Narrative identity disturbances in psychopathology: An ecologically valid transdiagnostic framework.

ABSTRACT

This article presents an ecologically valid transdiagnostic framework regarding narrative identity disturbances in psychopathology. Problems with self and identity are distressing, disruptive to everyday functioning, and central to theoretical models of recovery. Yet these problems are sorely understudied, in part due to differences in concepts, theories, and measurement models across disorder-specific literatures. Disorder-specific theories are useful for understanding the etiology of disturbances to self and identity. However, while root causes may vary across disorders, their effects on explicit, conscious, reflective experience share important transdiagnostic parallels. These problems affect the extended sense of self as an individual with memories, a present identity, and future expectancies. By extension, these problems are developmental, reflecting an ever-evolving conception of oneself across the life course. Finally, these problems are contextual and intersubjective, constructed over time through interactions with others in the family, community, and society. A unified transdiagnostic model for reflective self-disturbances should therefore be idiographic and grounded in developmental and personality theory, with a strong emphasis on ecological validity. Narrative identity is emerging as a coherent, cross-cutting framework for understanding problems with self and identity across diagnostic boundaries. Important current research directions include transdiagnostic samples and clinical control groups; more diverse samples; expanding on the latent structure of narrative identity in clinical populations, and developing new assessment techniques to supplement trained raters. These directions will further enhance narrative identity's utility for idiographic, developmental, and ecologically valid clinical research. (PsycInfo Database Record (c) 2024 APA, all rights reserved).