Luyckx Koen, Goossens Eva, Van Damme Carolien, Moons Philip
Faculty of Psychology and Educational Sciences, School Psychology and Child and Adolescent Development, Centre for Health Services and Nursing Research, University Hospitals of Leuven, Catholic University of Leuven, Leuven, Belgium.
Cardiol Young. 2011 Aug;21(4):411-20. doi: 10.1017/S1047951111000187. Epub 2011 Mar 16.
Identity formation is a core developmental task in adolescence and functions as a key resource for transitioning to adulthood. This study investigated how adolescents with congenital cardiac disease form their identity and how it relates to demographic and medical parameters, quality of life, perceived health, depressive symptoms, and loneliness. A total of 429 adolescents aged 14-18 years with congenital cardiac disease and 403 matched controls completed questionnaires on identity and all outcome variables. There were five meaningful identity statuses, similar to those obtained in the control sample, which were found in the patient sample. Of them, two statuses--achievement and foreclosure--were characterised by a strong sense of identity; one status--diffused diffusion--especially was characterised by a weak sense of identity combined with high scores on worry about the future. These identity statuses were differentially related to outcome variables, with individuals in diffused diffusion especially scoring highest on depressive symptoms, problems in school, treatment anxiety, and communication problems with clinicians, and lowest on quality of life. Having a strong sense of personal identity was found to protect against such maladaptive outcomes. In sum, most adolescents with congenital cardiac disease moved through their identity formation process in a similar manner to other adolescents. Adolescents with a diffused identity were particularly at risk of experiencing maladjustment and problems in treatment adherence. Hence, developing intervention strategies to provide continuity of care on the road to adulthood involves paying attention to core developmental tasks, such as identity formation in adolescents with congenital cardiac disease.
身份认同的形成是青少年核心的发展任务，也是向成年期过渡的关键资源。本研究调查了先天性心脏病青少年如何形成他们的身份认同，以及这与人口统计学和医学参数、生活质量、感知健康、抑郁症状和孤独感之间的关系。共有429名14 - 18岁患有先天性心脏病的青少年和403名匹配的对照组完成了关于身份认同和所有结果变量的问卷调查。在患者样本中发现了五种有意义的身份状态，与对照组样本中获得的状态相似。其中，两种状态——成就型和封闭型——的特点是强烈的身份认同感；一种状态——弥散型——的特点尤其在于身份认同感薄弱，同时对未来的担忧得分较高。这些身份状态与结果变量存在差异关联，弥散型状态的个体在抑郁症状、学业问题、治疗焦虑以及与临床医生的沟通问题上得分尤其高，而在生活质量方面得分最低。研究发现，拥有强烈的个人身份认同感可以预防这些适应不良的结果。总之，大多数患有先天性心脏病的青少年在身份认同形成过程中的经历与其他青少年相似。身份认同弥散的青少年在治疗依从性方面尤其面临适应不良和出现问题的风险。因此，制定干预策略以在通往成年的道路上提供持续护理，需要关注核心发展任务，比如先天性心脏病青少年的身份认同形成。
