Identity Functioning in Patients with an Eating Disorder: Developmental Trajectories throughout Treatment.

Increasing research has indicated a strong association between identity functioning and eating disorder (ED) symptomatology. However, a detailed investigation of identity throughout ED treatment is lacking. The present longitudinal study examined identity in inpatients with an ED and explored its simultaneous change with ED symptomatology throughout treatment. A total of 225 female patients completed questionnaires at admission. From these 225 patients participating at admission (Wave 1), 110 also participated in at least one additional measurement wave, with 43.64% (n = 48) participating at admission and during treatment, 16.36% (n = 18) participating at admission and at discharge, and 40% (n = 44) participating at admission, during treatment and at discharge. Questionnaires on identity synthesis, identity confusion, identity processes, and ED symptomatology were completed. Latent growth curve modeling was used to address the research questions. Throughout treatment, a decrease in identity confusion and an increase in identity synthesis and adaptive identity processes were found. Accordingly, increases in identity synthesis and identification with commitment were related to general decreases in the drive for thinness and body dissatisfaction. Similarly, such decreases in ED symptoms were related to general decreases in identity confusion and ruminative exploration. The present study points to an increase in identity functioning throughout treatment, and longitudinal associations between identity functioning and ED symptomatology were found. Helping patients to decrease their ruminative exploration and to increase their identification with previously made life commitments and treating body/weight concerns could both be helpful in ED treatment.

Inhabiting the body: Exploring the link between embodiment and identity in community adolescents.

The intricate relationship between the body and identity has been highlighted in previous studies. However, a holistic approach to the body that focuses on embodiment is lacking in research examining body - identity linkages. The current study (N = 917 adolescents; 58% female; Mage = 16.17, range = 14-19 years) examined the psychometric properties of a Dutch translation of the Experience of Embodiment Scale (EES) and explored the link between embodiment and personal identity. First, confirmatory factor analysis revealed a second-order factor structure for the EES and adequate reliability coefficients were obtained. Metric invariance across gender was demonstrated for the first- and second-order factors. Second, path analysis demonstrated that experiencing embodiment was positively associated with adaptive identity work. Third, five identity statuses emerged using cluster analysis. Adolescents in statuses reflecting less adaptive identity functioning displayed lower levels of embodiment. The EES shows promising indications of reliability and factor structure for assessing adolescents' Experience of Embodiment, and the present study demonstrates that embodiment is meaningfully related to identity functioning. These findings support the call for the adoption of a positive psychology framework within this research field, with attention given to more broadly defined body-related concepts such as embodiment.

Personal identity, somatic symptoms, and symptom-related thoughts, feelings, and behaviors in adolescence: Examining between- and within-person associations and the role of depressive symptoms.

Recent literature highlights the complex relationship between personal identity and body-related pathology, yet there is a lack of integrative longitudinal research on the relationship between identity and somatic symptoms. The present study investigated the longitudinal associations between identity functioning and (psychological characteristics of) somatic symptoms, and examined the role of depressive symptoms in this relationship. A total of 599 community adolescents (Time 1: 41.3% female; Mage = 14.93, SD = 1.77, range = 12-18 years) participated in three annual assessments. Using cross-lagged panel models, a bidirectional relationship between identity and (psychological characteristics of) somatic symptoms, mediated by depressive symptoms, emerged at the between-person level; whereas only a unidirectional relationship from psychological characteristics of somatic symptoms to identity functioning, mediated by depressive symptoms, emerged at the within-person level. Identity and depressive symptoms were bidirectionally related at both levels. The present study suggests that adolescent identity development is closely related to somatic and emotional distress.

Identity formation in adolescent and emerging adult cancer survivors: a differentiated perspective and associations with psychosocial functioning.

OBJECTIVE: Identity formation was investigated in adolescent and emerging adult cancer survivors from a (neo-)Eriksonian perspective by comparing survivors to control participants. In survivors, associations between identity and clinical/demographical variables and general and illness-specific functioning were investigated. DESIGN: Childhood cancer survivors (n = 125; Mage: 19.54; 47% male) were matched on age and gender with healthy controls (2:1). MAIN OUTCOME MEASURES: All participants completed identity questionnaires. Survivors reported on demographics, well-being (depressive symptoms, life satisfaction, physical functioning), and illness-specific experiences (PTSS, illness centrality, cancer self-identity, benefit finding, cancer-related worries). Medical records provided clinical information. RESULTS: Survivors did not differ from controls on identity synthesis or confusion or on the identity statuses resulting from cluster analysis on the identity dimensions (achievement, foreclosure, moratorium, diffusion). Identity synthesis related to better well-being and illness experiences, whereas confusion related to worse well-being and illness experiences. Youth in moratorium and diffusion reported lower well-being and more negative illness experiences. Associations between identity and demographical and clinical characteristics were inconsistent. CONCLUSIONS: This study revealed no significant differences in identity formation between cancer survivors and controls. However, survivors who struggle in their identity quest should be identified as they are at risk for poorer well-being and negative illness experiences.

Identity Formation, Body Image, and Body-Related Symptoms: Developmental Trajectories and Associations Throughout Adolescence.

Emerging evidence highlights the intricate link between identity and one's body, however, integrative longitudinal research on this identity-body interplay is lacking. The current study used three-wave longitudinal data (Time 1: N = 403; 52.1% female; Mage = 14.85, SD = 0.89, range = 13-19 years) spanning two years (2019-2021; T1 and T2 being pre-pandemic, T3 peri-pandemic) to identify identity trajectory classes and examine their co-development with negative and positive body image and various body-related variables (i.e., sociocultural pressures, internalization of appearance ideals, self-objectification, appearance comparison, and eating disorder symptoms). First, four identity classes emerged using latent class growth analysis (achievement, moratorium, carefree diffusion, and troubled diffusion). Second, using multigroup latent growth curve modeling, adolescents in less adaptive identity trajectory classes (i.e., engaging less in pro-active processes and more in ruminative processes) displayed higher levels of negative body image and body-related symptoms. The current study testified to the clinically meaningful associations linking identity formation to adolescents' body image and other body-related symptoms.

Trauma and self-harming behaviors in high school students: The mediating role of identity formation.

INTRODUCTION: This study investigated the link between trauma and self-harming behaviors in South African high school students, and examined the mediating role of identity formation. Traumatic experiences have been commonly associated with self-harming behaviors in adolescents. However, research addressing this association in non-Western countries is limited. METHODS: A total of 552 South African high school students aged 13-21 (60.4% female; Mage = 16 years) were included in the study. Students completed self-report questionnaires on traumatic experiences, identity formation, and self-harming behaviors (disturbed eating behaviors and suicidal thoughts and behaviors). RESULTS: Structural equation modelling indicated that the association between traumatic experiences and self-harming behaviors was partially mediated by identity formation. Traumatic experiences were associated with more identity diffusion, bulimia, and suicidal thoughts and behaviors. Identity diffusion, in turn, was associated with more drive for thinness, bulimia, body dissatisfaction, and suicidal thoughts and behaviors. Identity consolidation was positively associated with drive for thinness and negatively with body dissatisfaction and suicidal thoughts and behaviors. No moderation effects by gender or age were found. CONCLUSIONS: Traumatic experiences were associated with higher levels of identity diffusion, which, in turn, were associated with more self-harming behaviors in South African high school students. These findings suggest the importance of focusing on identity diffusion in prevention and intervention programs targeting self-harming behaviors.

Identity Functioning and Eating Disorder Symptomatology: The Role of Cognitive Emotion Regulation Strategies.

Introduction: Adolescence is the most critical life period for the development of eating disorder (ED) symptomatology. Although problems in identity functioning and emotion dysregulation have been proven important risk and maintaining factors of ED symptomatology, they have never been integrated in a longitudinal study. Methods: The present study is part of the Longitudinal Identity research in Adolescence (LIA)-study and aimed to uncover the temporal interplay between identity functioning, cognitive emotion regulation, and ED symptomatology in adolescence. A total of 2,162 community adolescents (Time 1: 54% female; M age = 14.58, SD = 1.88, range = 10-21 years) participated at three measurement points with 1-year intervals. They reported on identity functioning (identity synthesis and identity confusion), cognitive emotion regulation (rumination, catastrophizing, and positive reappraisal), and ED symptomatology (drive for thinness and bulimia symptoms). Results: Cross-lagged paths could be fixed for boys and girls and showed bidirectional associations between both dimensions of identity functioning and both rumination and catastrophizing over time. Similarly, these maladaptive cognitive emotion regulation strategies were bidirectionally related to ED symptomatology over time. Finally, indirect pathways pointed to bidirectional associations between both dimensions of identity functioning and bulimia symptoms through rumination and catastrophizing. Only unidirectional associations emerged for drive for thinness and almost no cross-lagged associations were found with positive reappraisal. Conclusion: The present study demonstrates that identity confusion may contribute to the development of ED symptomatology in adolescence through cognitive emotion dysregulation. It also reveals that these ED symptoms hamper identity development through emotion dysregulation. These results stress the importance of targeting both identity functioning and cognitive emotion regulation in the prevention and intervention of ED symptoms.

Non-Suicidal Self-Injury and Pathological Buying in Community Adults and Patients with Eating Disorders: Associations with Reactive and Regulative Temperament.

The present study investigated the (co-)occurrence of non-suicidal self-injury (NSSI) and pathological buying (PB) and their associations with reactive/regulative temperament in a sample of female patients with eating disorders (ED) and in a sample of community adults. Our samples consisted of 254 community adults (48.8% female) and 60 female patients with ED. All participants filled out self-report questionnaires to assess NSSI, PB, and reactive/regulative temperament. Prevalence rates of NSSI and PB were respectively 14.5% and 4.8% for community women, 13.1% and 1.5% for community men, and 36.7% and 10% for female patients with ED. Only for community women, NSSI was positively related to PB. NSSI was negatively related to self-regulation in community men and women. Additionally, NSSI was negatively predicted by BAS reactivity in the clinical sample and by the interaction of BAS reactivity and self-regulation in community men. PB was predicted by low self-regulation in the three groups. Additionally, PB was positively predicted by BAS reactivity and by the interaction of BAS reactivity and self-regulation in community women. These findings indicated group differences in the (co-)occurrence of NSSI and PB and in their associations with underlying temperamental characteristics between individuals with and without ED.