Presentation Information
[P-25-04]Identity Discontinuity and Incoherence as Mediators Between Childhood Adversity and Internalising Disorders: Clinical and Cultural Implications
*Brenda Lio Liaw Wen1, John Chee Meng Wong1, Liang Shen1, Dennis Kom3, Victoria Fee3, Ruochen Du1, Qai Ven Yap1, Natalie Cheok Ling Lei1, Natalie HuiJing Yap1, Muhammad Nabil Syukri Bin Sachiman1, Nicholas En-Ping Sii1, Michelle Si Wan Jing1, Jie Yu Teoh1, Leoniek M Kroneman1, Daniel Fung2, Say How Ong2, Cheong Sing Tian1, Jia Ying Teng1, Tze Pin Ng1, Frank Verhulst4 (1.National University of Singapore (NUS)(Singapore), 2.Institute of Mental Health (IMH)(Singapore), 3.Ministry of Education (MOE)(Singapore), 4.Erasmus University Medical Center(Netherlands))
Keywords:
adverse childhood experiences,depression,anxiety,adolescence,identity development
Introduction
Adverse childhood experiences (ACEs) are well-established risk factors for depression and anxiety. Identity formation is a central developmental task during adolescence, and early adversity may disrupt normative identity development. This study examines whether identity diffusion; specifically the dimensions of identity discontinuity and incoherence— mediates the relationship between ACEs and internalising disorders, offering insights for targeted, culturally informed interventions in adolescent mental health.
Methods
Data were extracted from the nationwide Youth and Epidemiology and Resilience Study (YEAR), a nationwide survey involving Singaporean adolescents aged 11–18. High-risk youth (≧75th percentile on the Youth Self Report) and a randomly selected 10% of low-risk youth completed the Kiddie Schedule for Affective Disorders and Schizophrenia (K-SADS) interview, which included ACEs assessment. Identity diffusion was measured using the Assessment of Identity Development in Adolescence (AIDA), comprising subscales of discontinuity and incoherence.
Results
The analysis included 459 participants (M_age = 14.0, SD = 2.26). Parallel mediation models showed that identity diffusion fully mediated the associations between ACEs and both depression and anxiety disorders. For depression, both discontinuity (β = .20, p < .001) and incoherence (β = .21, p < .001) had moderate indirect effects (total indirect β = .40). For anxiety, indirect effects were smaller (discontinuity: β = .15; incoherence: β = .18), but still significant (total indirect β = .33, p < .001). The direct effects of ACEs on both outcomes were non-significant. Identity incoherence showed a slightly stronger mediating effect across both outcomes.
Conclusion
Findings highlight identity diffusion, particularly incoherence—as a key mechanism linking ACEs to depression and anxiety. For adolescents who experienced ACEs, interventions should prioritise strengthening self-consistency, autonomy, and cognitive self-experiences. Addressing these specific areas of identity incoherence may enhance the effectiveness of targeted interventions and inform culturally responsive clinical strategies in adolescent mental health.
Adverse childhood experiences (ACEs) are well-established risk factors for depression and anxiety. Identity formation is a central developmental task during adolescence, and early adversity may disrupt normative identity development. This study examines whether identity diffusion; specifically the dimensions of identity discontinuity and incoherence— mediates the relationship between ACEs and internalising disorders, offering insights for targeted, culturally informed interventions in adolescent mental health.
Methods
Data were extracted from the nationwide Youth and Epidemiology and Resilience Study (YEAR), a nationwide survey involving Singaporean adolescents aged 11–18. High-risk youth (≧75th percentile on the Youth Self Report) and a randomly selected 10% of low-risk youth completed the Kiddie Schedule for Affective Disorders and Schizophrenia (K-SADS) interview, which included ACEs assessment. Identity diffusion was measured using the Assessment of Identity Development in Adolescence (AIDA), comprising subscales of discontinuity and incoherence.
Results
The analysis included 459 participants (M_age = 14.0, SD = 2.26). Parallel mediation models showed that identity diffusion fully mediated the associations between ACEs and both depression and anxiety disorders. For depression, both discontinuity (β = .20, p < .001) and incoherence (β = .21, p < .001) had moderate indirect effects (total indirect β = .40). For anxiety, indirect effects were smaller (discontinuity: β = .15; incoherence: β = .18), but still significant (total indirect β = .33, p < .001). The direct effects of ACEs on both outcomes were non-significant. Identity incoherence showed a slightly stronger mediating effect across both outcomes.
Conclusion
Findings highlight identity diffusion, particularly incoherence—as a key mechanism linking ACEs to depression and anxiety. For adolescents who experienced ACEs, interventions should prioritise strengthening self-consistency, autonomy, and cognitive self-experiences. Addressing these specific areas of identity incoherence may enhance the effectiveness of targeted interventions and inform culturally responsive clinical strategies in adolescent mental health.