Lupindo Bomikazi M, Maw Anastasia, Shabalala Nokuthula
University of Cape Town, Cape Town, South Africa.
Midrand, South Africa.
Curr Psychol. 2022 Aug 3:1-17. doi: 10.1007/s12144-022-03514-z.
Autism Spectrum Disorder (ASD) is a pervasive neurodevelopmental disorder associated with qualitative impairments in social interaction, social communication and restricted, repetitive behaviour (American Psychiatric Association, 2013). Symptoms of ASD are first evident in infancy and childhood. However, individuals presenting with less overt ASD symptomatology may only be diagnosed in adulthood, when the expectation of independence and productivity results in a growing crisis for the individual. This study applied an exploratory qualitative research design to explore first-hand experiences of ten adult males (25 years and above) who were diagnosed with autism during their adulthood. Purposive sampling was used to select participants through the Neurodiversity Centre, Cape Town, South Africa. In-depth one-on-one interviews, guided by a semi-structured interview schedule were conducted. The thematic analysis technique and NVivo 12 qualitative analysis software were used to organise the data and identify themes. Three key themes emerged: failure to diagnose ASD in childhood despite signs and symptoms, ramifications of missed/misdiagnosis in childhood and adulthood on psychological well-being and the impact of receiving a diagnosis of ASD in adulthood. Missed/misdiagnosis had serious implications for psychological well-being throughout childhood and into adulthood. Late diagnosis resulted in missed opportunities for early intervention to address impairments associated with ASD. Receiving a diagnosis provided an explanation for long standing difficulties, offered a way forward in terms of developing coping strategies and allowed for self-acceptance. The implications of these findings for the development of better early screening and assessment for ASD are discussed and future research pathways suggested.
自闭症谱系障碍(ASD)是一种广泛性神经发育障碍,与社交互动、社交沟通方面的质性损害以及局限的、重复的行为有关(美国精神病学协会,2013年)。ASD的症状在婴儿期和儿童期首次显现。然而,那些ASD症状不太明显的个体可能直到成年才被诊断出来,此时对独立和生产力的期望给个体带来了日益严重的危机。本研究采用探索性定性研究设计,以探究十名成年男性(25岁及以上)在成年期被诊断为自闭症的第一手经历。通过南非开普敦的神经多样性中心采用目的抽样法选取参与者。在一份半结构化访谈提纲的指导下进行了深入的一对一访谈。运用主题分析技术和NVivo 12定性分析软件来整理数据并识别主题。出现了三个关键主题:尽管有症状和体征但在儿童期未诊断出ASD、儿童期和成年期漏诊/误诊对心理健康的影响以及成年期被诊断为ASD的影响。漏诊/误诊在整个儿童期及成年期对心理健康都有严重影响。诊断延迟导致错失早期干预以解决与ASD相关损害的机会。获得诊断为长期存在的困难提供了解释,为制定应对策略指明了方向,并有助于自我接纳。讨论了这些发现对改进ASD早期筛查和评估的意义,并提出了未来的研究方向。