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Kählke F, Hasking P, Küchler AM, Baumeister H. Mental health services for German university students: acceptance of intervention targets and preference for delivery modes. Front Digit Health 2024; 6:1284661. [PMID: 38426046 PMCID: PMC10903098 DOI: 10.3389/fdgth.2024.1284661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Accepted: 01/22/2024] [Indexed: 03/02/2024] Open
Abstract
Introduction Most university students with mental disorders remain untreated. Evaluating the acceptance of intervention targets in mental health treatment, promotion, and prevention, as well as mental health service delivery modes is crucial for reducing potential barriers, increasing healthcare utilization, and efficiently allocating resources in healthcare services. Aim The study aimed to evaluate the acceptance of various intervention targets and delivery modes of mental health care services in German first-year university students. Methods In total, 1,376 first-year students from two German universities from the 2017-2018 multi-center cross-sectional cohort of the StudiCare project, the German arm of the World Mental Health International College Student Survey initiative, completed a web-based survey assessing their mental health. Mental disorder status was based on self-reported data fulfilling the DSM-IV criteria. We report frequencies of accepted delivery modes [categories: group or in-person therapy with on or off campus services, self-help internet- or mobile-based intervention (IMI) with or without coaching, or a combination of a in-person and IMI (blended)]. In a multinomial logistic regression, we estimate correlates of the preference for in-person vs. IMI vs. a combination of both modes (blended) modalities. Additionally, we report frequencies of intervention targets (disorder specific: e.g., social phobia, depressive mood; study-related: test anxiety, procrastination; general well-being: sleep quality, resilience) their association with mental disorders and sex, and optimal combinations of treatment targets for each mental illness. Results German university students' acceptance is high for in-person (71%-76%), moderate for internet- and mobile-based (45%-55%), and low for group delivery modes (31%-36%). In-person treatment (72%) was preferred over IMI (19%) and blended modalities (9%). Having a mental disorder [odds ratio (OR): 1.56], believing that digital treatments are effective (OR: 3.2), and showing no intention to use services (OR: 2.8) were associated with a preference for IMI compared to in-person modes. Students with prior treatment experience preferred in-person modes (OR: 0.46). In general, treatment targets acceptance was higher among female students and students with mental disorders. However, this was not true for targets with the highest (i.e., procrastination) and the lowest (i.e., substance-use disorder) acceptance. If only two intervention targets were offered, a combination of study-related targets (i.e., procrastination, stress, time management) would reach 85%-88% of the students. Conclusion In-person services are preferred, yet half of the students consider using IMI, preferably aiming for a combination of at least two study-related intervention targets. Student mental health care services should offer a combination of accepted targets in different delivery modes to maximize service utilization.
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Affiliation(s)
- Fanny Kählke
- TUM School of Medicine and Health, Professorship Psychology & Digital Mental Health Care, Technische Universität München, Munich, Germany
| | - Penelope Hasking
- Curtin enAble Institute, Curtin University, Perth, WA, Australia
| | - Ann-Marie Küchler
- Department of Clinical Psychology and Psychotherapy, Ulm University, Ulm, Germany
| | - Harald Baumeister
- Department of Clinical Psychology and Psychotherapy, Ulm University, Ulm, Germany
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Gander M, Buchheim A, Kohlböck G, Sevecke K. Unresolved attachment and identity diffusion in adolescence. Dev Psychopathol 2024:1-10. [PMID: 38305076 DOI: 10.1017/s0954579424000014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2024]
Abstract
This study examined the severity of unresolved attachment underlying adolescent identity diffusion. Our sample consisted of 180 inpatient adolescents aged 14 to 18 years (77% female, M age = 15.13, SD = 1.35; 23% male, M age = 14.85, SD = 1.41) and 84 age-matched non-clinical adolescents (52% female, M age = 16.14, SD = 1.21; 48% males, M age = 15.98, SD = 1.07). We used the Adult Attachment Projective Picture System (AAP) interview to assess attachment representations and the Assessment of Identity Development in Adolescence (AIDA) questionnaire to evaluate the severity of identity diffusion. Our results demonstrate a higher amount of unresolved attachment and identity diffusion in the patient sample than in the control sample. Furthermore, patients with an unresolved attachment status scored higher on identity diffusion than those with no unresolved attachment pattern. Interestingly, this was not found in the control group. Furthermore, patients with a greater severity of unresolved attachment showed the highest maladaptive identity development scores. Psychotherapeutic interventions integrating attachment-related aspects might be useful to treat young people with identity diffusion.
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Affiliation(s)
- Manuela Gander
- University of Innsbruck, Institute of Psychology, Innsbruck, Austria
- Department of Child and Adolescent Psychiatry, Tirol Kliniken, Hall in Tirol, Austria
| | - Anna Buchheim
- University of Innsbruck, Institute of Psychology, Innsbruck, Austria
| | - Gabriele Kohlböck
- Department of Child and Adolescent Psychiatry, Tirol Kliniken, Hall in Tirol, Austria
| | - Kathrin Sevecke
- Department of Child and Adolescent Psychiatry, Tirol Kliniken, Hall in Tirol, Austria
- Department of Child and Adolescent Psychiatry, Medical University of Innsbruck, Innsbruck, Austria
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Dixius A, Möhler E. Effects of a Standardized DBT-A Program on Identity Development in Adolescents. Brain Sci 2023; 13:1328. [PMID: 37759929 PMCID: PMC10526514 DOI: 10.3390/brainsci13091328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Revised: 09/11/2023] [Accepted: 09/13/2023] [Indexed: 09/29/2023] Open
Abstract
BACKGROUND Identity diffusion plays a central role in the onset of borderline personality disorders. Dialectical Behavioral Therapy for Adolescents (DBT-A) is a treatment program for adolescents with emotional instability and dysregulation. The interest of this study is to examine the potential effects of a standardized and certified DBT-A therapy program on the identity development of adolescents in an inpatient setting. METHODS A total of 138 adolescents aged 13 to 18 years with symptoms of severe emotional instability were assessed before and after a certified and standardized 12-week in-patient DBT-A program targeting emotional regulation with the following standardized instruments: the Assessment of Identity Development in Adolescence (AIDA), Scale of the Experience of Emotions (SEE), and Symptom Checklist (SCL-90-R). RESULTS The results indicate a significant change in identity development, emotion regulation, and general symptoms of psychopathology after treatment with DBT-A. CONCLUSIONS In this large sample of adolescents, DBT-A significantly improved identity development and reduced identity diffusion, however, without a treatment-as-usual control group as a limitation. Nevertheless, our results may become clinically relevant for the prevention of chronic impairment in emotionally unstable adolescents.
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Affiliation(s)
- Andrea Dixius
- Department of Clinical Pharmacy, Saarland University, 66123 Saarbrucken, Germany;
- SHG Clinic for Child and Adolescent Psychiatry, 66119 Saarbrucken, Germany
| | - Eva Möhler
- Department of Clinical Pharmacy, Saarland University, 66123 Saarbrucken, Germany;
- SHG Clinic for Child and Adolescent Psychiatry, 66119 Saarbrucken, Germany
- Child and Adolescent Psychiatry, Saarland University Hospital, 66421 Homburg, Germany
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4
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Cervantes BR, Kerr S, Vanwoerden S, Sharp C. Operationalizing intimacy and identity aspects of personality functioning in relation to personality disorder in adolescents. Front Psychiatry 2023; 14:1153274. [PMID: 37113535 PMCID: PMC10126270 DOI: 10.3389/fpsyt.2023.1153274] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Accepted: 03/20/2023] [Indexed: 04/29/2023] Open
Abstract
According to dimensional models of personality pathology, deficits in interpersonal (intimacy and empathy) and self (identity and self-direction) function (Criterion A) are core to all personality disorders. These aspects of personality functioning (Criterion A) have seldom been evaluated for how they might relate to one another in the context of personality pathology in adolescents. Moreover, the use of performance-based measures to evaluate aspects of Criterion A function remains an untapped resource. Therefore, the present study aimed to evaluate relations between two features of Criterion A, maladaptive intimacy and maladaptive (or diffused) identity, in adolescence. For intimacy, we leverage a performance-based approach to studying intimacy, operationalized in a developmentally relevant way (perceived parental closeness). For identity, we rely on a validated self-report measure of identity diffusion. We examined the relationship between these features with each other and their relations with borderline features. Additionally, we explored whether identity diffusion mediated the expected relationship between perceived parental closeness and borderline features. We hypothesized that greater distance in perceived parental closeness would be associated with higher levels of borderline features, as well as higher levels of identity diffusion, and that identity diffusion would account for the relationship between intimacy and personality pathology. The sample included 131 inpatient adolescents (M age = 15.35, 70.2% female). Results indicated that intimacy, operationalized as perceived parental closeness, with both mothers and fathers was significantly associated with levels of identity diffusion and borderline features. In addition, greater feelings of closeness with parents were associated with lower severity of borderline features via healthier identity function. Implications of the results, limitations, and future directions are discussed.
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Affiliation(s)
| | - Sophie Kerr
- Department of Psychology, University of Houston, Houston, TX, United States
| | - Salome Vanwoerden
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, United States
| | - Carla Sharp
- Department of Psychology, University of Houston, Houston, TX, United States
- *Correspondence: Carla Sharp,
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Bäumer AV, Fürer L, Birkenberger C, Wyssen A, Steppan M, Zimmermann R, Gaab J, Kaess M, Schmeck K. The impact of outcome expectancy on therapy outcome in adolescents with borderline personality disorder. Borderline Personal Disord Emot Dysregul 2022; 9:30. [PMID: 36464739 PMCID: PMC9721041 DOI: 10.1186/s40479-022-00200-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Accepted: 09/27/2022] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND Outcome expectancy has been found to be a significant predictor of psychotherapy outcome. However, given that severity, chronicity and comorbidity are moderators of outcome expectancy, it is important to provide evidence of whether the same holds true in clinical conditions marked by these attributes, such as in borderline personality disorder (BPD). The aim of the present study was to investigate the role of patients' outcome expectancy in adolescents undergoing early intervention for BPD using pre-post difference of psychosocial functioning as outcome. METHODS Forty-four adolescent BPD patients were treated with Dialectical Behavior Therapy for Adolescents (DBT-A) or Adolescent Identity Treatment (AIT). We investigated the effect of outcome expectancy on outcome with type of treatment as moderator. Based on the relevant literature, we assess the correlation between outcome expectancy and pretreatment symptomatology, namely BPD severity, personality functioning, childhood trauma and depression. RESULTS The results showed a significant effect of expectancy on outcome (stand. β = 0.30, p = 0.020) above autoregression. ANOVA analysis revealed no difference between the two treatments. Further, results indicate that pretreatment symptomatology, i.e., depression, childhood trauma and personality functioning dimensions self-direction and intimacy, are associated with early treatment expectancy. CONCLUSION Outcome expectancy as a common factor plays a key role in successful psychotherapy with adolescent BPD patients. Elevated pretreatment depression, childhood trauma and impairment in personality functioning dimensions self-direction and intimacy are risk factors associated with lower expectancy. Low outcome expectancy should be addressed in early psychotherapy to improve the therapeutical process.
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Affiliation(s)
- Anna-Valeska Bäumer
- Child and Adolescent Psychiatric Research Department, University Psychiatric Clinics, University of Basel, Wilhelm Klein-Strasse 27, CH-4056, Basel, Switzerland.
| | - Lukas Fürer
- Child and Adolescent Psychiatric Research Department, University Psychiatric Clinics, University of Basel, Wilhelm Klein-Strasse 27, CH-4056, Basel, Switzerland
| | - Carolin Birkenberger
- Division of Clinical Psychology and Psychotherapy, Faculty of Psychology, University of Basel, Basel, Switzerland
| | - Andrea Wyssen
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Martin Steppan
- Child and Adolescent Psychiatric Research Department, University Psychiatric Clinics, University of Basel, Wilhelm Klein-Strasse 27, CH-4056, Basel, Switzerland
| | - Ronan Zimmermann
- Child and Adolescent Psychiatric Research Department, University Psychiatric Clinics, University of Basel, Wilhelm Klein-Strasse 27, CH-4056, Basel, Switzerland.,Division of Clinical Psychology and Psychotherapy, Faculty of Psychology, University of Basel, Basel, Switzerland
| | - Jens Gaab
- Division of Clinical Psychology and Psychotherapy, Faculty of Psychology, University of Basel, Basel, Switzerland
| | - Michael Kaess
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland.,Department of Child and Adolescent Psychiatry, Center for Psychosocial Medicine, University Hospital Heidelberg, Heidelberg, Germany
| | - Klaus Schmeck
- Child and Adolescent Psychiatric Research Department, University Psychiatric Clinics, University of Basel, Wilhelm Klein-Strasse 27, CH-4056, Basel, Switzerland
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Body-Related Attitudes, Personality, and Identity in Female Adolescents with Anorexia Nervosa or Other Mental Disorders. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19074316. [PMID: 35409997 PMCID: PMC8998874 DOI: 10.3390/ijerph19074316] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Revised: 04/01/2022] [Accepted: 04/03/2022] [Indexed: 12/27/2022]
Abstract
The psychological integration of body-related attitudes (BodyRA) is a critical developmental task in adolescence. Adolescents must adapt to their changing body image and body satisfaction. For young people, BodyRA (body dissatisfaction, bulimia, and drive for thinness) are connected to insecurities, which can disturb identity integration and personality development. Our goal was to evaluate the importance of BodyRA also for other mental disorders other than anorexia nervosa (AN), and the association between BodyRA with temperament and personality traits and identity diffusion. Data for the period of 2012 to 2019 were retrospectively analyzed from a convenience sample of patients in a child and adolescent psychiatric hospital (n = 114). The patients were 13 to 17 years of age and had a BMI of 11.9−36.1 kg/m2. As expected, BodyRA were found to be more pronounced in AN, as well as in borderline personality disorder (BPD), depression (DD), and attention deficit hyperactivity disorder (ADHD). BodyRA correlated significantly with internalizing problems in patients with DD (r = 0.428−0.565, p < 0.01) and BPD (r = 0.680, p < 0.01) as well as with BMI (r = 0.404, p < 0.01) in patients with DD. Moreover, we detected significant correlations with impaired identity development in patients with DD (r = 0.482−0.565, p < 0.01) and BPD (r = 0.681−0.703, p < 0.01). BodyRA also correlated significantly with the personality traits of harm avoidance (r = 0.377−0.541, p < 0.01) and self-directedness (r = −0.537−−0.635, p < 0.01) in DD. These personality traits and bulimia were used as predictors for identity diffusion in the investigated disorders of this study. We conclude that BodyRA, harm avoidance and self-directedness are associated with identity development in adolescent females with mental disorders.
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González Flores S, Goth K, Díaz-Hernandez RA. Psychometric Properties of a Cultural Adapted Version of the Assessment of Identity Development in Adolescence in Panama. Front Psychiatry 2022; 13:806033. [PMID: 35432021 PMCID: PMC9009042 DOI: 10.3389/fpsyt.2022.806033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2021] [Accepted: 02/21/2022] [Indexed: 11/13/2022] Open
Abstract
UNLABELLED The Assessment of Identity Development in Adolescence (AIDA) is a self-report instrument to detect pathological development of Identity. In Panamá, psychometric instruments for assessment of psychopathology in adolescence are lacking. Our aim was to develop a valid and reliable version of the AIDA Inventory for Panamanian Population. AIDA was adapted to Spanish considering cultural aspects of Panamanian population. Two pilot tests were performed prior to main test to assess item-total correlation at subscale, primary scale and total scale levels and internal consistency at subscale level. A mixed sample of students and PD patients (N = 315) completed the AIDA inventory, the "Strength and Difficulties Questionnaire" and "Defense Style Questionnaire-40." AIDA was retested in a sub sample from school population (n = 98). The Structured Clinical Interview for Axis II Disorders was used for diagnosis of personality disorders in the patient sample (n = 25). Psychometric properties were tested to assess internal consistency, reliability, factorial validity, convergent validity, and criterion validity. AIDA Panama showed excellent internal consistency for the total scale Identity Diffusion with Cronbach's α:0.94 and a retest reliability of 0.84. A Bifactorial CFA was modeled to assess the dimensionality of the inventory. The proportion between OmegaH and Omega at total scales 96% of the variance is explained by a general factor. Furthermore, the Explained Common Variance for the General Factor is 73% supporting unidimensionality. In line with theory, AIDA total scale showed a high positive correlation (r = 0.67) with Total Difficulties scale and high positive correlation (r = 0.71) with Immature Defense scale. The AIDA total score differed highly significant (p = 0.000) between the patient sample and the students with a large effect size (d = 1.02). CONCLUSION The adaptation and validation of AIDA for Panamanian adolescent population was successful with good psychometric properties and significant correlations with related psychopathological constructs. AIDA showed high clinical validity by providing a valid discrimination between the school sample and a diagnosed PD sample, in line with the assumption that impaired identity functioning is at the core of personality disorders, especially in adolescence.
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Affiliation(s)
| | - Kirstin Goth
- Department of Child and Adolescent Psychiatry, University Clinics of Basel, Basel, Switzerland
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8
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Budde LI, Wilms S, Föcker M, Dalhoff A, Müller JM, Wessing I. Influence of Identity Development on Weight Gain in Adolescent Anorexia Nervosa. Front Psychiatry 2022; 13:887588. [PMID: 35693950 PMCID: PMC9186337 DOI: 10.3389/fpsyt.2022.887588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Accepted: 05/03/2022] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND Anorexia Nervosa (AN) typically begins during early adolescence, an important phase of personality development. A substantial proportion of adolescent AN patients shows impaired personality functioning, which might be a relevant but understudied aspect of illness severity. The developmental status of identity as key element of personality is suggested to influence inpatient treatment outcome in adolescents with AN. METHODS This study analyzed existing data of N = 60 adolescents with AN. Multilevel models assessed the influence of identity functioning, measured by the Assessment of Identity Development in Adolescence (AIDA) at admission, on weight gain [BMI (body mass index), BMI-SDS (BMI standard deviation score)] during 10 weeks of inpatient treatment. Moreover, the influence of other indicators of illness severity, i.e., eating disorders and comorbid psychopathologies, was explored. RESULTS As expected, higher AIDA scores negatively influenced the course of weight gain. A similar effect was observed for other psychopathology measures, especially body image distortion. In general, higher weight at admission was associated with less weight gain. Higher weight at admission was also predicted by higher other psychopathology measures, but not AIDA scores. CONCLUSION The course of weight gain during inpatient treatment was hampered in adolescent AN patients who have difficulties developing a stable identity. Unlike other aspects of psychopathology, this was independent of the initial weight. Thus, in addition to the level of underweight and other aspects of psychopathology, difficulties in identity development constitute a relevant aspect of illness severity in AN. This recommends consideration of identity development during treatment.
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Affiliation(s)
- Lynn I Budde
- Department of Child and Adolescent Psychiatry, University Hospital Münster, Münster, Germany
| | - Simon Wilms
- Department of Child and Adolescent Psychiatry, University Hospital Münster, Münster, Germany
| | - Manuel Föcker
- Department of Child and Adolescent Psychiatry, University Hospital Münster, Münster, Germany
| | - Anke Dalhoff
- Department of Child and Adolescent Psychiatry, University Hospital Münster, Münster, Germany
| | - Joerg M Müller
- Department of Child and Adolescent Psychiatry, University Hospital Münster, Münster, Germany
| | - Ida Wessing
- Department of Child and Adolescent Psychiatry, University Hospital Münster, Münster, Germany
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Karvonen M, Goth K, Eloranta SJ, Kaltiala R. Identity Integration in Adolescents With Features of Gender Dysphoria Compared to Adolescents in General Population. Front Psychiatry 2022; 13:848282. [PMID: 35757222 PMCID: PMC9218247 DOI: 10.3389/fpsyt.2022.848282] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Accepted: 05/16/2022] [Indexed: 11/13/2022] Open
Abstract
Adolescence is an important period for identity formation and identity consolidation is one of the main developmental tasks. Gender identity is an essential aspect of identity but so far little is known about its development. Neither has the identity development of adolescents with features of gender dysphoria (GD) been extensively studied so far. However, adolescents with features of GD have been shown to present extensive psychiatric psychopathology and could therefore be assumed also to have more problems with identity development. We set out to compare the identity integration of adolescents with features of GD (n = 215; 186 natal females, 29 natal males) and adolescents from general population (n = 400; 244 females, 154 males and 2 who did not report their sex) using a culture-adapted Finnish version of an assessment tool for adolescents and young adults on identity in terms of personality functioning, the Assessment of Identity Development in Adolescence (AIDA). AIDA is a 58-item self-report questionnaire enabling dimensional differentiation between healthy and impaired identity development. The continuous AIDA total score (sum score) and its subscales were analyzed using MANOVA, and dichotomized T-scores differentiating identity development in impaired and healthy range using cross-tabulations with chi-square statistics. Adolescents with features of GD showed identity development similar to adolescents in general population. The slight differences seen in AIDA scores were in favor of the GD group. The proportion scoring to identity impairment was lowest among gender-referred adolescents assigned males at birth. Identity integration of the gender-referred adolescents was further compared to that of 77 adolescents in specialist level psychiatric outpatient treatment (67 females, 10 males). The adolescent psychiatric outpatients scored much higher toward impaired identity on all AIDA scales than did the adolescents with features of GD. These results suggest that features of GD are not associated with problems in identity development in adolescents at large. Adolescents with features of GD may have been required to process their identity more, thereby advancing further in their identity consolidation process than young people on average.
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Affiliation(s)
- Milla Karvonen
- Department of Adolescent Psychiatry, Tampere University Hospital, Tampere, Finland
| | - Kirstin Goth
- Department of Child and Adolescent Psychiatry, Psychiatric University Clinics (UPK) Basel, Basel, Switzerland
| | - Sami J Eloranta
- Faculty of Social Sciences, Tampere University, Tampere, Finland
| | - Riittakerttu Kaltiala
- Department of Adolescent Psychiatry, Tampere University Hospital, Tampere, Finland.,Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland.,Vanha Vaasa Hospital, Vaasa, Finland
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10
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Comparison of Self-Differentiation and Identity Statuses in Twins and Nontwins. Twin Res Hum Genet 2021; 24:176-183. [PMID: 34315563 DOI: 10.1017/thg.2021.28] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Formation of identity and differentiation is crucial in the development process of adolescents and young people. Despite many studies on identity status and self-differentiation in adolescence and early adulthood stages, this issue has been less examined among twins. This study was conducted to compare self-differentiation and identity statuses in twins and nontwins. The sample of the study consisted of 128 identical twins, 176 nonidentical twins and 170 nontwins aged from 13 to 30 years and living in Mashhad in Iran, who completed the Objective Measure of Ego Identity Status and Self-Differentiation questionnaires. The results showed that the self-differentiation of identical and nonidentical twins was significantly higher than nontwins. The results also showed that level of Foreclosure identity, Moratorium identity and Achieved identity was similar among identical twins, nonidentical twins and nontwins, but significantly different in terms of Diffusion identity. Further, the results showed that twins younger than 18 years had scores higher than nontwins and twins over 18 years in terms of Diffusion identity. Findings revealed that females were significantly lower than males for Moratorium identity. The adolescence period and co-twins may be the reason for the high levels of Diffusion identity and self-differentiation. Also, it seems that identity development and differentiation are related to emotional and cognitive development.
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11
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Timler A, Bulsara C, Hands B. Physical and emotional development of adolescents with low motor competence: Mothers’ perspectives. Br J Occup Ther 2021. [DOI: 10.1177/03080226211031805] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background Parent support influences adolescent’s social-emotional well-being. One factor that may influence parent’s perception of support is their child’s level of motor competence. Aim The purpose of this study was to explore mothers’ experience of providing support for the health of adolescents with low motor competence physical and emotional development. Methods A phenomenological approach was used to guide this study. After initial screening, five one-on-one interviews with mothers of adolescents aged 12–16 years were conducted. Results Analysis of the interviews identified five themes of ‘supportive building blocks’, ‘building achievement and commitment,’ ‘building mechanisms for future support’ ‘building stability in relationships’ and ‘building confidence and a sense of autonomy’. Mother’s awareness of their child’s motor difficulties resulted in their active provision of alternative strategies for their child by building self-confidence and seeking support from health professionals. Conclusion Mothers were aware of their child’s inadequacies and actively sought support to help with their development. Support services that recognise low motor competence could better help mothers support their adolescent’s development. One implication arising from this study is the importance of using multi-disciplinarian teams such as occupational therapist, exercise physiologist and parents to help children with low motor competence.
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Affiliation(s)
- Amanda Timler
- Institute for Health Research, University of Notre Dame Australia, Perth Western Australia
| | - Caroline Bulsara
- Institute for Health Research, University of Notre Dame Australia, Perth Western Australia
| | - Beth Hands
- Institute for Health Research, University of Notre Dame Australia, Perth Western Australia
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12
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Musetti A, Giammarresi G, Goth K, Petralia A, Barone R, Rizzo R, Concas I, Terrinoni A, Basile C, Di Maggio C, Lopez F, Terrone G, Alessandra A, Messena M, Imperato C, Sibilla F, Caricati L, Mancini T, Corsano P, Aguglia E. Psychometric Properties of the Italian Version of the Assessment of Identity Development in Adolescence (AIDA). IDENTITY 2021. [DOI: 10.1080/15283488.2021.1916748] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Alessandro Musetti
- Department of Humanities, Social Sciences and Cultural Industries, University of Parma, Parma, Borgo Carissimi, Italy
| | | | - Kirstin Goth
- Department of Child and Adolescent Psychiatry, Psychiatric University Clinics, Basel, Switzerland
| | - Antonino Petralia
- Department of Clinical and Experimental Medicine, Section of Psychiatry, University of Catania, Catania, Italy
| | - Rita Barone
- Department of Clinical and Experimental Medicine, Section of Child Neurology and Psychiatry, University of Catania, Catania, Italy
| | - Renata Rizzo
- Department of Clinical and Experimental Medicine, Section of Child Neurology and Psychiatry, University of Catania, Catania, Italy
| | - Ilaria Concas
- Department of Clinical and Experimental Medicine, Section of Psychiatry, University of Catania, Catania, Italy
| | - Arianna Terrinoni
- Department of Human Neuroscience, Section of Child and Adolescent Neuropsychiatry, Sapienza University, Rome, Italy
| | - Consuelo Basile
- Department of Human Neuroscience, Section of Child and Adolescent Neuropsychiatry, Sapienza University, Rome, Italy
| | - Chiara Di Maggio
- Department of Human Neuroscience, Section of Child and Adolescent Neuropsychiatry, Sapienza University, Rome, Italy
| | - Felipe Lopez
- Associazione Nazionale Assessment E Psicodiagnostica, Rome, Italy
| | - Grazia Terrone
- Department of History, Cultural Heritage, Education and Society, University of Rome Tor Vergata, Rome, Italy
| | | | - Mattia Messena
- School of Medicine, University College Dublin, Dublin, Ireland
| | - Chiara Imperato
- Department of Humanities, Social Sciences and Cultural Industries, University of Parma, Parma, Borgo Carissimi, Italy
| | - Federica Sibilla
- Department of Humanities, Social Sciences and Cultural Industries, University of Parma, Parma, Borgo Carissimi, Italy
| | - Luca Caricati
- Department of Humanities, Social Sciences and Cultural Industries, University of Parma, Parma, Borgo Carissimi, Italy
| | - Tiziana Mancini
- Department of Humanities, Social Sciences and Cultural Industries, University of Parma, Parma, Borgo Carissimi, Italy
| | - Paola Corsano
- Department of Humanities, Social Sciences and Cultural Industries, University of Parma, Parma, Borgo Carissimi, Italy
| | - Eugenio Aguglia
- Department of Clinical and Experimental Medicine, Section of Psychiatry, University of Catania, Catania, Italy
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13
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Sekowski M, Gambin M, Sharp C. The Relations Between Identity Disturbances, Borderline Features, Internalizing Disorders, and Suicidality in Inpatient Adolescents. J Pers Disord 2021; 35:29-47. [PMID: 33779274 DOI: 10.1521/pedi_2021_35_501] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Previous studies have demonstrated positive associations between identity disturbances and suicidality in adolescents; however, mechanisms underlying these relationships are not well understood. The authors propose that borderline features and various internalizing disorders may mediate these relations. The aim of this study was to test a multiple mediation model of the associations between these constructs using structural equation modeling. Ninety-six inpatient adolescents aged 12-17 years completed the Assessment of Identity Development in Adolescents, the Childhood Interview for DSM-IV Borderline Personality Disorder, the Youth Self-Report, and the Columbia-Suicide Severity Rating Scale. Findings partly confirmed the theoretical model. Borderline features mediated the positive effect of identity disturbances on suicidal ideation severity. Mediations of withdrawn/depression and anxiety/depression on the effect of identity disruption on suicidal ideation intensity were demonstrated. Identity disruptions and borderline and depressive symptoms could be possible targets for interventions for youth experiencing suicidal ideation.
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Affiliation(s)
- Marcin Sekowski
- Department of Psychology, The Maria Grzegorzewska University, Warsaw
| | | | - Carla Sharp
- Department of Psychology, University of Houston, Houston, Texas
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14
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Rizki DDG, Keliat BA. The relationship between emotional problems with self-identity in adolescents. ENFERMERIA CLINICA 2021. [DOI: 10.1016/j.enfcli.2020.12.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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15
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Zettl M, Akin Z, Back S, Taubner S, Goth K, Zehetmair C, Nikendei C, Bertsch K. Identity Development and Maladaptive Personality Traits in Young Refugees and First- and Second-Generation Migrants. Front Psychiatry 2021; 12:798152. [PMID: 35126207 PMCID: PMC8813733 DOI: 10.3389/fpsyt.2021.798152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Accepted: 12/21/2021] [Indexed: 11/13/2022] Open
Abstract
Refugees are often exposed to a variety of stressors and traumatic events, posing a significant risk for the development of mental disorders. Young refugees may be particularly at risk because adverse life events affect identity formation, a developmental task that is typically expected in adolescence and emerging adulthood. Trauma and cultural changes may alter identity development, potentially leading to identity diffusion, a core concept of personality disorders. However, previous research on personality pathology among refugees is scarce. In this study, we examine identity development and maladaptive personality traits in young refugees and migrants. Refugees from 22 countries of origin were recruited in a German reception center (n = 120) and a group of adults with a migration background in first- or second generation was obtained via web-based recruitment (n = 281). Identity development was measured using the Assessment of Identity Development in Adolescence - Short Form. Maladaptive personality traits were assessed with the Personality Inventory for DSM-5-Brief Form. Group differences between refugees and migrants regarding identity development and trait expression were investigated using t-tests. The relationship between the two measures and their corresponding subscales was examined by means of correlation analyses. Refugees reported significantly higher levels of identity diffusion, negative affectivity, detachment, antagonism, and disinhibition compared to migrants. No significant differences were found for psychoticism. Correlation analyses revealed low to moderate positive associations between identity diffusion and maladaptive trait expression. Possible implications for early phase of resettlement, preventive psychiatric care and further research questions are discussed.
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Affiliation(s)
- Max Zettl
- Center for Psychosocial Medicine, Institute for Psychosocial Prevention, Medical Faculty, University Hospital Heidelberg, Heidelberg, Germany
| | - Zeynep Akin
- Department of Psychology, Ludwig-Maximilians-University Munich, Munich, Germany
| | - Sarah Back
- Department of Psychology, Ludwig-Maximilians-University Munich, Munich, Germany
| | - Svenja Taubner
- Center for Psychosocial Medicine, Institute for Psychosocial Prevention, Medical Faculty, University Hospital Heidelberg, Heidelberg, Germany
| | - Kirstin Goth
- Department of Child and Adolescent Psychiatric Research, Psychiatric University Clinics (UPK), Basel, Switzerland
| | - Catharina Zehetmair
- Department of General Internal Medicine and Psychosomatics, University Hospital Heidelberg, Heidelberg, Germany
| | - Christoph Nikendei
- Department of General Internal Medicine and Psychosomatics, University Hospital Heidelberg, Heidelberg, Germany
| | - Katja Bertsch
- Department of Psychology, Ludwig-Maximilians-University Munich, Munich, Germany.,Department of General Psychiatry, Medical Faculty, Center for Psychosocial Medicine, University Hospital Heidelberg, Heidelberg, Germany
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16
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Sharp C, Vanwoerden S, Schmeck K, Birkhölzer M, Goth K. An Evaluation of Age-Group Latent Mean Differences in Maladaptive Identity in Adolescence. Front Psychiatry 2021; 12:730415. [PMID: 34603108 PMCID: PMC8484521 DOI: 10.3389/fpsyt.2021.730415] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Accepted: 08/19/2021] [Indexed: 11/13/2022] Open
Abstract
Little is known about the differences between age groups in maladaptive personality function as denoted in Criterion A of the Alternative Model for Personality Disorder (AMPD) in the DSM-5, which is the entry criterion for diagnosing personality disorder in the upcoming ICD-11. The current study aimed to address this gap by evaluating latent mean age group differences in maladaptive identity, which is one aspect that has been identified as an important feature of maladaptive, general personality function as represented in the DSM-5 and ICD-11. We were also interested whether mean differences would track with mean differences in borderline personality disorder (BPD) features given prior data suggesting that general personality function overlap with the construct of BPD. A community sample of N = 2,381 adolescents, representing a mix of different socio-economic and educational backgrounds, ages 12-18 (M = 14.92, SD = 1.94; 46% male) completed a measure of maladaptive identity. A subset (n = 1,165) completed a measure of borderline personality features. Latent variable modeling was used to evaluate latent mean differences across seven age bands. Results suggested a normative increase in maladaptive identity after age 12, which remained consistent until age 17 when it dropped back to levels observed in 12-year-olds. Maladaptive identity was significantly associated with mean-level increases in borderline personality features, with these constructs becoming more closely associated with increasing age.
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Affiliation(s)
- Carla Sharp
- Department of Psychology, University of Houston, Houston, TX, United States
| | - Salome Vanwoerden
- Department of Psychology, University of Houston, Houston, TX, United States
| | - Klaus Schmeck
- Department of Child and Adolescent Psychiatry, University Clinics of Basel, Basel, Switzerland
| | - Marc Birkhölzer
- Department of Child and Adolescent Psychiatry, University Clinics of Basel, Basel, Switzerland
| | - Kirstin Goth
- Department of Child and Adolescent Psychiatry, University Clinics of Basel, Basel, Switzerland
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17
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Rivnyák A, Pohárnok M, Péley B, Láng A. Identity Diffusion as the Organizing Principle of Borderline Personality Traits in Adolescents-A Non-clinical Study. Front Psychiatry 2021; 12:683288. [PMID: 34295274 PMCID: PMC8289896 DOI: 10.3389/fpsyt.2021.683288] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2021] [Accepted: 06/09/2021] [Indexed: 11/13/2022] Open
Abstract
Growing evidence shows that diagnosing and treating borderline personality disorder (BPD) is of high relevance for affected youths. Although identity crisis is part of the normative developmental process, identity diffusion is a potential candidate for being an appropriate concept in further developing screening tools and interventions for BPD treatment in adolescence. We hypothesized that severity of borderline traits (as indicated by the strength of their associations with identity diffusion) would be negatively associated with non-clinical adolescents' endorsement of borderline features' presence. We also hypothesized that identity diffusion had a central role in the network of borderline personality traits and could be conceived of as a latent organizing principle of borderline personality disorder. In our study, 169 non-clinical adolescents (81 girls and 88 boys; M age = 15.38; SDage = 1.52) filled out self-report measures of borderline personality features and identity diffusion. According to our results, having strong feelings and interpersonal sensitivity were the two most endorsed borderline personality features. Borderline personality features were positively correlated with identity diffusion. The more severe a borderline personality feature was, the less relevant it was for non-clinical adolescents. According to a network analysis, identity diffusion was the most central and least redundant element of the network of borderline personality traits. Results are discussed from a clinical point of view, further encouraging professionals to use identity diffusion screening tools to detect BPD in adolescence.
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Affiliation(s)
- Adrienn Rivnyák
- Faculty of Humanities and Social Sciences, Institute of Psychology, University of Pécs, Pécs, Hungary
| | - Melinda Pohárnok
- Faculty of Humanities and Social Sciences, Institute of Psychology, University of Pécs, Pécs, Hungary
| | - Bernadette Péley
- Faculty of Humanities and Social Sciences, Institute of Psychology, University of Pécs, Pécs, Hungary
| | - András Láng
- Faculty of Humanities and Social Sciences, Institute of Psychology, University of Pécs, Pécs, Hungary
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18
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Eloranta SJ, Kaltiala R, Lindberg N, Kaivosoja M, Peltonen K. Validating measurement tools for mentalization, emotion regulation difficulties and identity diffusion among Finnish adolescents. NORDIC PSYCHOLOGY 2020. [DOI: 10.1080/19012276.2020.1863852] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- Sami J. Eloranta
- Tampere University Hospital, Tampere, Finland
- Tampere University, Tampere, Finland
| | | | - Nina Lindberg
- Helsinki University,Helsinki, Finland
- Helsinki University Hospital, Helsinki, Finland
| | - Matti Kaivosoja
- Central Ostrobothnia Central Hospital, Kokkola, Finland
- University of Turku, Turku, Finland
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19
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Abstract
TransIdentity - Identity Development Among Adolescent Trans*people Identity development is one of the most important developmental tasks of adolescence. Adolescents whose gender identity does not correspond to the gender assigned at birth (trangender people) are also faced with this challenge, as are cis-gender adolescents of the same age. This study is the first to examine the personality function of identity in transgender adolescents. Based on the self report of a population of 69 adolescents from the outpatient unit for gender dysphoria the extent of identity diffusion measured by AIDA (Assessment of Identity Development in Adolescence) was compared with the values of the normative sample consisting of German-speaking pupils. Both the overall construct of identity diffusion and the areas of continuity and coherence showed average values in the examined young people, which speaks against pathological identity development. Nevertheless, identity diffusion was found in over a third (36 %). Most notably the aspect of stabilising relationships and roles was above average, which suggests that positive role identification from the areas of culture, family and body-self is present to a lesser extent than in the norm sample. The identity-stabilizing feeling of social anchoring appears to be impaired in the young transidents studied.
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20
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Multipler Substanzmissbrauch als Variante von Hochrisikoverhalten im Jugendalter. Prax Kinderpsychol Kinderpsychiatr 2020; 69:156-169. [DOI: 10.13109/prkk.2020.69.2.156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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21
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Timler A, McIntyre F, Bulsara C, Rose E, Hands B. The Influence of Motor Competence on Adolescent Identity Health: A Mixed Method Study. RESEARCH QUARTERLY FOR EXERCISE AND SPORT 2020; 91:1-14. [PMID: 31479384 DOI: 10.1080/02701367.2019.1643821] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/25/2019] [Accepted: 07/09/2019] [Indexed: 06/10/2023]
Abstract
Our identity develops with age, and many impacting factors will determine whether it is healthy or unhealthy. A particularly fragile phase of identity development occurs during adolescence when level of motor competence may be influential, yet is rarely considered. Purpose: The purpose of this study was to examine male and female adolescent's perceptions towards their motor competence and identity development. In-depth information was also collected to understand what factors are important towards identity development during adolescence. Method: An explanatory sequential mixed methods study was used to examine the extent motor competence influenced the health of an adolescent's identity. A sample of 160 adolescents (male n = 103, female n = 57, Mage = 14.45 SD = .75) completed the Adolescent Motor Competence Questionnaire (AMCQ) and the Assessment of Identity Development in Adolescence (AIDA). The AMCQ scores were used to group the participants into high (HMC = > 83) and low (LMC = < 83) motor competence. Results: More females had less-healthy identities than males and those with LMC had less-healthy identities than those with HMC. Subsamples of 17 participants were interviewed in order to explain these results. The most at risk group, females with LMC, identified negative peer comparisons, poor social support and higher stress levels to achieve academic performance as key challenges. Conclusions. Well-designed support services for those with LMC, especially for the females should incorporate activities to develop individual competency and close friendships.
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Obimakinde A, Omigbodun O. The association between identity status, perceived parenting strategies, and mental health of in-school adolescents in South-West Nigeria: A descriptive survey. JOURNAL OF MENTAL HEALTH AND HUMAN BEHAVIOUR 2020. [DOI: 10.4103/jmhhb.jmhhb_1_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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23
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Goth K, Birkhölzer M, Schmeck K. Assessment of Personality Functioning in Adolescents With the LoPF-Q 12-18 Self-Report Questionnaire. J Pers Assess 2019; 100:680-690. [PMID: 30907712 DOI: 10.1080/00223891.2018.1489258] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
The classification of personality disorders (PDs) is in transition. The shortcomings of the categorical PD diagnoses led to the development of the Alternative Model for Personality Disorders (AMPD) in Section III of the DSM-5 regarding a dimensional differentiation of severity of personality pathology. Impairments in personality functioning are defined as a general Criterion A for PD. Inspired by the AMPD, the LoPF-Q 12-18 was developed to assess Levels of Personality Functioning (LoPF) dimensionally in adolescents from 12 to 18 years old in self-report. The questionnaire shows good scale reliabilities, good construct validity by demonstrating a systematic variation with pathology in line with theory, and a valuable clinical utility. The results suggest that the LoPF-Q 12-18 questionnaire is a clinically useful instrument to assess personality pathology in young people and that the concept of personality functioning is useful in detecting and describing central impairments of PD pathology at an early stage of development.
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Affiliation(s)
- Kirstin Goth
- a Child and Adolescent Psychiatric Hospital , Psychiatric University Hospitals , Basel , Switzerland
| | - Marc Birkhölzer
- a Child and Adolescent Psychiatric Hospital , Psychiatric University Hospitals , Basel , Switzerland.,b Child and Adolescent Psychiatric Hospital , Psychiatric University Hospitals , Zürich , Switzerland
| | - Klaus Schmeck
- a Child and Adolescent Psychiatric Hospital , Psychiatric University Hospitals , Basel , Switzerland
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24
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Schrobildgen C, Goth K, Weissensteiner R, Lazari O, Schmeck K. Der OPD-KJ2-SF – Ein Instrument zur Erfassung der Achse Struktur der OPD-KJ-2 bei Jugendlichen im Selbsturteil. ZEITSCHRIFT FUR KINDER-UND JUGENDPSYCHIATRIE UND PSYCHOTHERAPIE 2019; 47:428-440. [PMID: 31099291 DOI: 10.1024/1422-4917/a000667] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Zusammenfassung. Die Erfassung der Strukturdimensionen nach OPD-KJ-2 ist neben ihrer therapeutischen Relevanz vor dem Hintergrund ihrer inhaltlichen Nähe zu gegenwärtig diskutierten dimensionalen Herangehensweisen in der Diagnostik von Persönlichkeitsstörungen im DSM-5 und in der ICD-11 von hoher Aktualität. Im Rahmen dieser Studie erfolgte eine Evaluation der psychometrischen Gütekriterien des neu entwickelten Fragenbogens OPD-KJ-2-SF zur Erfassung der Strukturdimensionen im Jugendalter. Die Untersuchung wurde anhand einer gemischten klinischen und nichtklinischen Stichprobe (N = 589) durchgeführt. Der OPD-KJ2-SF zeigte sehr gute psychometrische Kennwerte mit guten Skalenreliabilitäten von .87 bis .98 Cronbachs Alpha auf Gesamt- und Hauptskalenebene. Alle Hauptskalen diskriminierten hoch signifikant mit Effektstärken (d) von 1.4 bis 1.6 zwischen den Schüler_innen und Patient_innen mit Persönlichkeitsstörungen. Der OPD-KJ2-SF erscheint als ein reliables und valides Instrument zur Erfassung von strukturellen Beeinträchtigungen im Jugendalter.
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Affiliation(s)
- Christian Schrobildgen
- Kinder- und Jugendpsychiatrische Klinik, Universitäre Psychiatrische Kliniken, Universität Basel, Schweiz.,Diese Autoren haben zu gleichen Teilen zu diesem Beitrag beigetragen
| | - Kirstin Goth
- Kinder- und Jugendpsychiatrische Forschungsabteilung, Universitäre Psychiatrische Kliniken, Universität Basel, Schweiz.,Diese Autoren haben zu gleichen Teilen zu diesem Beitrag beigetragen
| | | | - Olga Lazari
- Kinder- und Jugendpsychiatrische Forschungsabteilung, Universitäre Psychiatrische Kliniken, Universität Basel, Schweiz
| | - Klaus Schmeck
- Kinder- und Jugendpsychiatrische Forschungsabteilung, Universitäre Psychiatrische Kliniken, Universität Basel, Schweiz
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25
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Abstract
Assessment and Therapy of Adolescent Identity Diffusion Identity diffusion, one of the main diagnosis criteria for borderline personality disorder (BPD), is characterized by a lack of coherent sense of self and of significant others, paired with a painful sense of incoherence. The revision of the age limit for the diagnosis of personality disorders in DSM-5 has opened the doors to research on diagnosis and treatment of BPD in adolescence. This paper offers a summary of past and present work on the diagnosis and therapy of identity disturbance in adolescent patients.
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Kaufman EA, Crowell SE. Biological and Behavioral Mechanisms of Identity Pathology Development: An Integrative Review. REVIEW OF GENERAL PSYCHOLOGY 2018. [DOI: 10.1037/gpr0000138] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Although identity disturbance is a transdiagnostic mental health problem, modern explanatory models for its emergence are limited. To date, the social, developmental, clinical, and neuropsychological literatures exploring identity processes are also largely disconnected. Existing theories have laid the foundation for understanding important components of identity pathology, yet many overlook biological, behavioral, and interactive processes by which these difficulties may emerge. In this integrative review, we explore how broad transdiagnostic vulnerabilities for psychopathology and more specific risky behavioral processes may reciprocally interact and be refined over time into an identity disturbance profile. Our primary purpose is to review behavioral and biosocial theories and derive a testable conceptual framework for how identity disturbance emerges over the course of development. We aim to describe and integrate several disparate lines of theory and research in order to illuminate potential etiological pathways to identity pathology.
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27
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[What is "normal"? Maternal parenting behavior as risk and protective factor for psychopathology and identity diffusion]. ZEITSCHRIFT FUR PSYCHOSOMATISCHE MEDIZIN UND PSYCHOTHERAPIE 2018; 64:128-143. [PMID: 29862916 DOI: 10.13109/zptm.2018.64.2.128] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
What is "normal"? Maternal parenting behavior as risk and protective factor for psychopathology and identity diffusion Objectives: This study analyzes the implications of today's highly altered maternal parenting behaviors on children's development and psychological health. METHODS The relationship between maternal parenting behaviors (support, psychological control, and anxious monitoring) and delayed identity development or identity diffusion as well as internalizing or externalizing symptomatology was investigated in a sample of 732 youths (301 adolescents, 351 young adults, and 80 patients). Cluster analysis identified two types of maternal parenting behaviors: authoritative maternal behavior and dysfunctionalmaternal behavior. RESULTS As expected, patients exhibited a high degree of dysfunctional maternal parenting behavior (low support, high psychological control), delayed identity development as well as elevated identity diffusion and symptomatology.Authoritative maternal parenting emerged as a protective factor in the prediction of identity diffusion and symptomatology.All three groups described a high degree of anxious maternal monitoring. CONCLUSIONS The implications of changed maternal parenting behaviors on identity diffusion and symptomatology are discussed in light of societal changes and changing criteria of personality disorders in the new DSM-5.
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Pathological Internet Use-An Important Comorbidity in Child and Adolescent Psychiatry: Prevalence and Correlation Patterns in a Naturalistic Sample of Adolescent Inpatients. BIOMED RESEARCH INTERNATIONAL 2018; 2018:1629147. [PMID: 29789775 PMCID: PMC5896356 DOI: 10.1155/2018/1629147] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/13/2017] [Accepted: 02/20/2018] [Indexed: 12/24/2022]
Abstract
Background Few studies have examined the prevalence of problematic internet use (PIU) in young people undergoing inpatient treatment in child and adolescent psychiatry centers. The aims of our study were thus (a) to assess the frequency of comorbid PIU in a sample of adolescent psychiatric inpatients and compare it with a control group of nonreferred adolescents and (b) to gain insights into correlations between PIU and psychiatric comorbidities. Methods 111 child and adolescent psychiatry inpatients (CAP-IP, mean age 15.1 ± 1.4 years; female : male 72.4% : 27.6%) undergoing routine psychodiagnostics were screened for the presence of PIU. The widely used Compulsive Internet Use Scale (CIUS) was chosen for this purpose. Prevalence rates of PIU were then compared to matched nonreferred control subjects from a school sample. Additionally, comorbidities of inpatients with PIU were compared to inpatients without PIU. Results Our inpatient sample showed a much higher prevalence of PIU than that found in previous populational samples of young people. Compared with a matched school sample, addictive internet use was 7.8 times higher and problematic internet use 3.3 times higher among our adolescent sample. PIU was significantly associated with characteristic patterns of psychopathology, that is, suicidality, difficulties in establishing stable and consolidated identity, and peer victimization. Conclusion PIU among adolescents undergoing inpatient psychiatric treatment is much more frequent than among their peers in the general population and is associated with specific patterns of psychopathology.
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Schlüter-Müller S, Goth K, Jung E, Schmeck K. Assessment and Treatment of Identity Pathology During Adolescence. Scand J Child Adolesc Psychiatr Psychol 2014. [DOI: 10.21307/sjcapp-2015-006] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Abstract
Personality disorders can be seen as patterns of maladaptive personality traits that have their onset during childhood or adolescence and that have an impact on the individual throughout the life span. Identity disturbance is seen as the central construct for detecting severe personality pathology—and, most notably, borderline personality disorder—in adults and adolescents. Therefore, in the revision of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, the construct of “identity” has been integrated as a core diagnostic criterion for personality disorders.
One of the most central tasks of normal adolescent development is the consolidation of identity. Crises in the development of identity usually resolve into a normal and consolidated identity with flexible and adaptive functioning. By contrast, identity diffusion is viewed as a lack of integration of the concept of the self and significant others; it is also seen as the basis for subsequent personality pathology, including that of borderline personality disorder, which leads to a broad spectrum of maladaptive and dysfunctional behaviors.
To measure identity pathology and its improvement with treatment, we developed a self-report questionnaire entitled Assessment of Identity Development in Adolescence to establish a reliable, valid, and time-efficient inventory to represent a dimensional concept of healthy and impaired personality development. The reliability of this self-report questionnaire is excellent, and the total score differentiated significantly between controls and patients with personality disorders. Adolescent Identity Treatment is a treatment model that focuses on identity pathology as the core characteristic of personality disorders. This model integrates specific techniques for the treatment of adolescent personality pathology on the background of object-relation theories and modified elements of Transference-Focused Psychotherapy. Moreover, psychoeducation, behavior-oriented home plans, and family work support the therapeutic process of the adolescent.
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Affiliation(s)
- Susanne Schlüter-Müller
- Gemeinschaftspraxis Schneckenhofstraße , Praxis, Frankfurt am Main , Germany
- Department of Child and Adolescent Psychiatry , Basel , Switzerland
| | - Kirstin Goth
- Department of Child and Adolescent Psychiatry , Basel , Switzerland
| | - Emanuel Jung
- Department of Child and Adolescent Psychiatry , Basel , Switzerland
| | - Klaus Schmeck
- Department of Child and Adolescent Psychiatry , Basel , Switzerland
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30
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Kieling C, Martin A. Catalyzing the publication of international research in child and adolescent mental health. Child Adolesc Psychiatry Ment Health 2013; 7:23. [PMID: 23899334 PMCID: PMC3849087 DOI: 10.1186/1753-2000-7-23] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2013] [Accepted: 07/18/2013] [Indexed: 12/05/2022] Open
Affiliation(s)
- Christian Kieling
- Department of Psychiatry, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Rua Ramiro Barcelos, 2350 - 400N, Porto Alegre, RS, 90350-009, Brazil.
| | - Andrés Martin
- Child Study Center, Yale School of Medicine, 230 South Frontage Road, New Haven, CT, 06520, USA
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