Identity Development in Eating Disorders

Introduction. Identity development represents a core issue in patients with an eating disorder (ED). Although several theorists have underscored the harmful impact of identity related difficulties in ED, in-depth research remains scarce. Using a recently developed identity model that allows for capturing commitment and exploration processes and identifying identity statuses or types (representing combinations of these processes), the present study aimed at investigating personal identity in ED and its psychosocial associations. Method. A total of 123 female patients with ED (aged 11-57) and age-matched community controls reported on identity as well as several clinical outcome variables that commonly co-occur with ED (anxiety, depressive symptoms, borderline symptoms, non-suicidal self-injury [NSSI], and need satisfaction). Results. First, patients with ED scored lower on committing to and identifying with identity-related choices and scored higher on ruminative or maladaptive exploration when compared to controls. Second, with respect to identity statuses, patients with ED experienced less identity synthesis, more identity confusion, and a certain degree of identity disorder when compared to controls. Finally, in patients with ED, the identity disorder status was associated with the highest scores on anxiety, depression, borderline symptoms, and NSSI, and with the lowest scores on need satisfaction. Conclusion. This study indicates that patients with ED experience more identity problems than their age-mates, but considerable variability in identity statuses were observed among patients as well. In addition, patients who simultaneously suffer from an identity disorder experience the most problematic psychosocial development.status: publishe