Fairview Health, Minneapolis, MN, USA.
Department of Genetics, Cell Biology, and Development, University of Minnesota, Minneapolis, MN, USA.
J Genet Couns. 2020 Dec;29(6):1059-1080. doi: 10.1002/jgc4.1238. Epub 2020 Mar 7.
Emerging adulthood, a distinct developmental period between ages 18 and 29 years, comprises five features: identity exploration, experimentation/possibilities, negativity/instability regarding one's outlook, self-focus, and feeling in-between adolescence and adulthood. A growing literature examines the impact of genetic conditions on individuals who chronologically fit the emerging adulthood period. This systematized literature review uses the emerging adulthood theory to determine whether individuals living with or at-risk for a genetic condition experience the features of this period as well as similarities and differences between these two groups. A literature search yielded 1,303 peer-reviewed papers from the 17 years since emerging adulthood theory was published. Ten papers met inclusion criteria-five for those Living With a genetic condition (e.g., cystic fibrosis) and five for those At-Risk for a genetic condition (e.g., hereditary breast and ovarian cancer). Content analysis yielded themes consistent with the five emerging adulthood features for both individuals Living With and At-Risk for genetic conditions. Negativity/instability was most prevalent, and feeling in-between was least prevalent in both groups. Results further suggest unique challenges related to one's genetic conditions/risk with respect to independence (from family, healthcare providers), career/education, relationships/social life, family planning, and life perspective experiences. Salient differences were apparent between the groups in their experiences of the emerging adulthood features. For instance, Living With individuals reported challenges concerning their ongoing physical symptoms, whereas At-Risk individuals reported challenges regarding genetic testing decisions and anticipation of physical symptoms. Thus, emerging adults Living With and At-Risk for genetic conditions appear to experience the main emerging adulthood features, but they face unique challenges related to their genetic conditions/risk. Understanding emerging adults' experiences can aid genetic counselors in addressing their specific concerns.
成年初显期是指 18 至 29 岁之间的一个独特发展阶段,有五个特征:身份探索、尝试/可能性、对前景的消极/不稳定、自我关注和感觉自己处于青春期和成年期之间。越来越多的文献研究了遗传状况对符合成年初显期的个体的影响。本系统文献综述使用成年初显期理论来确定患有或有遗传疾病风险的个体是否经历了这一时期的特征,以及这两个群体之间的相似之处和不同之处。文献搜索在成年初显期理论发表后的 17 年中产生了 1303 篇同行评议论文。符合纳入标准的有 10 篇论文,其中 5 篇是关于患有遗传疾病(如囊性纤维化)的个体,5 篇是关于有遗传疾病风险(如遗传性乳腺癌和卵巢癌)的个体。内容分析产生了与患有和有遗传疾病风险的个体的五个成年初显期特征一致的主题。两个群体中,消极/不稳定最为普遍,介于两者之间的情况最少。结果进一步表明,与个人的遗传状况/风险相关的独特挑战涉及独立性(与家庭、医疗保健提供者)、职业/教育、关系/社交生活、计划生育和生活观点体验。两组在成年初显期特征的体验方面存在明显差异。例如,患有遗传疾病的个体报告了与其持续身体症状相关的挑战,而有遗传疾病风险的个体报告了与基因测试决策和对身体症状的预期相关的挑战。因此,患有遗传疾病和有遗传疾病风险的成年初显期个体似乎经历了主要的成年初显期特征,但他们面临与遗传状况/风险相关的独特挑战。了解成年初显期个体的体验可以帮助遗传咨询师解决他们的具体问题。