(PS4-A12) Identity, Somatic Symptoms, and Symptom-related Thoughts, Feelings, and Behaviors in Adolescence: Examining Between- and Within-person Associations and the Role of Depressive Symptoms

From early adolescence, adolescents are challenged to form their identity (Erikson, 1968). Although previous theory and empirical research have highlighted the importance of the interplay between bodily functioning and identity formation in adolescents (Kling et al., 2018; Raemen et al., 2022; Verschueren et al., 2018), to date no longitudinal study has examined the relationship between identity and somatic symptoms and symptom-related thoughts, feelings and behaviors over time. The present study used a three-wave longitudinal design in a sample of adolescents over a two-year period to examine the longitudinal associations and directionality of effects between identity and (psychological characteristics of) somatic symptoms, and to investigate the role of depressive symptoms in this relationship. A total of 599 community adolescents (Time 1: 41.3% female; mean=14.93, SD=1.77, range=12-18 years) participated in three annual assessments. Associations were examined at the between-person and within-person levels using classic and random intercept cross-lagged panel models, respectively. At the between-person level, we found that adolescents with a synthesized identity were less likely to experience psychological characteristics of somatic symptoms, whereas those with a confused identity were more likely to experience somatic symptoms, through the mediating mechanism of depressive symptoms. Alternatively, high levels of somatic symptoms predicted less identity synthesis and more identity confusion, again mediated by depressive symptoms. Notably, the indirect relationship from psychological characteristics of somatic symptoms to identity confusion through the mediating mechanism of depressive symptoms was the only relationship that also occurred at the within-person level. Finally, our study also indicated a bidirectional relationship between these constructs at both levels. Overall, the results of the present study suggest that somatic and emotional distress are closely related to adolescent identity formation. The results of our study may be relevant to clinical practice. Given that adolescents with a weaker sense of identity reported more (psychological characteristics of) somatic symptoms and more depressive symptoms, targeting adolescents with difficulties in forming a strong sense of identity in clinical programs may prevent or reduce the development of such symptoms. By teaching adolescents to think about themselves and their interests, practitioners can help them to identify the goals, plans and beliefs they want to pursue throughout their lives (Berman et al., 2008).