A Conceptual Framework for Understanding the Cultural and Contextual Factors on Autism Across the Globe.
A Conceptual Framework for Understanding the Cultural and Contextual Factors on Autism Across the Globe.
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DOI：
10.1002/aur.2276
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发表时间：
2020-07
期刊：
影响因子：
--
通讯作者：
Hoekstra RA
中科院分区：
文献类型：
--
作者：
de Leeuw A;Happé F;Hoekstra RA
自闭症研究严重偏向西方高收入国家。全球大多数自闭症人口居住的大多数低收入和中等收入环境中缺乏适合文化的自闭症筛查和诊断工具。迄今为止，对于可能影响自闭症谱系障碍患者的识别和诊断过程的可能的文化和背景因素尚缺乏清晰的概述。本研究旨在通过提出一个概念框架来概述这些因素。采用多学科审查方法为概念框架的发展提供信息，将对相关自闭症研究文献的系统审查与涵盖全球心理健康、文化精神病学、跨文化心理学和智力障碍研究关键文本的更广泛的文献检索相结合。由此产生的概念框架考虑了四个相互关联的层面上的识别、寻求帮助和诊断过程：i）表达，ii）识别，iii）解释和iv）报告自闭症症状，并描述了与每个层面相关的文化和背景因素，包括典型和非典型行为的文化规范，针对特定文化的养育方式，心理健康素养，文化信仰，态度和耻辱， 以及服务的可负担性、可用性、可及性和可接受性。该框架列出了影响自闭症识别、寻求帮助和诊断的文化和背景因素，可以作为开发适合文化的自闭症筛查和诊断工具的跳板，并为未来的跨文化自闭症研究方向提供信息。该框架还与临床医生和政策制定者相关，旨在改善对全球服务不足的自闭症人群的支持。
Autism research is heavily skewed towards western high-income countries. Culturally appropriate screening and diagnostic instruments for autism are lacking in most low- and middle-income settings where the majority of the global autism population lives. To date, a clear overview of the possible cultural and contextual factors that may affect the process of identifying and diagnosing individuals with ASD is missing. This study aims to outline these factors by proposing a conceptual framework. A multidisciplinary review approach was applied to inform the development of the conceptual framework, combining a systematic review of the relevant autism research literature with a wider literature search spanning key texts in global mental health, cultural psychiatry, cross-cultural psychology and intellectual disability research. The resulting conceptual framework considers the identification, help-seeking and diagnostic process at four interrelated levels: i) the expression, ii) recognition, iii) interpretation and iv) reporting of autism symptoms, and describes the cultural and contextual factors associated with each of these levels, including cultural norms of typical and atypical behaviour, culture-specific approaches to parenting, mental health literacy, cultural beliefs, attitudes and stigma, as well as the affordability, availability, accessibility and acceptability of services. This framework, mapping out the cultural and contextual factors that can affect the identification, help-seeking and diagnosis of ASD, may function as a springboard for the development of culturally appropriate autism screening and diagnostic instruments, and inform future cross-cultural autism research directions. The framework also has relevance for clinicians and policy makers aiming to improve support for underserved autism populations worldwide.
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影响因子：
6.2
作者：
Carruthers S;Kinnaird E;Rudra A;Smith P;Allison C;Auyeung B;Chakrabarti B;Wakabayashi A;Baron-Cohen S;Bakolis I;Hoekstra RA
通讯作者：
Hoekstra RA
影响因子：
6.4
作者：
Baghdadli, A;Picot, MC;Aussilloux, C
通讯作者：
Aussilloux, C
影响因子：
73.3
作者：
Bornstein, Marc H.
通讯作者：
Bornstein, Marc H.
影响因子：
2.6
作者：
Al-Dababneh, Kholoud Adeeb;Al-Zboon, Eman K.;Baibers, Haitham
通讯作者：
Baibers, Haitham
影响因子：
2.8
作者：
Brohan E;Slade M;Clement S;Thornicroft G
通讯作者：
Thornicroft G