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Skúsenosti Žien S Poruchou Autistického Spektra So Získaním Diagnózy V Dospelom Veku: Význam Diagnostiky a Jej Súčasný Stav

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Skúsenosti Žien S Poruchou Autistického Spektra So Získaním Diagnózy V Dospelom Veku: Význam Diagnostiky a Jej Súčasný Stav Masarykova univerzita Filozofická fakulta Psychologický ústav Bakalárska práca Skúsenosti žien s poruchou autistického spektra so získaním diagnózy v dospelom veku: Význam diagnostiky a jej súčasný stav Erika Zbiňovská Vedúca práce: Mgr. Helena Klimusová, Ph.D. Brno, 2021 Abstrakt Jednou z tém súčasného výskumu porúch autistického spektra je porozumenie špecifikám autizmu u žien. Mnoho z nich je diagnostikovaných neskoro, preto si táto práca kladie za cieľ fenomenologicky predstaviť skúsenosti štyroch respondentiek so získaním diagnózy v dospelosti. Teoretická časť práce sa zaoberá definovaním porúch autistického spektra, prevalenciou a etiológiou, genderovými odlišnosťami, stratégiou sociálneho kamuflovania a tým, aké postupy a nástroje sa v súčasnosti využívajú pri diagnostikovaní autizmu. Za využitia interpretatívnej fenomenologickej analýzy bolo identifikovaných dohromady 8 hlavných tém: vnímanie vlastných zvláštností pred diagnostikou, ukrývanie svojho autentického ja, prežívanie neistoty, skúsenosť s diagnostikou, úľava v zmysle oslobodenia sa, opätovná strata slobody, skúsenosť s podpornými skupinami pre ľudí s PAS a prijímanie znovuobjavenej identity. Abstract One of the topics in current research on autism spectrum disorders is understanding the nature of autism in women. Many of them are diagnosed late, for this reason this bachelor’s thesis aims to phenomenologically present the experiences of four female respondents who received diagnosis in adulthood. The theoretical part of the thesis deals with the definition of autism spectrum disorders, their prevalence and etiology, gender differences, social camouflaging strategy and what practices and tools are currently used in the process of diagnosing autism. Using interpretative phenomenological analysis, a total of eight main topics were identified: perceiving one’s own peculiarities prior to being diagnosed, hiding one’s authentic self, experiencing uncertainty, experience with diagnostic process, relief in sense of liberation, repeated loss of freedom, experience with support groups for people with ASD and acceptance of rediscovered identity. Kľúčové slová autizmus u žien, diagnóza autizmu, neskorá diagnostika, interpretatívna fenomenologická analýza Key words autism in women, autism diagnosis, late diagnosis, Interpretative Phenomenological Analysis Čestné prehlásenie Prehlasujem, že som záverečnú bakalársku prácu vypracovala samostatne. Všetky zdroje, ktoré som pri písaní tejto práce použila, sú uvedené v zozname literatúry podľa predpisov Masarykovej univerzity. V Brne 3. mája 2021 Erika Zbiňovská Poďakovanie Za vedenie práce, cenné pripomienky a ľudský a povzbudivý prístup ďakujem Mgr. Helene Klimusovej, PhD. Za ochotu a podnetnú konzultáciu ohľadom interpretatívnej fenomenologickej analýzy som vďačná Mgr. Barbare Lášticovej, PhD. Veľká vďaka taktiež patrí všetkým zúčastneným respondentkám za ich dôveru, ochotu a otvorenosť v zdieľaní ich životných skúseností. Dlhodobo a hlboko vďačná som svojej rodine a blízkym za to, že sú, a že sú práve takí, akí sú. Aj vďaka nim som nazberala dostatok odvahy na chopenie sa témy, ktorú považujem za mimoriadne dôležitú. Zoznam použitých skratiek AS – Aspergerov syndróm DSM – Diagnostic and Statistical Manual of Mental Disorders IPA – Interpretatívna fenomenologická analýza MKN – Mezinárodní klasifikace nemocí PAS – Poruchy autistického spektra Obsah Úvod ................................................................................................................................................ 8 1. Definovanie porúch autistického spektra ................................................................................ 9 1.1. Z histórie ............................................................................................................................. 10 1.2. Súčasná klasifikácia ............................................................................................................ 12 1.2.1. MKN-10 / DSM-5 ....................................................................................................... 13 1.2.2. Triáda autizmu ............................................................................................................. 16 1.2.2.1. Sociálne interakcie a sociálne správanie .............................................................. 17 1.2.2.2. Komunikácia ......................................................................................................... 18 1.2.2.3. Predstavivosť, záujmy, hra ................................................................................... 19 1.2.3. Nešpecifické variabilné rysy ....................................................................................... 19 2. Prevalencia................................................................................................................................. 20 2.1. Pomer pohlaví ................................................................................................................. 21 3. Etiológia .................................................................................................................................... 22 4. Genderové špecifiká .................................................................................................................. 23 4.1. Neurologický profil ............................................................................................................ 23 4.2. Behaviorálne charakteristiky .............................................................................................. 25 5. Sociálne kamuflovanie .............................................................................................................. 26 5.1. Príčiny kamuflovania .......................................................................................................... 27 5.2. Dôsledky kamuflovania ...................................................................................................... 27 6. Súčasný priebeh diagnostiky ..................................................................................................... 29 6.1. Diagnostický proces u detí ................................................................................................. 29 6.1.1. Screening autizmu ....................................................................................................... 30 6.1.2. Diagnostické nástroje .................................................................................................. 31 6.2. Diagnostický proces u dospelých ....................................................................................... 32 6.2.1. Diagnostické nástroje určené pre dospelých ............................................................... 33 6.3. Girls‘ Questionnaire For Autism Spectrum Conditions ..................................................... 35 7. Výskumný cieľ .......................................................................................................................... 36 7.1. Osnova otázok .................................................................................................................... 36 8. Metóda výskumu ....................................................................................................................... 37 8.1. IPA – charakteristika .......................................................................................................... 37 8.2. Metóda zberu dát ................................................................................................................ 40 8.3. Výskumný súbor ................................................................................................................. 41 8.4. Etika výskumu .................................................................................................................... 42 8.5. Subjektívny vzťah k téme ................................................................................................... 42 8.6. Postup analýzy dát .............................................................................................................. 44 9. Výsledky .................................................................................................................................... 44 9.1. Popis skúseností jednotlivých prípadov ............................................................................. 45 9.2. Analýza hlavných tém ........................................................................................................ 53 9.2.1. Vnímanie vlastných zvláštností pred diagnostikou ..................................................... 53 9.2.2. Ukrývanie svojho autentického ja ............................................................................... 55 9.2.3. Prežívanie neistoty ....................................................................................................... 57 9.2.4. Skúsenosť s diagnostikou ............................................................................................ 58 9.2.5. Úľava v zmysle oslobodenia sa ................................................................................... 60 9.2.6. Opätovná strata slobody .............................................................................................. 63 9.2.7. Skúsenosť s podpornými skupinami pre ľudí s PAS ................................................... 65 9.2.8. Prijímanie znovuobjavenej identity ............................................................................. 67 10. Diskusia ..................................................................................................................................
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