How might childhood adversity predict adult psychological distress? Applying the Identity Disruption Model to understanding depression and anxiety disorders

J Affect Disord. 2020 Mar 15:265:112-119. doi: 10.1016/j.jad.2020.01.036. Epub 2020 Jan 13.

Abstract

Background: Experiencing adversity in childhood is associated with increased risk of a range of psychopathologies, including depression and anxiety disorders. However, there is limited understanding of psychological mechanisms that may help to explain these relationships. The Identity Disruption Model proposes that early adversity can disrupt typical identity development, which may then increase one's vulnerability to psychopathology. The present study aims to apply the Identity Disruption Model to understanding symptoms of depression, generalized anxiety disorder, obsessive-compulsive disorder (OCD), and social anxiety.

Methods: A non-clinical sample of adults from the United States (n = 382) completed an online survey assessing early adversity, self-concept clarity, intolerance of uncertainty, and depression, generalized anxiety, OCD, and social anxiety symptoms. Structural equation models: (1) tested whether early adversity predicts psychopathology via a disrupted sense of self, and (2) explored the role of intolerance of uncertainty in the relationship between early adversity and psychopathology.

Results: Early adversity predicted more severe symptoms of depression and anxiety via lower self-concept clarity. Furthermore, a parallel mediation model showed that self-concept clarity and intolerance of uncertainty simultaneously mediated the relationship between early adversity and psychopathology.

Limitations: The data are cross-sectional in nature and longitudinal research is needed to more conclusively test the causal pathways.

Conclusions: Disrupted identity may be one mechanism through which childhood adversity predicts depression and anxiety disorder symptoms later in life. The Identity Disruption Model provides new avenues for future research and suggests potential points of early intervention for the prevention of depression and anxiety disorders.

Keywords: Anxiety; Depression; Early adversity; Intolerance of uncertainty; Personal identity; Self-concept clarity.

MeSH terms

  • Adult
  • Anxiety
  • Anxiety Disorders* / diagnosis
  • Child
  • Cross-Sectional Studies
  • Depression*
  • Humans
  • Psychological Distress