Identity development & psychopathology

Question 1

wat zijn de transitionele levensfasen

Answer 1

adolescence and young adulthood, 12-30
- many changes take place: physical maturation, cognitive maturation, social changes, societal demands, expectations increase….
- making a transition from childhood to adulthood
- shifting from dependence to independence

Question 2

wanneer identity development

Answer 2

this is a lifelong process, changing life circumstances means you need to adapt something

Question 3

4 types of identity functioning

Answer 3

1. identity synthesis/consolidation
2. identity confusion
3. identity disturbance
4. lack of identity

Question 4

identity synthesis/consolidation

Answer 4

most adaptive, we feel unique and integrated. we have a sense of continuity, feel like we are the same person through time, coherence between all the different identities (cultural, individual, etc).

Question 5

identity confusion

Answer 5

usually a small period.
sense of a lack of continuance, coherence, not a persistent self.

-> depression, anxiety, confusion

Question 6

identity disturbance

Answer 6

long lasting, still not knowing what you are or what you want in life. lastig om keuzes te maken, omdat je niet goed weet wat bij jou past.

-> borderline patients usually experience this

Question 7

lack of identity

Answer 7

geen gevoel dat je uniek bent, feeling fragmented, broken, empty inside.

Question 8

the 4 types of identity functioning depend on their sense of….

Answer 8

• distinctiveness: having a sense of being unique and disting from others (i am me)
• continuity: having a sense of being the same person over time (i am still me)
• coherence: having a sense of being the same person across life domains (i am a whole)

Question 9

wat mist er dus bij lack of identity

Answer 9

distinctiveness

Question 10

waarom is het lastig om te differentieren tussen typisch en atypische identiteitsontwikkeling

Answer 10

• lastig bepalen of het een continuum is of echt verschillende dimensies
• periodes van identity confusion are normal and adaptive
• when should confusion give way to consolidation?

Question 11

which factors are considered to impact identity development?

Answer 11

• early life experiences (attachment, childhood trauma…)
• internal factors (personality traits, ethnicity, curiosity…)
• external factors (media, peers….)

Question 12

patroon van identity synthesis over time

Answer 12

• first: decrease
• then: increase
• later: decrease

correspondeert met starten met school en daarna starten op de arbeidsmarkt/uni -> dit is dus adaptief!

Question 13

percentages voor identity confusion:
- adaptive
- diffused
- progression
- regression

Answer 13

• adaptive: 70%
• diffused: 12%
• progression: 8%
• regression: 10%

Question 14

two processes in the development of a sense of identity

Answer 14

• exploration: exploration in breadth, exploration in depth, ruminative exploration
• commitment: commitment making, identification with commitment

Question 15

exploration in adolescence vs late twenties

Answer 15

in late twenties more rumination due to social pressure

Question 16

commitment in adolescence vs late twenties

Answer 16

commitment processes increase more linearily

Question 17

identity formation assessment via surveys nadelen

Answer 17

• Self-report and other informants (e.g., parents or partner) bias
• Operationalize identity as a global construct (dit is niet handig: mensen kunnen verschillen op verschillende domeinen (wel weten wat voor vriend je bent, niet wat voor carriere je wil))
• Fail to distinguish normative and pathological identity formation
• Fail to provide a contextualized, comprehensive understanding of identity formation

Question 18

if you could see identity, it would be a story

Answer 18

ok

Question 19

voorbeeld identiteitsurvey

Answer 19

Self-Concept and Identity Measure (SCIM)

• consolidated identity
• disturbed identity
• lack of identity

Question 20

identity formation assessment via stories

Answer 20

• Written or told stories about personally significant events that are, at their core, about identity (narrative identity)
• The stories we tell about ourselves reveal, construct, and sustain ourselves over time
• Stories are based on facts and interpretations, and provide insight into what experience mean to individuals
• but: a lot of different ways in which these stories can be quantified (not clear)

Question 21

focus of quantifying stories today

Answer 21

• Affective themes
• Motivational themes (agency, communion)
• Structural aspects of the story
• Autobiographical reasoning within the story (e.g., making connections between the event and identity)

Question 22

motivational themes =

Answer 22

agency
communion

Question 23

research: correlations among themes

Answer 23

small to moderate correlations between:

agency
communion
exploratory processing

Question 24

why is identity crucial for wellbeing?

Answer 24

1. identity is like an inner compass, providing a sense of coherence, continuity and unity. it provides a sense of direction and meaning in life. it facilitates decision making, allowing you to navigate life tasks and social roles.
2. identity contributes to self-esteem, self-worth, and life satisfaction
3. identity allows us to participate fully in society, helps us get a sense of belonging

Question 25

research: higher levels of 1) identity synthesis/consolidation and 2) agency, communion, coherence and autobiographical reasoning are related to:

Answer 25

• higher levels of life satisfaction, life purpose and self esteem
• lower levels of internalizing and externalizing symptoms

Question 26

identity is linked to different psychiatric disorders, such as….

Answer 26

• personality disorders
• eating disorders
• non suicidal self injury

Question 27

DSM-5 includes two models for diagnosing personality disorders:

Answer 27

• Section II: categorical model for PDs
• Lists diagnostic criteria for ten different PDs
• Identity disturbance is a core symptom of Borderline Personality Disorder (BPD)
• Section III: Alternative Model for PDs (AMPD)
• Proposes that all PDs are characterized by identity disturbance

Question 28

how does the AMPD refer to identity disturbances

Answer 28

AMPD: identity disturbance refers to a host of identity-related difficulties (e.g., problems with self-other distinction, having an unstable and incoherent sense of identity, lacking life goals,…)

Question 29

research linking identity development and personality disorders in adolescents and young adults:

Answer 29

• Survey data:
• Identity disturbance and lack of identity are related to all PDs
• Identity disturbance distinguishes adolescents with and without BPD
• Narrative data:
• Thwarted themes of agency and communion are related to BPD and ASPD (symptoms)
• Low levels of narrative coherence are related to BPD and ASPD (symptoms)

Question 30

which identity class report stable and high levels of BPD features

Answer 30

adolescents in the diffused identity class

Question 31

how does identity disturbance feel?

Answer 31

• “It’s terribly confusing, not being able to navigate who I am, what I really truly think
  and feel, and what my view is on things.”
• “It is really difficult for me to answer the question about who I am, because I feel it
  is so dependent on the mood I’m in and on the situation and the people around me.”
• “I need others… in order to feel that I exist, because if I was all alone, I would just be
  nothing.”
• “It’s very confusing not to have this unifying thread or principle in your life, like who
  am I, and what do I want. It makes it very difficult to make plans.”

Question 32

development of BPD: biology, environment and outcome

Answer 32

1. biology:
   - temperament: high emotional reactivity and low negative affect tolerance
   - personality: high impulsivity, high obsessive-compulsive, high perfectionism
2. environment:
   - system: attachment ruptures, with low support and connection, high control and criticism
   - trauma: emotional/physical/sexual/childhood neglect/abuse
3. outcome: emotional dysregulation and mentalizing problems
   - affective instability, interpersonal instability, impulsivity, chronic feelings of inner emptiness, unstable and fragmented sense of identity

Question 33

body-related disorders =

Answer 33

anorexia nervosa, bulimia nervosa, binge eating, non-suicidal self-injury

Question 34

dus welke twee groepen stoornissen zijn gelinkt aan identiteitsverstoringen

Answer 34

• persoonlijkheidsstoornissen
• body-related disorders (eating disorders, NSSI)

Question 35

twee aspecten van identiteit die verstoord zijn in body-related disordoers

Answer 35

• Higher levels of identity confusion, ruminative exploration
• Lower levels of identity synthesis, commitment processes

Question 36

identity confusion and NSSI research

Answer 36

Higher levels of identity confusion significantly increased the likelihood of transitioning from no NSSI to subthreshold NSSI

Question 37

mechanisms underlying the link between identity and body-related disorders

Answer 37

the body-related disorders may act as ways to try to regulate the emotions and regain a sense of control. however, this only reinforces the negative affect and cognitions

Question 38

kijken naar schema van ID en body-related disorders

Answer 38

oke

Question 39

identity disturbance en anorexia

Answer 39

identity disturbance -> search for source of self-definition -> body as a source of self-definition -> anorexia nervosa -> body as central part of identity -> gaining weight is a threat to identity -> identity disturbance…

Question 40

take home messages

Answer 40

• Identity formation is a key developmental task of adolescence and young adulthood
• Identity is shaped by internal and external factors, and constructed through exploration and commitment processes
• Identity synthesis/consolidation is crucial to function adaptively in life and experience a sense of well-being
• Identity disturbance is a transdiagnostic risk factor as it relates to all personality disorders, eating disorders, and NSSI
• The relationship between identity disturbance and psychopathology seems to be bi-directional, but we need more research
• Underlying mechanisms may include emotion regulation, having an alternative source for self-definition