How Misattributed Paternity Shapes Paternal Mental Health and Family Relationships: A Systematic Review

Authors

• Joy Eberechukwu Ezeaku, University of Nebraska-LincolnFollow

First Advisor

Katelyn Coburn

Committee Members

Blakelee Kemp, Cody Hollist

Date of this Version

4-2026

Document Type

Thesis

Citation

A thesis presented to the faculty of the Graduate College at the University of Nebraska in partial fulfillment of the requirements for the degree of Master of Science

Major: Child, Youth and Family Studies

Under the supervision of Professor Katelyn Coburn

Lincoln, Nebraska, April 2026

Comments

Copyright 2026, Joy Eberechukwu Ezeaku. Used by permission

Abstract

Direct-to-consumer DNA testing has transformed the discovery of biological relationships, resulting in more frequent unexpected parentage revelations outside clinical, legal, or counseling contexts (Becker et al., 2025; Grethel et al., 2023; Guerrini et al., 2022). Although research has predominantly examined adults making these discoveries, presumed and social fathers remain underrepresented, despite experiencing comparable disruptions (Avni et al., 2023; Muzingili et al., 2025; Robson et al., 2024). This review synthesizes evidence on three primary outcomes: changes in family relationships, identity shifts, and psychosocial effects following misattributed paternity or donor conception, with particular attention to fathers. Employing PRISMA 2020, the PEOS framework, the Mixed Methods Appraisal Tool, and narrative synthesis, the review identified 328 records across six databases. After removing 147 duplicates and screening 181 records, 18 full-text reports were assessed, resulting in the inclusion of 9 studies. The principal findings indicate frequent family relationship breakdowns, identity destabilization, and outcomes influenced by secrecy, discovery context, and cultural factors. In studies centered on fathers, non-paternity disclosure often undermined identity, partner trust, social standing, and paternal roles, especially in cultures linking fatherhood to masculinity and lineage. Most of the evidence derives from descriptive qualitative studies (Thelingwani et al., 2024), with limited research employing standardized measures for fathers or examining long-term outcomes. Further research is warranted to address these gaps, particularly regarding fathers and longitudinal effects.

Advisor: Katelyn Coburn