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1.
Front Genet ; 15: 1380637, 2024.
Article in English | MEDLINE | ID: mdl-39050256

ABSTRACT

Individuals harboring breast cancer gene 1/2 (BRCA1/2) pathogenic variants are at increased lifetime risk for developing cancer. Learning one's BRCA1/2 carrier status is a watershed moment that can result in psychological distress, anxiety, and depression, as well as feelings of vulnerability and stigma. However, emotional and coping responses to learning one's BRCA1/2 carrier status and after risk-reducing interventions (i.e., preventative bilateral mastectomy) are variable, and existing literature reveals mixed and sometimes contradictory results. Drawing on the concept of narrative identity from the field of psychology, we sought to examine if "identity theft" (the sudden overtaking of one's narrative agency by an external force) may help explain the heterogeneity of emotional and coping responses following the revelation of BRCA carrier status and the subsequent medical intervention one may receive. This Perspective explores BRCA related identity theft using two case studies. Narrative analysis of qualitative interviews uncover the ways that patients experience the disintegration (theft) of their identity as well as their efforts to build and reintegrate a new BRCA carrier identity. This initial qualitative exploration provides preliminary support for the relevance of narrative identity and identity theft to hereditary cancer. We posit that applying the lens of identity theft may hold promise as a unifying concept, integrating across the variable emotional and coping responses among BRCA carriers. Employing a lens of identity theft may help inform the development of tailored narrative interventions as part of precision healthcare to support active coping and psychosocial wellbeing.

2.
Res Integr Peer Rev ; 9(1): 2, 2024 Feb 16.
Article in English | MEDLINE | ID: mdl-38360805

ABSTRACT

Journal editors have a large amount of power to advance open science in their respective fields by incentivising and mandating open policies and practices at their journals. The Data PASS Journal Editors Discussion Interface (JEDI, an online community for social science journal editors: www.dpjedi.org ) has collated several resources on embedding open science in journal editing ( www.dpjedi.org/resources ). However, it can be overwhelming as an editor new to open science practices to know where to start. For this reason, we created a guide for journal editors on how to get started with open science. The guide outlines steps that editors can take to implement open policies and practices within their journal, and goes through the what, why, how, and worries of each policy and practice. This manuscript introduces and summarizes the guide (full guide: https://doi.org/10.31219/osf.io/hstcx ).

4.
Rehabil Psychol ; 68(4): 351-361, 2023 Nov.
Article in English | MEDLINE | ID: mdl-37470994

ABSTRACT

PURPOSE/OBJECTIVE: The COVID-19 pandemic has exacerbated existing health inequities for people with disabilities (PWD), including disparities in mental health needs and service use. The present study investigated prospective predisposing, enabling, and illness-related correlates of mental health service need and use among PWD during the COVID-19 pandemic. RESEARCH METHOD/DESIGN: Data were collected online at two time points: October-December 2020 and October-December 2021. U.S. adults with disabilities completed self-report measures on demographic and disability characteristics, pandemic-related stressors (e.g., worries about COVID-19), depression, anxiety, barriers to service use, and perceived mental health needs and service use. Two logistic regressions were used to examine the effect of predisposing, enabling, psychosocial barriers, and illness-related factors on perceived mental health service need and service use. RESULTS: Perceptions of mental health service needs were significantly predicted by gender (female-identified, transgender and gender diverse [TGD]), younger age, increased depressive symptoms, and presence of a prepandemic mental health condition. Among those who reported a perceived need, mental health service use was predicted by gender (female-identified and TGD), greater income, lower frequency of anticipated provider disability bias, and presence of a prepandemic mental health condition. CONCLUSIONS/IMPLICATIONS: This study provides vital descriptive data on the pattern of mental health service utilization among PWD during the COVID-19 pandemic, a uniquely disruptive, challenging time. Findings further underscore the necessity of providing disability competency training and bias reduction interventions to mental health professionals, as anticipated provider disability bias was a key factor in nonservice use of PWD. (PsycInfo Database Record (c) 2023 APA, all rights reserved).


Subject(s)
COVID-19 , Disabled Persons , Mental Health Services , Adult , Humans , Female , Pandemics , Prospective Studies
5.
J Pers ; 91(1): 5-13, 2023 02.
Article in English | MEDLINE | ID: mdl-36176226

ABSTRACT

This Special Issue of Journal of Personality, focused on psychobiographies of social change agents, aims to make contributions to the field in terms of content, method, and process. The content of the issue is focused on understanding people who powerfully impact their world, from eminent global leaders to everyday change agents. The contributions to the Special Issue are unified by their adoption of psychobiographical methods, though as a set they offer both excellent representations of common psychobiographical approaches as well as vital innovations in this tradition. The process of curating this Special Issue sought to make several interventions in typical practices, including the cultivation of an intentional community of scholars representing both experienced and fledgling psychobiographers, the pursuit of a relational approach to publishing, and the adoption of open science practices. Psychobiography has an important role to play in contemporary personality psychology and we hope this Special Issue will itself serve as a foundation for continued innovation in the field.


Subject(s)
Personality , Social Change , Humans , Personality Disorders
6.
J Res Pers ; 101: 104302, 2022 Dec.
Article in English | MEDLINE | ID: mdl-36185499

ABSTRACT

This study examines narrative identity among a large, diverse sample of people with disabilities (PWDs) in the United States during the "second wave" of the Covid-19 pandemic (October-December 2020). The study relied on abductive analyses, combining a purely inductive phase of inquiry followed by two rounds of investigation that filtered inductive insights through three theoretical lenses: social-ecological theory, the theory of narrative identity, and perspectives from the interdisciplinary field of disability studies. The central result was the identification of a particular configuration of self, one that was demonstrably interdependent with both immediate interpersonal contexts and with broader cultural contexts. This interdependent self was interpreted in both positive and negative ways by PWDs. These findings invite future inquiry into commonplace conceptualizations of an independent self at the center of personality research and suggest that dominant conceptualizations of "the good life" may overly emphasize independence.

7.
Pers Soc Psychol Rev ; 26(2): 87-92, 2022 May.
Article in English | MEDLINE | ID: mdl-35057665
8.
Rehabil Psychol ; 67(2): 179-188, 2022 May.
Article in English | MEDLINE | ID: mdl-35084914

ABSTRACT

PURPOSE/OBJECTIVE: Emerging research has highlighted sources of magnified stress and trauma for people with disabilities during the COVID-19 pandemic, as compared to others in the general population. However, little research has examined the mental health impact of the pandemic on people with disabilities in relation to disability-related stigma, social isolation, and demographic characteristics. The present study therefore sought to identify predictors of depression and anxiety symptoms among U.S. adults with disabilities during the COVID-19 pandemic. RESEARCH METHOD/DESIGN: Data were collected online between October and December 2020. U.S. adults with disabilities (n = 441) completed self-report measures of depression, anxiety, psychosocial processes, and a range of demographic and disability characteristics. RESULTS: In our sample, 61.0% and 50.0% of participants met criteria for a probable diagnosis of major depressive disorder and generalized anxiety disorder, respectively. Participants also experienced significantly higher levels of disability-related stigma and social isolation compared to prepandemic norms. Hierarchical regression analyses identified higher social isolation, presence of chronic pain, younger age, higher disability-related stigma, and higher worries about contracting COVID-19 as significant predictors of both depression and anxiety symptoms. CONCLUSION/IMPLICATIONS: This study highlights important demographic and psychosocial predictors of mental health risks for people with disabilities in the context of COVID-19. Findings further underscore the need to attend to those at elevated risk within the disability community as rehabilitation professionals, disability organizations, and policy makers work to support people with disabilities in postpandemic recovery and create a more equitable response to ongoing and future public health crises. (PsycInfo Database Record (c) 2022 APA, all rights reserved).


Subject(s)
COVID-19 , Depressive Disorder, Major , Disabled Persons , Adult , Anxiety/diagnosis , Anxiety/epidemiology , Anxiety Disorders/diagnosis , Anxiety Disorders/epidemiology , Depression/diagnosis , Depression/epidemiology , Depressive Disorder, Major/epidemiology , Humans , Pandemics , SARS-CoV-2
9.
Dev Psychol ; 57(11): 1981-1990, 2021 Nov.
Article in English | MEDLINE | ID: mdl-34914458

ABSTRACT

Though Erikson recognized identity development as a lifelong project, most research on identity has focused on adolescents and emerging adults. Less is known about how the identity formed in adolescence is maintained and adapted across the adult life span. The purpose of the present paper is to provide a conceptual review and elaboration of Erikson's (1968) theory focused on identity integration, a construct that is particularly relevant to adult identity development. Identity integration describes the process of bringing together various aspects of one's self into a coherent whole, and the sense of self-continuity and wholeness that emerges as a result of these processes. Informed by the identity and life span development literatures, we present a conceptual framework that describes how identity integration is maintained across the adult life span, and how it is reestablished when changing life circumstances present threats to an individual's identity. These maintenance and reestablishment processes help to support adults' well-being and adaptation to major life transitions and stressful events. This conceptual framework is intended to facilitate research on identity integration in adulthood, a time of life that has been less often studied in the identity literature but that can involve identity dynamics that are just as critical as those in adolescence. (PsycInfo Database Record (c) 2021 APA, all rights reserved).


Subject(s)
Adolescent Development , Models, Psychological , Social Identification , Adolescent , Adult , Humans , Self Concept
10.
J Pers ; 89(1): 84-112, 2021 Feb.
Article in English | MEDLINE | ID: mdl-31837271

ABSTRACT

OBJECTIVE: This qualitative investigation focused on identity integration in a sample of individuals who acquired physical disabilities in adulthood. It also argues for the importance and ethics of these methods in the broader field of scholarship on personality change following adversity. METHOD: Thirteen adults participated in the study. Participants engaged in an expanded Life Story Interview wherein they narrated the story of their life, including a section devoted to their story of acquiring a physical disability. In addition, participants completed questionnaires concerning their psychological well-being and maturity. RESULTS: We identified two dimensions of narrative themes participants used in grappling with identity integration: one represented active processing of one's life experiences and the other represented the extent to which participants described their identity as wholly transformed by the experience of acquiring a disability. When overlaid, these dimensions yielded four narrative strategies titled: Adapters, Wanderers, Drifters, and Resisters. We also observed that Adapters seemed to have better psychological well-being and maturity than the other groups. CONCLUSIONS: This study offers a foundation for future scholarship on identity among people with disabilities. It also describes the contexts in which retrospective, qualitative methods are especially appropriate for research on personality change following adversity.


Subject(s)
Disabled Persons , Narration , Adult , Humans , Personality Disorders , Retrospective Studies , Surveys and Questionnaires
11.
Curr Psychiatry Rep ; 22(12): 67, 2020 10 09.
Article in English | MEDLINE | ID: mdl-33034756

ABSTRACT

PURPOSE OF REVIEW: Identity is one of the key domains that is disturbed in people manifesting personality disorder (PD). Within the field of personality psychology, there is a robust approach to studying identity focused on narrative identity which has been largely overlooked in studying PD. In this paper, a systematic review was conducted of studies published in the past decade that focused on how individuals manifesting personality pathology craft their narrative identity. RECENT FINDINGS: This review revealed disturbances related to several motivational/affective themes (e.g., negative valence/valence shifts and thwarted themes of agency and communion), autobiographical reasoning (negative self-inferences), and structural elements (e.g., low coherence and fewer life script events) within the narrative identity of people who manifest PD. Narrative identity is disturbed in people experiencing personality pathology and may have crucial implications for enhancing our conceptual understanding of PD and for PD interventions. This review also points to several research limitations and gaps that we encourage the field to pursue in the future.


Subject(s)
Narration , Self Concept , Humans , Motivation , Personality , Personality Disorders
12.
J Pers Soc Psychol ; 119(4): 920-944, 2020 Oct.
Article in English | MEDLINE | ID: mdl-30998044

ABSTRACT

A robust empirical literature suggests that individual differences in the thematic and structural aspects of life narratives are associated with and predictive of psychological well-being. However, 1 limitation of the current field is the multitude of ways of capturing these narrative features, with little attention to overarching dimensions or latent factors of narrative that are responsible for these associations with well-being. In the present study we uncovered a reliable structure that accommodates commonly studied features of life narratives in a large-scale, multi-university collaborative effort. Across 3 large samples of emerging and midlife adults responding to various narrative prompts (N = 855 participants, N = 2,565 narratives), we found support for 3 factors of life narratives: motivational and affective themes, autobiographical reasoning, and structural aspects. We also identified a "functional" model of these 3 factors that reveals a reduced set of narrative features that adequately captures each factor. Additionally, motivational and affective themes was the factor most reliably related to well-being. Finally, associations with personality traits were variable by narrative prompt. Overall, the present findings provide a comprehensive and robust model for understanding the empirical structure of narrative identity as it relates to well-being, which offers meaningful theoretical contributions to the literature, and facilitates practical decision making for researchers endeavoring to capture and quantify life narratives. (PsycInfo Database Record (c) 2020 APA, all rights reserved).


Subject(s)
Individuality , Narration , Adult , Female , Humans , Male , Middle Aged , Motivation , Personality , Young Adult
13.
Brain Behav Immun ; 77: 101-109, 2019 03.
Article in English | MEDLINE | ID: mdl-30579939

ABSTRACT

BACKGROUND: Chronic caregiving stress may accelerate biological aging; however, the ability to integrate the meaning of caregiving through self-awareness, adaptation, and growth can buffer the negative effects of stress. Narrative researchers have shown that people who coherently integrate difficult experiences into their life story tend to have better mental health, but no prior study has examined the prospective association between narrative identity and biological indicators, such as telomere length. We tested whether narrative identity might be prospectively associated with resilience to long-term parenting stress, depressive symptoms, and protection from telomere shortening, especially among caregivers. METHODS: We conducted a semi-structured interview about parenting and quantified narrative themes by applying well-validated, standardized coding systems with high inter-rater reliability among 88 mothers: 32 "caregivers" (mothers with a child diagnosed with an autism spectrum disorder), and 56 "controls" (mothers with a neurotypical child). To assess longitudinal changes, we measured mental health (parenting stress [PS], depressive symptoms [DS]) and leukocyte telomere length [LTL], a biomarker of aging, at baseline and again 18 months later. We examined whether narrative identity themes were related to these outcomes and whether associations differed across caregivers versus controls. RESULTS: Caregivers exhibited significantly higher basal levels of PS and DS relative to controls (all p's < .05), but no significant difference in LTL (p > .05). Caregivers rated higher in the narrative theme of integration showed healthier future 18-month trajectories in PS (B = -0.832, 99% CI: [-1.315, -0.155], p < .01) and LTL (B = 1.193, 99% CI: [0.526, 2.130], p < .01), but no differences in depressive symptoms (p > .05), adjusting for age and antidepressant use. Analyses examining affective themes in caregiver narratives did not demonstrate significant associations. Narrative themes did not predict outcomes in controls. CONCLUSIONS: The data suggest that narratives reflecting coherent integration, but not necessarily affect, prospectively relate to psychological and biological stress resilience. Maternal caregivers' ability to tell an integrated story of their parenting experiences forecasts lower parenting stress and telomere shortening over time. This study suggests the possibility that helping individuals better integrate the meaning of stressful experiences, but not necessarily to affectively redeem them, may constitute a potential novel target for intervention among chronically stressed populations such as caregivers.


Subject(s)
Caregivers/psychology , Stress, Physiological/physiology , Telomere/physiology , Adult , Cellular Senescence/physiology , Depression/psychology , Female , Humans , Leukocytes , Mental Health , Mothers , Narration , Narrative Therapy/methods , Parenting/psychology , Prospective Studies , Reproducibility of Results , Resilience, Psychological , Stress, Psychological/genetics , Stress, Psychological/psychology , Surveys and Questionnaires , Telomere Shortening/physiology
14.
J Pers Assess ; 100(6): 593-602, 2018.
Article in English | MEDLINE | ID: mdl-29902081

ABSTRACT

The DSM-5 Section III alternative model for personality disorders (AMPD) is a personality disorder (PD) nosology based on severity of personality dysfunction and pathological traits. We examined the degree to which the personality constructs identified by McAdams and Pals (2006; dispositional traits, characteristic adaptations, narrative identity) and the paradigms of personality assessment described by Wiggins (2003; psychodynamic, interpersonal, personological, multivariate, empirical) are represented within the AMPD. Nine raters expert with the AMPD and personality evaluated elements of Criterion A and the 25 trait facets of Criterion B for presence of type and degree of personality constructs and paradigms, as well as level of inference. Criterion B showed higher rater agreement compared to Criterion A. Criteria A and B reflect different configurations of construct, paradigm, and level of inference. The characteristic adaptation construct and interpersonal paradigm were strongly reflected in both Criteria A and B. The psychodynamic and personological paradigms and the narrative identity construct were highly correlated, and the multivariate, empirical, and dispositional traits variables were highly correlated. Results illustrate differential conceptual emphases as well as areas of overlap with Criteria A and B. This characterization highlights that PD nosology rests on personality theory and suggests implications for integrative PD assessment.


Subject(s)
Models, Psychological , Personality Assessment/standards , Personality Disorders/diagnosis , Personality , Diagnostic and Statistical Manual of Mental Disorders , Humans , Personality Inventory/standards , Surveys and Questionnaires/standards , Symptom Assessment
15.
J Pers ; 86(5): 803-824, 2018 Oct.
Article in English | MEDLINE | ID: mdl-29222912

ABSTRACT

OBJECTIVE: Personality psychology has largely ignored the experiences of people with disabilities. This article strives to bring the thriving, interdisciplinary field of disability studies to personality psychology via a case study of Samantha (N = 1). Samantha feels that she grew up as a hearing person who could not hear and is now a deaf person who can hear. METHOD: Narrative identity provides the theoretical, methodological, and analytical framework for the rich, qualitative examination of Samantha's life story, interwoven with approaches from disability studies and intersectionality theory. Two Life Story Interviews (McAdams, 2008), conducted 2 weeks prior to Samantha's cochlear implant surgery and again 7 weeks after the surgery, provide the foundation for this case study and are interpreted alongside additional self-report measures. Grounded theory methods were used to interpret Samantha's narrative identity. RESULTS: Samantha's story demonstrates the ways in which narrative identity can serve as a foundation for meaning and psychological well-being, as well as a demonstration of the ways in which the study of identity can be enriched by perspectives from disability studies. CONCLUSIONS: As an initial effort at integrating personality psychology and disability studies, this article sought to approach this task by privileging ethical representation over generalizability.


Subject(s)
Cochlear Implantation/psychology , Deafness/psychology , Disabled Persons/psychology , Personality/physiology , Self Concept , Adult , Female , Humans
16.
Pers Soc Psychol Rev ; 20(2): 142-75, 2016 May.
Article in English | MEDLINE | ID: mdl-25968138

ABSTRACT

Grounded in four theoretical positions-structural, cognitive, phenomenological, and ethical-the present review demonstrates the empirical evidence for the incremental validity of narrative identity as a cross-sectional indicator and prospective predictor of well-being, compared with other individual difference and situational variables. In doing so, we develop an organizational framework of four categories of narrative variables: (a) motivational themes, (b) affective themes, (c) themes of integrative meaning, and (d) structural elements. Using this framework, we detail empirical evidence supporting the incremental association between narrative identity and well-being, a case that is strongest for motivational, affective, and integrative meaning themes. These categories of themes serve as vital complimentary correlates and predictors of well-being, alongside commonly assessed variables such as dispositional personality traits. We then use the theoretically grounded review of the empirical literature to develop concrete areas of future research for the field.


Subject(s)
Emotional Adjustment , Personal Narratives as Topic , Self Concept , Forecasting , Humans , Models, Psychological , Reproducibility of Results
17.
J Pers Soc Psychol ; 108(3): 476-96, 2015 Mar.
Article in English | MEDLINE | ID: mdl-25751718

ABSTRACT

This article presents 2 longitudinal studies designed to assess the relationship between variability in narrative identity and trajectories of mental health over several years. In Study 1, core scenes from 89 late-mid-life adults' life stories were assessed for several narrative themes. Participants' mental health and physical health were assessed concurrently with the narratives and annually for the subsequent 4 years. Concurrent analyses indicated that the themes of agency, redemption, and contamination were significantly associated with mental health. Longitudinal analyses indicated that these same 3 themes were significantly associated with participants' trajectories of mental health over the course of 4 years. Exploratory analyses indicated that narratives of challenging experiences may be central to this pattern of results. In Study 2, similar longitudinal analyses were conducted on a sample of 27 late-mid-life adults who received a major physical illness diagnosis between the baseline assessment and 6 months later and a matched sample of 27 control participants who remained healthy throughout the study. Participants' mental health and physical health were assessed every 6 months for 2 years. In this study, the themes of agency, communion, redemption, and contamination in participants' life narratives collected at baseline (before any participant became sick) were significantly associated with mental health in the group of participants who went on to receive a medical diagnosis, but not in the control group. Taken together, the results of these 2 studies indicate that the way an individual constructs personal narratives may impact his or her trajectory of mental health over time.


Subject(s)
Mental Health , Self Concept , Disease/psychology , Female , Health Status , Humans , Longitudinal Studies , Male , Middle Aged , Narration , Personal Satisfaction , Psychiatric Status Rating Scales , Self-Assessment , Surveys and Questionnaires
18.
J Consult Clin Psychol ; 81(5): 839-45, 2013 Oct.
Article in English | MEDLINE | ID: mdl-23875822

ABSTRACT

OBJECTIVE: The present study had two aims: (a) to replicate previous findings regarding the characteristics of sudden gains (SGs) in psychotherapy under routine clinical conditions and (b) to examine whether clients' narrative meaning-making processes were associated with SGs in mental health. METHOD: 54 psychotherapy clients completed the Systemic Therapy Inventory of Change (Pinsof et al., 2009) and wrote private narratives prior to beginning treatment and between every session for 12 assessment points over the course of psychotherapy for a variety of presenting problems. Clients' narratives were coded using existing systems (Adler, 2012; A. M. Hayes, Feldman, & Goldfried, 2006) to assess their content in eight themes: processing, avoidance, coherence, positive self, negative self, agency, hope, and hopelessness. RESULTS: The prevalence, magnitude, and timing of SGs in mental health observed in the present study were similar to those observed in prior research. Two narrative meaning-making processes-processing and coherence-were significantly associated with SGs in mental health. CONCLUSION: The present study significantly extends prior research on SGs, replicating the characteristics of these gains in routine clinical conditions with a measure of general functioning and identifying two narrative meaning-making processes that are associated with SGs in mental health.


Subject(s)
Mental Disorders/therapy , Narration , Psychotherapy/methods , Surveys and Questionnaires/standards , Treatment Outcome , Adult , Female , Humans , Male , Mental Disorders/diagnosis , Middle Aged , Prospective Studies , Psychiatric Status Rating Scales , Qualitative Research , Random Allocation , Reproducibility of Results , Single-Blind Method
19.
J Pers ; 81(6): 595-605, 2013 Dec.
Article in English | MEDLINE | ID: mdl-22812587

ABSTRACT

This article provides an overview of the emerging field of research on clients' stories about their experiences in psychotherapy. The theory of narrative identity suggests that individuals construct stories about their lives in order to provide the self with a sense of purpose and unity. Psychotherapy stories serve both psychological functions. Focusing on the theme of agency as a vehicle for operationalizing purpose and coherence as a way of operationalizing unity, this article will describe the existing scholarship connecting psychotherapy stories to clients' psychological well-being. Results from cross-sectional qualitative and quantitative studies as well as longitudinal research indicate a connection between the stories clients tell about therapy and their psychological well-being, both over the course of treatment and after it is over. In addition, a preliminary analysis of therapists' stories about their clients' treatment is presented. These analyses reveal that the way therapists recount a particular client's therapy does not impact the relationships between clients' narratives and their improvement. The article concludes with a discussion of how this body of scholarship might be fruitfully applied in the realm of clinical practice.


Subject(s)
Health Personnel , Mental Disorders/psychology , Narration , Psychotherapy , Humans , Mental Disorders/therapy
20.
J Pers Disord ; 26(4): 498-512, 2012 Aug.
Article in English | MEDLINE | ID: mdl-22867502

ABSTRACT

While identity disturbance has long been considered one of the defining features of Borderline Personality Disorder (BPD), the present study marks only the third empirical investigation to assess it and the first to do so from the perspective of research on narrative identity. Drawing on the rich tradition of studying narrative identity, the present study examined identity disturbance in a group of 40 mid-life adults, 20 with features of BPD and a matched sample of 20 without BPD. Extensive life story interviews were analyzed for a variety of narrative elements and the themes of agency, communion fulfillment (but not communion), and narrative coherence significantly distinguished the stories of those people with features of BPD from those without the disorder. In addition, associations between the theme of agency and psychopathology were evident six and twelve months following the life story interview. This study seeks to bridge the mutually-informative fields of research on personality disorders and normal identity processes.


Subject(s)
Borderline Personality Disorder/psychology , Identification, Psychological , Identity Crisis , Narration , Self Concept , Attitude to Health , Empirical Research , Female , Humans , Male , Mental Health , Middle Aged , Regression Analysis , Self Efficacy , Sense of Coherence , Surveys and Questionnaires
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