Department of Psychology, University of Houston, 3695 Cullen Blvd, Room 126, Houston, TX, 77204, USA.
Department of Psychology, University of Warsaw, ul. Stawki 5/7, Warsaw, 00-183, Poland.
J Adolesc. 2019 Oct;76:65-74. doi: 10.1016/j.adolescence.2019.08.002. Epub 2019 Aug 28.
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.
107 adolescents (M = 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.
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.
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.
与身份扩散相反，身份整合与更高的自尊、生活意义和功能有关。创伤可能对身份产生负面影响；然而，很少有研究调查青少年，尤其是那些患有精神障碍的青少年的创伤和身份问题。此外，尚未确定经历过创伤的青少年中促进健康身份的因素。本研究旨在检验童年期虐待与精神障碍青少年身份扩散之间的关系，并评估反省功能（RF）是否为这些关系的中介。
107 名（M=15.36，75.7%为女性）在美国一家精神病院住院的青少年完成了儿童期虐待（身体、性和情感虐待；身体和情感忽视；总虐待）、身份扩散和 RF 的自我报告测量。路径分析用于检验童年期虐待、RF 和身份扩散之间关系的两种模型。
在双变量水平上，总虐待和除身体虐待以外的所有形式的虐待都与身份扩散显著相关。在路径分析（模型 1）中，情感和身体忽视与身份扩散直接相关，而 RF 中介了情感虐待与身份扩散之间的关系。在模型 2 中，RF 部分中介了总虐待水平与身份扩散之间的关系。
情感虐待、情感忽视、身体忽视和总合并虐待暴露可能是青少年身份扩散的风险因素。针对 RF 可能有助于建立有精神障碍症状且经历过虐待的青少年的健康身份，特别是情感虐待。
