Naicker Vrinda V, Bury Simon M, Hedley Darren
Olga Tennison Autism Research Centre, School of Psychology and Public Health, La Trobe University, Melbourne, VIC, Australia.
Front Psychiatry. 2023 Jan 5;13:1079371. doi: 10.3389/fpsyt.2022.1079371. eCollection 2022.
Receiving a child's autism diagnosis can be stressful; as such, parent resolution contributes to the wellbeing and development of healthy parent-child relationships. In other significant childhood diagnoses (e.g., cerebral palsy, diabetes), the degree to which parents adjust to (a) their child's diagnosis and (b) their changes in expectations concerning their child's development and capacity (referred to as resolution to diagnosis), has been associated with improved outcomes including facilitating parent-child relationships and improved parental wellbeing. Given potential benefits to parent and child, and the heterogenous nature of autism, examining the unique factors associated with resolution to diagnosis is important. In this systematic review we identified factors that support or inhibit parental resolution to their child receiving a diagnosis of autism.
We completed a systematic review following PRISMA guidelines of peer-reviewed studies from 2017 to 2022, that investigated parental resolution or acceptance of an autism diagnosis. Papers including "acceptance" needed to encompass both accepting the diagnosis and the implications regarding the child's abilities. We searched six databases (Scopus, Web of Science, MEDLINE, PsycINFO, ProQuest), with additional papers located following review of reference lists.
Fourteen papers with 592 participants that investigated parental resolution or acceptance of an autism diagnosis, were included. We identified six common factors that facilitate or inhibit parental resolution and acceptance of an autism diagnosis including: symptom severity; religion, belief, and culture; knowledge and uncertainty; negative emotions (i.e., denial, shame, guilt); positive emotions; and support. Greater resolution was associated with improved "attunement and insightfulness" in the parent-child relationship.
The review was limited by the small number of studies meeting inclusion criteria. Second, the quality of included studies was mixed, with over half of the studies being qualitative and only one randomized control trial (RCT) identified.
Parental resolution can have an impact on parent's perception of their child's capabilities and impact the parent-child relationship. We identified six categories that aid in inhibiting or promoting resolution to diagnosis. Despite taking a broad approach on the definition of resolution, the low number of studies identified in the review indicates a need for more research in this area.
http://www.crd.york.ac.uk/PROSPERO/, PROSPERO [ID: CRD42022336283].
孩子被诊断为自闭症可能会给家长带来压力；因此，家长的心理调适有助于建立健康的亲子关系，促进孩子的幸福和成长。在其他重大儿童疾病诊断（如脑瘫、糖尿病）中，家长对（a）孩子的诊断结果以及（b）对孩子发展和能力期望的变化（即对诊断的心理调适）程度，与包括促进亲子关系和改善家长幸福感在内的更好结果相关。鉴于对家长和孩子都有潜在益处，且自闭症具有异质性，研究与对诊断的心理调适相关的独特因素很重要。在本系统评价中，我们确定了支持或抑制家长对孩子自闭症诊断心理调适的因素。
我们按照PRISMA指南对2017年至2022年的同行评审研究进行了系统评价，这些研究调查了家长对自闭症诊断的心理调适或接受情况。包含“接受”的论文需要涵盖接受诊断以及对孩子能力的影响。我们检索了六个数据库（Scopus、科学网、MEDLINE、PsycINFO、ProQuest），并在查阅参考文献列表后找到了其他论文。
纳入了14篇论文，共592名参与者，这些论文调查了家长对自闭症诊断的心理调适或接受情况。我们确定了六个促进或抑制家长对自闭症诊断心理调适和接受的共同因素，包括：症状严重程度；宗教、信仰和文化；知识与不确定性；负面情绪（即否认、羞耻、内疚）；积极情绪；以及支持。更好的心理调适与亲子关系中“更协调和有洞察力”相关。
本评价受到符合纳入标准的研究数量较少的限制。其次，纳入研究的质量参差不齐，超过一半的研究为定性研究，仅识别出一项随机对照试验（RCT）。
家长的心理调适会影响家长对孩子能力的认知，并影响亲子关系。我们确定了六个有助于抑制或促进对诊断心理调适的类别。尽管对心理调适的定义采取了宽泛的方法，但评价中识别出的研究数量较少表明该领域需要更多研究。
http://www.crd.york.ac.uk/PROSPERO/，PROSPERO [ID：CRD42022336283] 。
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