Search

Contemporary conceptualisations describe identity development as a process of in-depth exploration of one’s identity, making firm commitments, and possible reconsideration of these commitments, which youth engage in when forming their educational and their friendship identities (i.e., three-factor model; Meeus 1996, Crocetti, Rubini & Meeus, 2008b). Forming an identity, when defined in this way, is a prominent task of adolescence and young adulthood. During these years, the central identity question, "Who am I?", becomes especially relevant as a young person transitions from childhood to adulthood. Forming a coherent identity provides an individual security and stability, however, defining a clear understanding of the self and articulating this to others can be a distressing challenge for some youth. In the 1960s, developmental scientists such as Erikson (1963; 1968) and Marcia (1966) described the intrapersonal conflict that can occur when exploring and committing to adult roles that are relevant to both the self and the wider society. Identity is also relevant to clinical psychology, which has focused on identity disturbance, defined as an unstable sense of self that involves sudden changes in self-image and feelings of emptiness and negative self-evaluation (APA, 2013). This is most notably described as a symptom of borderline personality disorder. Despite these two streams of study involving a central theme of identity, they have remained fairly separate areas of research investigation. Founded in a developmental psychopathological framework, which places importance on the simultaneous consideration of typical and atypical development (Cicchetti & Rogosch, 1996), the aims of this research were to clarify the contributions of the identity processes of commitment, exploration, and reconsideration (in two age-relevant domains, education/ideological identity and friendship/interpersonal identity), identity disturbance, and self-regulatory deficits (emotion dysregulation and intolerance of uncertainty) in the presence of symptoms of maladjustment, including symptoms of depression and anxiety, symptoms of borderline personality disorder, and aggression. Four studies were conducted. Study 1 included 336 Australian adolescents aged 12-15 years, while Studies 2-4 were conducted with 505 youth aged 12-20 years recruited from a large high school, a first-year university course, and community mental health centres. Study 1 tested associations of typical identity processes with identity disturbance and symptoms of maladjustment (low self-worth, depression, social anxiety, emotion dysregulation, and identity disturbance), using person-level analyses to identify clusters of adolescents based on their levels of commitment, in-depth exploration, and reconsideration of commitment. Study 2 examined the relationship between in-depth identity exploration and symptoms of mental health disorders (borderline personality features, depressive symptoms, and social anxiety symptoms), by considering the moderating roles of identity commitment, emotion dysregulation, and intolerance of uncertainty. Study 3 focussed on testing the unique associations of typical identity processes and identity disturbance with mental health symptoms of depression and social anxiety, and relational and overt aggression. Lastly, Study 4 was a closer examination of the correlates of adolescent identity disturbance and borderline personality features, considering four criteria for identity disturbance described in the DSM-5 (an unstable self, negative view of self, emptiness, and dissociation), as well as typical identity processes as potential correlates. Three general conclusions are drawn from the results of this program of research: 1) identity disturbance is important to consider when evaluating identity formation during adolescence as typical perspectives may miss youth experiencing severe identity distress; 2) aspects of identity formation can serve as indicators of identity formation distress that is of clinical concern (such as low commitment to self-driven education identity, or feelings of emptiness); and 3) identity formation distress may be a transdiagnostic feature of psychopathology in youth. Theoretical, methodological, and practical implications are discussed. Identity formation difficulties are potential pathways to the development of psychopathology in youth that warrant more investigation, including longitudinal investigations to determine the impacts of identity distress over the course of development. However, the current program of research provides a foundation from which to better identify adolescents at risk of developing psychopathology, and hence promote adaptive mental health and well-being.

The aim of this study was to investigate whether torasemide modifies collagen cross-linking in the failing human heart. We analyzed the degree of cross-linking and the expression of the enzyme lysyl oxidase, which regulates cross-linking, in the myocardium of patients with chronic heart failure at baseline and after 8 months of treatment with either torasemide or furosemide in addition to their standard heart failure therapy. Whereas lysyl oxidase protein expression was very scarce in normal hearts, it was highly expressed in failing hearts. Cross-linking was increased (P