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Identity formation in adolescents with congenital cardiac disease: a forgotten issue in the transition to adulthood

Published online by Cambridge University Press:  16 March 2011

Koen Luyckx ,
Eva Goossens ,
Carolien Van Damme  and
Philip Moons
Koen Luyckx*
Affiliation:
Faculty of Psychology and Educational Sciences, School Psychology and Child and Adolescent Development, Centre for Health Services and Nursing Research, University Hospitals of Leuven, Catholic University of Leuven, Leuven, Belgium
Eva Goossens
Affiliation:
Department of Public Health, Centre for Health Services and Nursing Research, University Hospitals of Leuven, Catholic University of Leuven, Leuven, Belgium
Carolien Van Damme
Affiliation:
Faculty of Psychology and Educational Sciences, Centre for Social and Cultural Psychology, University Hospitals of Leuven, Catholic University of Leuven, Leuven, Belgium
Philip Moons
Affiliation:
Division of Congenital and Structural Cardiology, Department of Public Health, Centre for Health Services and Nursing Research, University Hospitals of Leuven, Catholic University of Leuven, Leuven, Belgium
*
Correspondence to: K. Luyckx, Department of Psychology, Catholic University Leuven, Tiensestraat 102, 3000 Leuven, Belgium. Tel: 32 (0)16 325978; Fax: 32 (0)16 326144; E-mail: Koen.Luyckx@psy.kuleuven.be
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Abstract

Identity formation is a core developmental task in adolescence and functions as a key resource for transitioning to adulthood. This study investigated how adolescents with congenital cardiac disease form their identity and how it relates to demographic and medical parameters, quality of life, perceived health, depressive symptoms, and loneliness. A total of 429 adolescents aged 14–18 years with congenital cardiac disease and 403 matched controls completed questionnaires on identity and all outcome variables. There were five meaningful identity statuses, similar to those obtained in the control sample, which were found in the patient sample. Of them, two statuses – achievement and foreclosure – were characterised by a strong sense of identity; one status – diffused diffusion – especially was characterised by a weak sense of identity combined with high scores on worry about the future. These identity statuses were differentially related to outcome variables, with individuals in diffused diffusion especially scoring highest on depressive symptoms, problems in school, treatment anxiety, and communication problems with clinicians, and lowest on quality of life. Having a strong sense of personal identity was found to protect against such maladaptive outcomes. In sum, most adolescents with congenital cardiac disease moved through their identity formation process in a similar manner to other adolescents. Adolescents with a diffused identity were particularly at risk of experiencing maladjustment and problems in treatment adherence. Hence, developing intervention strategies to provide continuity of care on the road to adulthood involves paying attention to core developmental tasks, such as identity formation in adolescents with congenital cardiac disease.

Keywords

Cardiac defectscongenitalidentityadolescencequality of lifedepressive symptomsloneliness
Type
Original Articles
Information
Cardiology in the Young , Volume 21 , Issue 4 , 12 July 2011 , pp. 411 - 420
Copyright
Copyright © Cambridge University Press 2011

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Footnotes

*

KL is a postdoctoral researcher at the Fund for Scientific Research, Flanders.

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