetshenziswa kumasampula zingahluka kakhulu (kusuka emahoreni ambalwa ngonyaka kuye emahoreni amaningi ngosuku). Ngaphezu kwalokho, bekubonakala kufanelekile ukuthi ifomethi yokuphendula engaguquki ingahle iveze umkhuba wokuthi yiliphi izinga lokusetshenziswa kwezithombe zocansi okufanelekile. Ngakho-ke, sinqume ukusebenzisa ifomethi yokuphendula eguquguqukayo yalo mbuzo osondelene, yize ubuthaka obaziwayo.
Ngaphezu kwalokho, ilabhorethri imelela indawo yokufakelwa, ngoba ukusetshenziswa kwezithombe zobulili ezingcolile ekuphileni kwansuku zonke kuvame ukuhambisana nokushaya indlwabu. Ngakho-ke, kuhlala kungaqinisekile ukuthi umvuzo uvela ekushayeni indlwabu / i-orgasm kanye / noma kokuqukethwe kocansi uqobo. UGola et al. (2016) waphikisana ngokuqiniseka ukuthi isisusa sobulili singaba imikhombandlela nemivuzo. Uma amafilimu ezocansi nawo ehunyushwa njengezimpawu, izifundo ezizayo zingavumela ukushaya indlwabu ukuthi kufinyelele esigabeni sokulethwa sangempela. Kodwa-ke, ubunzima bokuziphatha nobuchwepheshe budinga ukucatshangelwa ukwenza lolu cwaningo. Ukuqonda kangcono ukuthuthukiswa kwe-CSBD, izifundo ezihlanganisa zonke izici zezimpawu ze-CSBD (ezinempilo, ezingaphansi kokwelapha, zokwelashwa) ziyadingeka.
iziphetho
Ucwaningo lwethu luhlolisise ukucubungulwa kwezinkomba kanye ne-VSS stimuli kusetshenziswa i-SIDT kusampula enkulu engeyona eyemitholampilo. Ngaphezu kwalokho, i-SIDT yethu eguquliwe yenza ngcono i-SIDT yangaphambilini ngokusebenzisa iziqeshana zefilimu esikhundleni sezithombe ezimile, ngokusebenzisa amavidiyo wokubhucungwa njengesimo sokulawula esikhundleni sezithombe eziqhuliwe, nangokusebenzisa imikhondo engenalo ulwazi lwezocansi. Sikwazile ukuphindaphinda imiphumela ekhombisa ukubandakanyeka kohlelo lokuvuza phakathi kokucubungula izinkomba kanye ne-VSS. Ngokuphikisana nemibono yethu, asikwazanga ukubona imiphumela yezici zomuntu ezicatshangwa njengezici zobungozi ekuthuthukiseni i-CSBD kuzimpendulo ze-neural kunoma iyiphi i-ROI exhunywe ohlelweni lomvuzo. Ucwaningo lwesikhathi esizayo kufanele luhlolisise zonke izibonakaliso ze-CSBD ukuqonda kangcono ukuthi ukusetshenziswa kwezithombe zocansi kukhula kanjani kube yisimo sokuziphatha futhi yiziphi izinto ezingabikezela lokhu kuthuthukiswa.
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