CoChat
Sign Up
Cited by 106Identity, Memory, and TherapyChild and Adolescent Psychosocial and Emotional DevelopmentEating Disorders and Behaviors

Identity Development and Social-Emotional Disorders During Adolescence and Emerging Adulthood: A Systematic Review and Meta-Analysis

Open access
Potterton, Rachel, Austin, Amelia, Robinson, Lauren, Webb, Hannah, Allen, Karina L., Schmidt, Ulrike·2022·Journal of Youth and Adolescence
DOI 10.1007/s10964-021-01536-7PMC PMC8732894
Open this paper in CoChat — free accountOpen PDF

Abstract

Depression, anxiety and eating disorders (“social-emotional disorders”) are common during adolescence/emerging adulthood, periods of intense identity development. Despite this, there are few reviews of existing research on the relationship between symptoms of these disorders and ongoing identity development. This study systematically reviewed, narratively synthesized and meta-analyzed longitudinal investigations of the relationship between identity synthesis/confusion and depression, anxiety and eating disorders symptoms during adolescence/emerging adulthood. Three databases (PsycInfo, Medline, Embase) were searched. Study quality was systematically appraised, findings were qualitatively synthesized and (where possible) meta-analyzed. 20 studies (55% “fair” quality, 45% “poor” quality) were identified, including 13,787 participants (54.2% female, mean age = 14.48 years, range 10–29 years). The narrative synthesis found evidence of bidirectional relationships between identity synthesis/confusion and depression, anxiety and eating disorder symptoms. Meta-analyses and meta-regressions of a sub-sample of studies (N = 9) indicated no significant associations between identity synthesis or confusion and anxiety or depression symptoms. More high-quality research is needed before firm conclusions can be drawn.

AI snapshot

Written from the paper’s full text.

TL;DR

This systematic review and meta-analysis examined longitudinal associations between identity synthesis/confusion and depression, anxiety, and eating disorder symptoms during adolescence and emerging adulthood. Narrative synthesis found some evidence of bidirectional relationships, but meta-analyses of a sub-sample found no significant associations between identity and anxiety or depression symptoms.

Key findings

  • The review identified 20 studies with 13,787 participants (54.2% female, mean age = 14.48 years, range 10–29 years); 55% were rated “fair” quality and 45% “poor” quality, with no studies rated “good.”
  • Narrative synthesis found evidence of bidirectional relationships between identity synthesis/confusion and depression, anxiety, and eating disorder symptoms; for example, high synthesis/low confusion trajectories were associated with fewer depression and anxiety symptoms than low synthesis/high confusion trajectories.
  • Meta-analyses of 9 studies found a significant increase in identity synthesis over time (SMD = 0.11; 95% CI 0.02–0.20; p = 0.02) and a significant decrease in depression and anxiety symptoms over time (SMD = −0.11; 95% CI −0.18 to −0.03; p = 0.005), but no significant change in identity confusion (SMD = −0.01; 95% CI −0.16 to 0.14; p = 0.94).
  • Meta-regressions found no statistically significant predictors of change in identity synthesis or depression and anxiety symptoms, and the meta-analyses indicated no significant associations between identity synthesis or confusion and anxiety or depression symptoms.

Methods

  • Systematic review conducted according to PRISMA; PsycInfo, Medline, and Embase were searched from inception until 22 June 2021, supplemented by internet and reference-list hand-searches.
  • Inclusion criteria required longitudinal quantitative studies using (neo)Eriksonian identity measures and measures of social-emotional disorder symptoms, with at least 95% of samples aged 10–30 years; non-English studies and gray literature were excluded.
  • Findings were narratively synthesized; study quality was appraised with the Newcastle Ottawa Scale; meta-analyses and meta-regressions were conducted in Stata/SE 16.0 using random-effects models and standardized mean differences.

Limitations

  • The paper states that gray literature and non-English studies were excluded, studies were predominantly from the Netherlands and the United States, and most included studies were only of fair quality with shortfalls in selection, comparability, and outcome measurement (e.g., self-report questionnaires, <70% retention).
  • The paper states that meta-analyses could not include all identified studies due to heterogeneity, included multiple publications from the same cohort, and may have been underpowered for meta-regression with only nine studies.
  • Evident from the text: no included studies assessed the efficacy of identity-focused clinical interventions, only three studies focused on eating disorder symptoms, and a meta-analysis of eating disorder symptoms was not possible due to insufficient data.

Model-written summary. Check it against the paper before relying on it.

Integrity signals

Registry

Crossref · 10.1007/s10964-021-01536-7

Cites

60 of 60 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Claims the paper makes

14 of 47 cited sources checked · 3 supported · 0 flagged · accuracy not yet measured

  • Findingcitation

    There was no prospective association between identity confusion and drive for thinness.

    “There was no prospective association between identity confusion and drive for thinness.”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites Verschueren et al., 2018 source
  • Findingcitation

    A high-risk eating disorder symptom trajectory (normal BMI + high eating disorder symptoms) had higher levels of identity confusion compared to low-risk groups (normal/low BMI + low eating disorder symptoms).

    “This study found that a “high risk” eating disorder symptom trajectory (i.e., normal BMI + high levels of eating disorder symptoms) had higher levels of identity confusion compared to “low risk” groups”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites Verschueren et al. 2019 source
  • Findingcitation

    High identity confusion predicted high body dissatisfaction and bulimia one and two years later, with small effect sizes.

    “High identity synthesis also predicted low eating disorders symptoms (body dissatisfaction; bulimia; drive for thinness) and high identity confusion predicted high body dissatisfaction and bulimia one and two years later, with small effect sizes.”
    Quote in the paperSubstantial claim1 of 1 sources checked
    • cites Verschueren et al., 2018 source

      The Results section, “Directionality of Effects Linking Identity Formation and ED Symptomatology” (page unavailable), reports that identity confusion positively predicted body dissatisfaction and bulimia symptoms over time in a study with three annual measurements. The reported cross-lagged paths link consecutive measurements; our copy does not establish a separate prediction two years later or document the claimed small effect sizes. (LLM, conf=0.82)

      Experimental — accuracy not yet measured
  • Findingcitation

    Identity synthesis and confusion predicted eating disorder symptoms one and two years later in Belgian adolescents and emerging adults.

    “identity synthesis and confusion predicted eating disorder symptoms one and two years later”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites Verschueren et al., 2021 source
  • Findingcitation

    One study found that high depression and anxiety symptoms did predict higher identity confusion.

    “one of these studies found that high depression and anxiety symptoms did predict higher identity confusion”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites Hatano et al., 2020 source

      The ‘Identity Processes, Trajectories, and Their Associations’ section identifies anxiety and depression as internalizing problems. The ‘Relations Among Identity Trajectories, Subjective Well-Being, and Psychosocial Problems’ section reports an association between internalizing problems and moratorium identity trajectories. It does not report that depression and anxiety symptoms predicted later identity confusion; the paper analyzes associations with identity trajectories, not that directional prediction. (LLM, conf=0.83)

      Experimental — accuracy not yet measured
  • May combine two claims. 32
  • Classified as probably not a substantial claim. 33

  • May combine two claims.

    Findingcitation

    High body dissatisfaction and bulimia symptoms (but not drive for thinness) predicted lower identity synthesis and higher identity confusion one and two years later amongst Dutch adolescents, with small effect sizes.

    “They found that high body dissatisfaction and bulimia symptoms (but not drive for thinness) predicted lower identity synthesis and higher identity confusion one and two years later amongst Dutch adolescents, with small effect sizes.”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites Verschueren et al., 2018 source

      The Results (Directionality of Effects Linking Identity Formation and ED Symptomatology) report that body dissatisfaction and bulimia symptoms predicted lower identity synthesis and higher identity confusion across successive annual measurements; the Discussion says drive for thinness did not show the same pattern. But Participants and Procedure identifies the students as Flemish adolescents in Dutch-speaking Belgium, not adolescents in the Netherlands. The models test one-year cross-lagged paths over a two-year study, rather than a distinct prediction two years later, and the cited passages do not establish the claimed small effect sizes. (LLM, conf=0.89)

      Experimental — accuracy not yet measured

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Findingcitation

    Within-person increases in identity synthesis were associated with decreases in depressive symptoms six months later during adolescence, with a small effect size, but there was no effect of identity confusion.

    “within-person increases in identity synthesis were associated with decreases in depressive symptoms six months later – with a small effect size – during adolescence, but there was no effect of identity confusion”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites Meca et al., 2019 source

      The Results (Establishing Directional Effects; page unavailable) report that higher-than-usual identity coherence predicted lower depressive symptoms at the next wave (β = −0.164), while the Discussion says identity confusion did not predict subsequent depressive symptoms. However, Methods (Procedure; page unavailable) specifies that the analyses used waves 12 months apart, not six months apart. The finding also concerns recently immigrated Hispanic adolescents, rather than adolescents generally. (LLM, conf=0.91)

      Experimental — accuracy not yet measured

  • May combine two claims.

    Interpretationown data

    Visual inspection of the forest plot suggests that two studies by the same research group, drawing participants from the same cohort, found effects in the opposite direction to the other studies (increasing identity confusion), driving the counter-intuitive finding of no significant change in identity confusion.

    “Visual inspection of the forest plot suggests that two studies - by the same research group, and drawing participants from the same cohort - found effects in the opposite direction to the other studies (i.e., increasing identity confusion), driving this counter-intuitive finding (Hatano et al., 2019; Hatano et al., 2020).”
    Quote in the paperSubstantial claim2 of 2 sources checked
    • cites Hatano et al., 2019 source

      Split into 2 atoms — 0 confirmed, 2 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.

      Experimental — accuracy not yet measured
    • cites Hatano et al., 2020 source

      Split into 2 atoms — 0 confirmed, 2 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.

      Experimental — accuracy not yet measured

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Findingown data

    The review included 18 articles, reporting 20 studies.

    “The review therefore included a total of 18 articles, reporting 20 studies.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    The systematic search yielded 1318 records following deduplication.

    “The systematic search yielded a total of 1318 records following deduplication.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingnone given

    All included studies used self-report measures of both identity development and mental health problems.

    “All studies used self-report measures of both identity development and mental health problems.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    Seven studies (35.0%) included both adolescents and emerging adult participants (range 10-24 years).

    “seven studies (35.0%) included both adolescents and emerging adult participants (range: 10–24 years)”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingcitation

    The association between high anxiety trajectories and low synthesis/high confusion pertained to school-related anxiety symptoms only, and not social and generalized anxiety.

    “one study found that this pertained to school-related anxiety symptoms only, and not social and generalized anxiety”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Crocetti et al., 2009; Nelemans et al., 2014

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    After screening, 1300 articles were excluded as not relevant.

    “1300 articles were excluded as not relevant”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Included studies comprised 13,787 participants, all nonclinical community-based samples.

    “Studies include a total of 13,787 participants, and all were nonclinical, community-based samples.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Findingown data

    Three studies (15.0%) focused on eating disorder symptoms; the remainder measured depression and anxiety symptoms.

    “Three studies (15.0%) focused on eating disorder symptoms; the remainder measured depression and anxiety symptoms.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    The review identified 20 studies, including 13,787 participants (54.2% female, mean age = 14.48 years, range 10-29 years).

    “20 studies (55% “fair” quality, 45% “poor” quality) were identified, including 13,787 participants (54.2% female, mean age = 14.48 years, range 10–29 years).”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    One study (5.0%) included emerging adults only (range 17-29 years).

    “one study (5.0%) emerging adults only (range: 17–29 years)”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Only two studies reported data on eating disorder symptoms, so a meta-analysis of change in eating disorder symptoms was not possible due to insufficient data.

    “As only two studies reported data on eating disorder symptoms, it was not possible to conduct a meta-analysis of change in eating disorder symptoms due to insufficient data.”
    Quote in the paperSubstantial claim

  • Classified as probably not a substantial claim. May combine two claims.

    Findingreasoning

    Sufficient data were not available to standardize baseline identity and depression/anxiety scores, so only studies providing raw baseline scores on the same continuous measure were included in these continuous predictors.

    “As sufficient data were not available to standardize baseline identity and depression/anxiety scores, only studies who provided raw baseline scores on the same continuous measure (i.e., the same scale) were able to be included in these continuous predictors.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingcitation

    High identity synthesis predicted lower depressive symptoms in adolescents but had no such effect for anxiety disorder symptoms.

    “high identity synthesis predicted lower depressive symptoms in adolescents but found no such effect for anxiety disorder symptoms”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Schwartz et al., 2012 source

  • Classified as probably not a substantial claim.

    Findingnone given

    Data on change in depression and anxiety symptoms and identity synthesis and confusion over time were available for all studies.

    “Data on change in depression and anxiety symptoms and identity synthesis and confusion over time (i.e., standardized mean difference—mean scores at follow-up minus mean scores at baseline, divided by the pooled pretest standard deviation) were available for all studies.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    Just two studies reporting required data used a measure of anxiety only, and several studies assessed anxiety and depression as a composite; therefore change in depression and anxiety symptoms were examined together.

    “Just two studies reporting the required data used a measure of anxiety only, and several studies assessed anxiety and depression as a composite. For this reason, change in depression and anxiety symptoms were examined together, rather than in separate meta-analyses.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingcitation

    Three studies (reported in two publications) found no evidence for an effect of within-person change in identity synthesis but did find such an effect for identity confusion in adolescents and emerging adults.

    “Three studies (reported in two publications) found no evidence for an effect of within-person change in identity synthesis but did find such an effect for identity confusion in adolescents and emerging adults”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Becht et al., 2019; Hatano et al., 2020

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • May combine two claims.

    Findingown data

    After trim and fill correction, the pooled effect for change in identity synthesis (SMD = 0.11; 95% CI: 0.01-0.203) and for depression and anxiety symptoms (SMD = −0.132; 95% CI: −0.201 to −0.06) remained statistically significant.

    “The trim and fill correction was performed and pooled effect sizes were converted to an exponential form, with key findings for change in identity synthesis (SMD = 0.11; 95% CI: 0.01–0.203) and depression and anxiety symptoms (SMD = −0.132; 95% CI: −0.201 to −0.06) remaining statistically significant.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    The Egger test indicated small study effects within the identity synthesis meta-analysis (t = −5.61, p = 0.00), but not in the identity confusion (t = 1.50, p = 0.77) or depression and anxiety symptoms (t = 2.93, p = 0.16) meta-analyses.

    “The Egger test indicated small study effects within the identity synthesis meta-analysis (t = −5.61, p = 0.00), but not in the identity confusion (t = 1.50, p = 0.77) and depression and anxiety symptoms (t = 2.93, p = 0.16) meta-analyses.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingcitation

    Preliminary evidence indicated that effects may differ according to identity domain, with depressive symptoms associated with later educational synthesis but not interpersonal synthesis.

    “Preliminary evidence indicated that effects may differ according to identity domain (i.e., depressive symptoms associated with later educational synthesis, but not interpersonal synthesis) (van Doeselaar et al., 2018).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites van Doeselaar et al., 2018 source

  • Classified as probably not a substantial claim.

    Study design and conductown data

    The quality of included studies was independently appraised by two reviewers using the NOS.

    “The quality of included studies was independently appraised by two reviewers (RP and AA) using the Newcastle Ottawa Quality Assessment Scale (NOS)”
    Quote in the paperSubstantial claim

  • Classified as probably not a substantial claim. May combine two claims.

    Premisecitation

    Depressive, anxiety and eating disorders may be conceptualized collectively as 'social-emotional disorders' and may share etiological and maintenance factors.

    “suggested that these disorders might be conceptualized collectively as “social-emotional disorders”, and may share etiological and maintenance factors (Rapee et al., 2019).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Rapee et al., 2019 source

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductnone given

    Ratings were compared between reviewers and consensus achieved through discussion.

    “Ratings were compared between reviewers and consensus achieved through discussion.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    The NOS's inter-rater reliability has been found to range from fair to high depending on the types of studies assessed and the raters.

    “The scale’s inter–rater reliability has been found to range from fair to high depending on the types of studies assessed and the raters (Hartling et al., 2013; Oremus et al., 2012).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Hartling et al., 2013; Oremus et al., 2012

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • Classified as probably not a substantial claim.

    Premisecitation

    Successful identity development involves moving from a state of predominant identity confusion towards identity synthesis.

    “It proposes that successful identity development involves moving from a state of predominant “identity confusion” (i.e., a sense of inconsistency or uncertainty in one’s idea of oneself) towards “identity synthesis””
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Erikson, 1950

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    Eligibility criteria were specified prior to study selection.

    “Prior to study selection, eligibility criteria were specified”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    Two reviewers independently screened titles and abstracts of retrieved articles.

    “Two reviewers (RP, AA) independently screened the titles and abstracts of retrieved articles.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    Discrepancies between reviewers' decisions were resolved through discussion.

    “Discrepancies between the reviewers’ decisions were resolved through discussion.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    No third-party was consulted.

    “No third-party was consulted.”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim.

    Premisecitation

    Exploration and commitment are key processes underpinning identity confusion and synthesis.

    ““Exploration” (i.e., trying various identity options) and “commitment” (i.e., selecting identity options) were later proposed as the key processes underpinning identity confusion and synthesis (Marcia, 1966).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Marcia, 1966 source

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductown data

    One reviewer extracted data, and a second reviewer independently checked the extracted data.

    “One reviewer (RP) extracted data concerning sample characteristics, measures and main findings from the included articles using a prepiloted data form. These data were independently checked (i.e., extracted data were compared to those reported in the included articles) by a second reviewer (AA).”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    The NOS was developed to assess the quality of nonrandomized studies in systematic reviews and meta-analyses and is recommended for use by the Cochrane Collaboration.

    “This scale was developed to assess the quality of nonrandomized studies in systematic reviews and meta-analyses and is recommended for use by the Cochrane Collaboration (Higgins et al., 2019).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Higgins et al., 2019

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Based on levels of past and current exploration and commitment, individuals can be categorized into four discrete identity statuses: diffusion, moratorium, foreclosure, and achievement.

    “Based on levels of past and current exploration and commitment, individuals can be categorized into four discrete identity statuses: “diffusion”; “moratorium”; “foreclosure” and “achievement” (Marcia, 1966).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Marcia, 1966 source

  • Classified as probably not a substantial claim.

    Study design and conductcitation

    A systematic review was conducted in accordance with PRISMA guidelines.

    “A systematic review was conducted in accordance with the relevant PRISMA statement guidelines (Moher et al., 2009).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Moher et al., 2009 source

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    Full text versions of remaining articles were screened independently by the same reviewers.

    “Full text versions of the remaining articles were then obtained and screened independently by the same reviewers.”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim.

    Premisecitation

    Studies focused exclusively on ethnic identity development were excluded because its development is conceptualized distinctly from other forms of identity.

    “Studies focused exclusively on ethnic identity development were excluded because its development is conceptualized distinctly from other forms form of identity (Phinney & Ong, 2007).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Phinney & Ong, 2007 source

  • Classified as probably not a substantial claim. May combine two claims.

    Premisecitation

    Identity development difficulties and social-emotional disorders may be related through common causes, identity difficulties increasing disorder likelihood, disorder increasing identity difficulties, or both.

    “identity development difficulties may increase the likelihood of the emergence of social-emotional disorders, social-emotional disorders may increase the likelihood of identity development difficulties, or both phenomena may be underpinned by common causes (Klimstra & Denissen, 2017).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Klimstra & Denissen, 2017 source

  • May combine two claims.

    Premisecitation

    Ongoing identity development may increase vulnerability to social-emotional disorders, whilst such difficulties may also impede identity development.

    “Ongoing identity development may increase vulnerability to social-emotional disorders, whilst such difficulties may also impede identity development (Klimstra & Denissen, 2017).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Klimstra & Denissen, 2017 source

  • May combine two claims.

    Interpretationreasoning

    The narrative review found some support for bidirectional relationships between identity confusion/synthesis and social-emotional disorders, i.e., that high identity confusion and low identity synthesis are both a cause and a consequence of social-emotional disorders.

    “The narrative review therefore found some support for bidirectional relationships between identity confusion/synthesis and social-emotional disorders i.e., that high identity confusion and low identity synthesis are both a cause and a consequence of social-emotional disorders.”
    • Also stated in: § Conclusion · hedged
      “The narrative synthesis found some evidence for bidirectional relationships between identity synthesis and confusion and socio-emotional disorders during adolescence and emerging adulthood.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductown data

    Consensus between reviewers following independent rating of study quality was 86%, and after discussion consensus was 100%.

    “Consensus between the reviewers following independent rating of study quality was 86%. After discussion, consensus was 100%”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductcitation

    Non-English studies and gray literature were excluded from the review.

    “non-English studies and gray literature (i.e., research unpublished or published in noncommercial form) were also excluded from the review”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductreasoning

    It is possible that potentially informative studies were not identified, which may bias the findings.

    “it is possible that potentially informative studies were not identified which may bias the findings.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Study design and conductnone given

    Studies demonstrated shortfalls in selection and comparability of study groups (e.g., nonrepresentative samples; relevant factors not controlled for at baseline) and measurement of outcomes (e.g., self-report questionnaires; <70% retention rates).

    “Studies demonstrated shortfalls in selection and comparability of study groups (e.g., nonrepresentative samples; relevant factors not controlled for at baseline) and measurement of outcomes (e.g., self-report questionnaires; <70% retention rates).”
    • Also stated in: § Conclusion · plain
      “There were shortfalls in selection and comparability of study groups (e.g., nonrepresentative samples; relevant factors not controlled for at baseline) and measurement of outcomes (e.g., self-report questionnaires; <70% retention rates).”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Study design and conductown data

    Heterogeneity across the three meta-analyses was high (Higgins I2 ranged from 75.92% to 91.13%), justifying the use of a random-effects model.

    “The Higgins I2 heterogeneity statistic ranged from 75.92% to 91.13% across our three sets of analyses, justifying the use of the random-effects model.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    Consensus between reviewers following independent screening of full texts was 88%.

    “Consensus between the reviewers following independent screening of full texts was 88%.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Interpretationnone given

    Including multiple publications drawing on participants from the same cohort may bias the estimates of effect size.

    “It is possible that this may bias the estimates of effect size.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Study design and conductown data

    Studies were predominantly conducted in the Netherlands and the United States, which may limit the generalizability of the review's findings.

    “Studies were predominantly conducted in the Netherlands and the United States, which may limit the generalizability of the review’s findings.”
    Quote in the paperNot a substantial claim
    • Rests on an assumption: There are likely to be differences between the Netherlands and the United States and other countries regarding identity development and its association with mental health.

  • May combine two claims.

    Study design and conductreasoning

    Many studies did not control for identity development/social-emotional disorder at baseline, making it difficult to be certain about the direction of the effect.

    “However, it is important to note that many studies did not control for identity development/social-emotional disorder at baseline so it is difficult to be certain about the direction of the effect.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Study design and conductreasoning

    This review highlights issues with the quality of research within the field, with all included studies only of fair or poor quality.

    “This review highlights issues with the quality of research within the field, with all included studies only of fair or poor quality.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductnone given

    Gray literature and non-English studies were excluded from the review.

    “Gray literature and non-English studies were excluded from the review.”
    Quote in the paperNot a substantial claim
52 of 52

  • The authors state this as an assumption.

    The random effects model assumes both within-group variability and between-study heterogeneity.

    “The random effects model assumes both within-group variability and between-study heterogeneity.”

  • The paper relies on this without support.

    Intervention development remains in its infancy.

    “However, intervention development remains in its infancy”

  • The paper relies on this without support.

    There are few reviews of existing research on the relationship between symptoms of these disorders and ongoing identity development.

    “Despite this, there are few reviews of existing research on the relationship between symptoms of these disorders and ongoing identity development.”

  • The paper relies on this without support.

    Increased understanding of any link between identity development and social-emotional disorders may help to improve prevention and intervention efforts.

    “Increased understanding of any link between identity development and social-emotional disorders may help to improve prevention and intervention efforts for these difficulties.”

  • The paper relies on this without support.

    Rigorous reviews which synthesize existing basic research are needed to advance the field.

    “rigorous reviews which synthesize existing basic research are needed to advance the field.”

  • The paper relies on this without support.

    Social-emotional disorders are common during adolescence/emerging adulthood.

    “Social-emotional disorders are common during adolescence/emerging adulthood, times of intense identity development.”
    “Social-emotional disorders are common during adolescence/emerging adulthood, yet few reviews synthesize existing research on the relationship between these disorders and ongoing identity development.”

  • The paper relies on this without support.

    Few reviews synthesize existing basic research exploring the relationship between identity development and social-emotional disorders.

    “yet few reviews synthesize existing basic research exploring this relationship.”
    “yet few reviews synthesize existing research on the relationship between these disorders and ongoing identity development.”

  • The paper relies on this without support.

    There are likely to be differences between the Netherlands and the United States and other countries regarding identity development and its association with mental health.

    “There are likely to be differences between these countries and other countries regarding identity development and its association with mental health.”
8 of 8

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

Each contradiction between two passages listed here was confirmed by an independent check.

  • Reported quality categories overlap

    Minor

    Under the stated thresholds, every study meeting the "fair" criterion also meets the "good" criterion. The report nevertheless assigns 11 studies to fair and says none were good.

  • Duplicate-study rules conflict at exactly 50% unique participants

    Minor

    For studies from the same cohort with exactly 50% unique participants, one rule retains only the longest-follow-up study while the other includes all studies.

  • Eligibility rules conflict at exactly 5% adults

    Minor

    A sample with exactly 95% of participants aged 10-30 and 5% aged over 30 satisfies both the inclusion and exclusion criteria.

  • Meta-regression coefficient lies outside its reported confidence interval

    Minor

    The reported study-duration coefficient is 0.11, but its 95% confidence interval ends at 0.08.

  • Identity-confusion study percentage uses the wrong denominator

    Minor

    Six of the seven studies in this meta-analysis is 85.7%, not 66.7%.

    Reported 66.7 · recomputed 85.714286

5 of 5

Cites

Flagged first, then by citations

1 of the 61 references couldn’t be matched to a known paper.

Research works printed but not linked: 1

  1. Wells, G., Shea, B., O’Connell, D., Peterson, J., Welch, V., Losos, M., & Tugwell, P. (2014). Newcastle-Ottawa quality assessment scale cohort studies. Ontario, Canada: University of Ottawa.

Cited by

Sorted by citations

Related

Authors
Potterton, R., Austin, A., Robinson, L., Webb, H., Allen, K. L., & Schmidt, U.
Affiliations
King's College London (GB)
Corresponding author
Potterton, Rachel
ORCID
Venue
Journal of Youth and Adolescence
Publisher
Springer Science and Business Media LLC
Published
2021-11-16
Volume
51
Issue
1
Pages
16-29
ISSN
  • 0047-2891 (ISSN-L)
  • 1573-6601
DOI
10.1007/s10964-021-01536-7
PMC
PMC8732894
OpenAlex
W3212406359
Cited by
106
References
61
Citations by year
2026: 49 · 2025: 31 · 2024: 12 · 2023: 12 · 2022: 2
FWCI
1.47
Type
journal article
Language
en
Open access
Licence
Locations
  • Journal of Youth and Adolescence (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • Edinburgh Research Explorer (University of Edinburgh) (submittedVersion, cc-by)
  • PubMed Central (submittedVersion, cc-by)
Funders
  • National Institute for Health Research
  • Institute of Psychiatry, Psychology and Neuroscience, King’s College London
Topics
  • Social Sciences › Psychology › Developmental and Educational Psychology › Identity, Memory, and Therapy
  • Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
  • Social Sciences › Psychology › Clinical Psychology › Eating Disorders and Behaviors
Keywords
identity construction, identity synthesis, identity confusion, depression, anxiety, eating disorders, adolescence, emerging adulthood, bidirectional relationship
MeSH terms
Adolescent, Adult, Anxiety, Anxiety Disorders, Child, Depression, Female, Humans, Longitudinal Studies, Male, Social Conditions, Young Adult

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Claims read by deepseek-v4.1-flash under definition version 3 (extract-v3) on 2026-10-16.

Classified by jev-1.13-20260917 (gold-guideline-v0.2) on 2026-10-16.

Cited sources are checked by gpt-6-sol.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review