Illness and narrative identity: examining past and future life story chapters in individuals with bipolar disorder, diabetes mellitus or no chronic illness

The purpose of this study was to investigate whether narrative identity challenges are specific to Bipolar Disorder (BD) as a mental illness or a reflection of living with chronic illness. Nineteen individuals diagnosed with BD, 29 individuals diagnosed with Type 1 Diabetes Mellitus (T1DM) and 25 controls without chronic mental or somatic illness identified past and future life story chapters which were self-rated on emotional tone and self-event connections and content-coded for agency and communion themes. Individuals with BD self-rated their past chapters as more negative and less positive, and their chapters were lower on content-coded agency and communion themes compared to T1DM and controls. There were fewer group differences for future chapters, but BD was associated with lower self-rated positive emotional tone and self-stability connections as well as lower content-coded agency and communion themes. The results indicate that narrative identity is affected in individuals with BD above and beyond the consequences of living with chronic illness. This may reflect distinct effects of mental versus somatic illness on narrative identity.

Measuring narrative identity: rater coding versus questionnaire-based approaches

Narrative identity - how individuals narrate their lived and remembered past - is usually assessed via independent rater coding, but new methods relying on self-report have been introduced. To test the assumption that different methods assess aspects of the same underlying construct, studies measuring similar components of narrative identity with different methods are needed. However, such studies are surprisingly rare. To begin to fill this gap, the present study compared the narrative variables, temporal coherence, causal coherence, and thematic coherence, measured via rater coding of participants' self-generated narratives of the remembered past and via subscales of the self-report measure Awareness of Narrative Identity Questionnaire (ANIQ). The results showed that the ANIQ subscales did not correlate significantly with their corresponding rater-coded dimension, and that the ANIQ subscales were generally unrelated to the other rater-coded dimensions. Furthermore, an exploratory factor analysis demonstrated that the ANIQ subscales loaded together on a factor that did not include any rater-coded variables. The findings suggest that the narrative variables share little empirical overlap when assessed via the ANIQ and rater coding of self-generated narratives.

Specific autobiographical memories are a resource for identity strength among mature but not emerging adults

Four studies, three pre-planned on Open Science Framework, with 2296 participants explored the potential role of recollecting autobiographical memories in enhancing the sense of identity. Among emerging adults (college students under age 25), recollecting important autobiographical memories did not strengthen sense of identity. Autobiographical memories failed to strengthen identity among emerging adults despite inducing low self-clarity first; despite attempts to prime self-consistent memories by having emerging adults report their stable self-aspects first; and despite attempts to inspire self-event connections by asking emerging adults to explain how the memories exemplified something enduring about the self. Among mature adults (age 25 and older), recollecting important autobiographical memories strengthened sense of identity. Identity was strengthened regardless of whether mature adults were asked to explain how the memories exemplified something enduring about the self. Differences in types of memories or motivation did not account for the differential effects of recollecting autobiographical memories in identity. In short, mature adults appear to readily use autobiographical memories as a resource for identity in a way that emerging adults have not yet mastered.

Family relationships as a source of narrative identity of people with advanced dementia

BACKGROUND

The growing body of research on narrative identity, while helpful, rarely focuses on people with dementia. In this paper, we explore how individuals living with advanced dementia construct their narrative identities in relation to their family experiences, which play a crucial role in shaping identity as shown by recent studies.

METHODS

We conducted a qualitative study using data from 15 semi-structured interviews with people aged 66 to 94 who have advanced dementia. The data were analyzed using a textual-oriented discourse analysis.

RESULTS

We identified two discourses-autobiographical and economic-that organize their narrative identities. Through the autobiographical discourse, participants emphasized their sense of belonging within a social group and their role as custodians of family identity. Within the economic discourse, they negotiated their social utility and value, particularly in response to demeaning discourses targeting individuals who do not accumulate wealth. In the structural analysis, we identified two narrative types-looped or unfolding-that depend on their affective experiences related to their family. We especially explored how the repetition of narrative threads by individuals with dementia might indicate a traumatic background rather than just memory disruptions.

CONCLUSIONS

This study provides insights into the narrative identities of individuals with advanced dementia, shedding light on the intersection of family experiences and identity formation in this population.

"Feeling shattered and ephemeral": How do positive and negative symptoms affect self-concept clarity among individuals experiencing psychosis?

PURPOSE

Incoherence in sense of self in schizophrenia may mask individuals' ability to perceive reality accurately, and cause them to feel alienated from themselves and others. This descriptive correlational study investigates the relationship between positive and negative symptoms in relation to self-concept clarity (SCC) in schizophrenia.

METHOD

A sample of 200 inpatients with schizophrenia were recruited to complete the Self-Concept Clarity Scale and were rated on the Brief Psychiatric Rating Scale (BPRS-version 4.0).

RESULTS

A strong inverse correlation between positive and negative symptoms in relation to SCC (r = 0.242, P < 0.001, and r = 0.225, P = 0.001, respectively).

CONCLUSION

The overall BPRS scores were identified as independent precursors of low SCC.

The Interplay Between Childhood Sexual Abuse, Self-Concept Clarity, and Dissociation: A Resilience-Based Perspective

BACKGROUND

Despite a robust consensus regarding the potentially negative implications of childhood sexual abuse (CSA), research investigating risk and protective factors-particularly among well-functioning young adults-is scant. Dissociation is one of the major maladaptive outcomes of CSA. Nevertheless, CSA explains only about 10% of the variance of dissociation. Possibly, this modest effect size is due to protective factors moderating the relation between CSA and dissociative symptoms. One such factor may be the extent to which one has succeeded in developing a clear and coherent sense of who they are.

OBJECTIVE

We aimed to explore whether self-concept clarity (SCC) moderates the relationship between CSA and dissociation (Model 1), and an alternative hypothesis, whereby CSA may moderate the relationship between SCC and dissociation (Model 2).

PARTICIPANTS AND SETTING

This was tested among 65 well-functioning young women drawn from an earlier study that intentionally oversampled CSA survivors.

METHODS

We included data from survivors of CSA by a known perpetrator (n = 35) and women with no sexual trauma (n = 30).

RESULTS

Findings were consistent with both Model 1 and Model 2, but only when depersonalization-derealization, namely detachment, was considered. Simple effects analyses revealed that CSA was related to depersonalization-derealization only under low SCC levels (Model 1), and SCC was negatively related to depersonalization-derealization only in the CSA group (Model 2).

CONCLUSIONS

Findings suggest that SCC is a protective factor, buffering the association between CSA and detachment (depersonalization-derealization) symptoms. Clinical implications are discussed.

Construcción y validación de una Escala de Claridad Subjetiva del Autoconcepto en adultos mexicanos

Los propósitos del presente estudio fueron construir una Escala de Claridad Subjetiva del Autoconcepto para adultos, y aportar evidencias de su configuración y red nomológica. Participaron 697 voluntarios de entre 18 y 60 años, residentes de la Ciudad de México y área metropolitana. El instrumento se construyó basándose en dos estudios exploratorios y en un modelo que propone que la claridad del autoconcepto (CA) se compone por la certeza, congruencia y estabilidad de las autodescripciones. Con base en la realización de análisis factoriales exploratorios y de consistencia interna, se obtuvo un instrumento conformado por 18 reactivos, distribuidos en cuatro factores que explican el 49% de la varianza, con una Alfa de Cronbach de .84. y con evidencias de validez convergente al estar relacionado con la autoestima. En conclusión, se aporta un instrumento con evidencias de validez y confiabilidad para medir la CA en México, el cual permitirá conocer el papel de este constructo para el bienestar y salud mental de los adultos.

Everyday heroes: Graphical life stories and self-defining memories in COVID-19 medical volunteers

OBJECTIVE

This study aimed to explore the autobiographical foundations of specific narrative identities, which made it possible to choose medical volunteering in the time of the pandemic, resist highly hazardous conditions of working in COVID-19 "red zones," and emerge from this work with a sense of meaning and optimism.

METHOD

In this study, we focused on the graphical life stories, self-defining memories (SDMs), and self-defining future projections (SDFPs) of four individuals who worked at COVID-19 "red zone" hospitals as medical volunteers.

RESULTS

The analysis revealed that all participants incorporated their volunteering experiences as meaningful and satisfying into their general narrative identity. They scored high on standard scales assessing subjective well-being and reported autonomous regulation of volunteer motivation. We identified narrative trunk lines and metaphors across autobiographical data, which differentiated the participants into four types of general identities extensively manifesting in volunteering identity: faith-based, influence-based, help-based, and success-based. The participants' graphical life stories, SDMs, and SDFPs showed similar patterns consisting of adult-oriented childhood, focus on mid-life events, and a redemption sequence in narration.

CONCLUSION

These findings could be taken as touchstones to highlight the critical value of self-continuity and sense of purpose in active coping with global challenges.

The relation between self-event connections and personality functioning in youth with severe psychopathology

Objective

One way in which individuals construct their narrative identity is by making self‐event connections, which are often linked to better functioning. Being unable to make connections is related to identity discontinuity and psychopathology. Work in the general population corroborates this association, but also highlights the importance of focusing on specific aspects of these connections and on vulnerable populations.

Method

We examined the association of self‐event connections with personality functioning in youth with severe psychopathology (cross‐sectional N = 228, M_age = 19.5, longitudinal N = 84), and the role of event and connection valence in the subsample of youth who made a connection (n = 188 and n = 68). Negative affectivity was controlled for in all models.

Results

We found no evidence that self‐event connections, nor connection valence and its interaction with event valence, are related to functioning. Positive event valence was associated with better functioning. Higher negative affectivity was strongly linked to lower functioning and explained the relation between event valence and functioning. No longitudinal associations emerged.

Conclusions

These findings show that for youth with severe psychopathology making self‐event connections may not be associated with better functioning. Moreover, negative affectivity may be a distal predictor of both event valence and functioning.

The Link from Child Abuse to Dissociation: The Roles of Adult Disorganized Attachment, Self-Concept Clarity, and Reflective Functioning

In this study of 624 adult participants from the general population (i.e., a community sample), we examine adult disorganized attachment, a construct that can now be measured on a self-report scale, and its linkage between child abuse to dissociation. Prior research has demonstrated that child abuse is positively associated with adult disorganized attachment, which in turn is linked to a variety of externalizing and internalizing behaviors (e.g., depression, anxiety) in adulthood. Based on the literature regarding self-concept, we further consider that having an integrated sense of self is crucial in examining how having an adult disorganized attachment could result in dissociative symptoms. We consider two measures representing an unintegrated sense of self - self-concept clarity and reflective functioning - and find that both play a role in moderating the mediating effects of adult disorganized attachment. Specifically, lower levels of clarity were associated with higher levels of dissociation in our sample, and reflective functioning played a more nuanced and complex role in examining moderated mediation in our sample. Overall, using moderated mediation analysis, we found support for our hypotheses.

Psychological adjustment in care providers following restraint of psychiatric patients

Mental healthcare providers face many difficult interactions with patients that can be emotionally demanding and have adverse effects on their well-being. Recent theoretical models suggest that the interpretation of stressful episodes may be more important for psychological adjustment than the nature of the episodes. This study examined whether care providers' interpretations of mechanical restraint episodes were related to their adjustment. We asked 80 mental healthcare providers to recall mechanical restraint episodes and to rate them on centrality to identity and positive and negative influence on self-understanding. They also completed scales measuring current symptoms of post-traumatic stress, depression, life satisfaction, and well-being. The results showed that care providers who interpreted mechanical restraint episodes as having a central negative influence on their identity experienced more symptoms of post-traumatic stress. Care providers who gave higher ratings of positive self-change following episodes reported more well-being. Our findings suggest, that considering care providers' subjective interpretations of episodes and not merely the objective facts surrounding them is critical if we wish to mitigate the negative emotional impact of episodes.

Differences Between Subclinical Ruminators and Reflectors in Narrating Autobiographical Memories: Innovative Moments and Autobiographical Reasoning

Reasoning may help solving problems and understanding personal experiences. Ruminative reasoning, however, is inconclusive, repetitive, and usually regards negative thoughts. We asked how reasoning as manifested in oral autobiographical narratives might differ when it is ruminative versus when it is adaptive by comparing two constructs from the fields of psychotherapy research and narrative research that are potentially beneficial: innovative moments (IMs) and autobiographical reasoning (AR). IMs captures statements in that elaborate on changes regarding an earlier personal previous problem of the narrator, and AR capture the connecting of past events with other parts of the narrator’s life or enduring aspects of the narrator. A total of N = 94 university students had been selected from 492 students to differ maximally on trait rumination and trait adaptive reflection, and were grouped as ruminators (N = 38), reflectors (N = 37), and a group with little ruminative and reflective tendencies (“unconcerned,” N = 19). Participants narrated three negative personal experiences (disappointing oneself, harming someone, and being rejected) and two self-related experiences of more mixed valence (turning point and lesson learnt). Reflectors used more IMs and more negative than positive autobiographical arguments (AAs), but not more overall AAs than ruminators. Group differences were not moderated by the valence of memories, and groups did not differ in the positive effect of narrating on mood. Trait depression/anxiety was predicted negatively by IMs and positively by AAs. Thus, IMs are typical for reflectors but not ruminators, whereas the construct of AR appears to capture reasoning processes irrespective of their ruminative versus adaptive uses.

The redemption and contamination research form: exploring relations with narrative identity, personality traits, response styles, and life satisfaction

Narrative identity is typically assessed by collecting participants' autobiographical scenes and then coding these stories for themes including redemption (negative beginning, positive ending) and contamination (positive beginning, negative ending). Complimenting this approach, we introduce a self-report measure capturing the degree to which individuals explicitly view their lives and social worlds in redemptive and contaminated ways - the Redemption and Contamination Research Form (RCRF). In Studies 1 and 2, participants completed the RCRF and a measure of life satisfaction. In Study 2, participants also provided three autobiographical scenes, later coded for redemption and contamination. Across studies, our novel self-rated redemptive mindset variable corresponded positively with life satisfaction and, in Study 2, the redemption present in scenes. Relations remained significant after considering several covariates (e.g., traits, response styles). These results, which illustrate the utility of self-rated redemptive mindsets, carry implications for the multi-method assessment of constructs indigenous to narrative identity.

Narrative Identity in Psychopathology: A Negative Past and a Bright but Foreshortened Future

We examined narrative identity as a possible transdiagnostic marker of psychopathology by interviewing individuals with schizophrenia, individuals with depression and a nonclinical control group about past and future chapters in their life stories. Participants were 20 patients with schizophrenia, 20 patients with depression, and 20 nonclinical control participants matched on age, gender, and education. Participants described up to 10 chapters in their past and future life stories and self-rated chapters on emotional tone and self-event connections. In addition, cognitive function and current levels of symptoms was assessed. Both patient groups self-rated their past chapters as more negative and less positive compared to the control group, but did not differ from each other. There were no group differences in positivity of future chapters, but both patient groups identified fewer future chapters with shorter temporal projections. The results are consistent with the notion that negative past aspects of narrative identity are a transdiagnostic marker of psychopathology, while also suggesting that individuals with mental illness construct a positive future, which may support hope.

Identifying distinct sets of predictors of specific functions of autobiographical memory

Grounded in the ecological approach, research has charted several adaptive functions of autobiographical remembering. Each represents a rather different psychosocial domain (i.e., self, social, directive). The goal of this research was to determine the contributions of each of a set of variables, controlling for all others, in predicting use of autobiographical memory to serve each specific function. In two studies, participants (N = 100; N = 195) rated frequency of functional use of specific event memories and completed a brief battery of memory-related measures. Most Study One results were replicated in Study Two. Self-relevance of memories was related to their functional use regardless of domain. Each function was also, however, predicted by a unique set of variables consistent with its use in a given psychosocial domain. Findings emphasise how a combination of factors come into play to allow humans to use autobiographical memory to serve various different functions in navigating daily life.