Childhood maltreatment and identity diffusion among inpatient adolescents: The role of reflective function

Abstract

Introduction: Identity integration, as opposed to identity diffusion, has been associated with greater self-esteem, meaning in life, and functioning. Trauma may have negative effects on identity; however, few studies have examined trauma and identity among adolescents, particularly those with psychiatric disorders. Moreover, factors that may promote healthy identity in adolescents who have experienced trauma have not been identified. This study aimed to test associations between childhood maltreatment and identity diffusion among adolescents with psychiatric disorders, and evaluated reflective function (RF) as a mediator of these associations. Methods: 107 adolescents (M age = 15.36, 75.7% female) who were inpatient at a psychiatric hospital in the United States completed self-report measures of childhood maltreatment (physical, sexual, and emotional abuse; physical and emotional neglect; total maltreatment), identity diffusion, and RF. Path analysis was used to test two models of the relations between childhood maltreatment, RF, and identity diffusion. Results: Total maltreatment and all forms of maltreatment except physical abuse were significantly associated with identity diffusion at the bivariate level. In path analysis (Model 1), emotional and physical neglect were directly associated with identity diffusion, and RF mediated the association between emotional abuse and identity diffusion. In Model 2, RF partially mediated the association between overall level of maltreatment and identity diffusion. Conclusions: Emotional abuse, emotional neglect, physical neglect, and total combined maltreatment exposure may be risk factors for adolescent identity diffusion. Targeting RF may help to build healthy identity among adolescents with symptoms of psychiatric disorders who have experienced maltreatment, particularly emotional abuse.

Neurocognitive Heterogeneity in Social Anxiety Disorder: The Role of Self-Referential Processing and Childhood Maltreatment

“…One possibility is that clinical heterogeneity within SAD may relate to differences across the life span in exposure to traumatic events, such as childhood maltreatment. Prior work has demonstrated that childhood maltreatment is associated with anxiety and depression (Iffland et al, 2012;Simon et al, 2009;Vachon et al, 2015), later identity diffusion (i.e., when a person's identity remains unresolved and not fully formed), altered self-perception (Scott et al, 2014), and negative self-referential processing (Penner et al, 2019;Toth et al, 2000). Given the known relationships between childhood maltreatment, psychopathology, and altered self-referential processing, we hypothesized that heterogeneity in SAD, in the form of more extreme negative self-beliefs and altered DMN activation, might be associated with greater exposure to childhood maltreatment.…”

Childhood emotional abuse and problematic social networking sites use in a sample of Italian adolescents: The mediating role of deficiencies in self‐other differentiation and uncertain reflective functioning

“…1.3 | CEA, uncertain reflective functioning, and problematic use of SNS CEA has a negative impact on the development of reflective functioning (Penner et al, 2019). Reflective functioning is the manifestation of the ability to mentalize (Fonagy et al, 2002), which refers to one's capacity for understanding the mental states (i.e., thoughts, feelings, wishes, and desires) underlying human behavior.…”

Examining Associations Between Child Abuse and Neglect Experiences With Emotion Regulation Difficulties Indicative of Adolescent Suicidal Ideation Risk

“…Items are rated on a 5-point Likert scale (range: 1 "Never True, " to 5 "Very Often True"). Psychometric properties have been established for the CTQ-SF (49), and the CTQ-SF has been used with adolescent inpatients specifically [e.g., (50)]. Cronbach's alpha were as follows for CTQ-SF subscales in the current study: emotional abuse (α = 0.86), sexual abuse (α = 0.96), physical abuse (α = 0.63), emotional neglect (α = 0.90), and physical neglect (α = 0.54).…”