Understanding Identity Changes in Psychosis: A Systematic Review and Narrative Synthesis
Open accessAbstract
Background and Objective: Experiencing psychosis can be associated with changes in how people see themselves as individuals and in relation to others (ie, changes in their identity). However, identity changes receive little attention in treatment, possibly due to a lack of clarity or consensus around what identity change means in people with psychosis. We aimed to create a conceptual framework synthesizing how identity changes are understood in the psychosis literature. Methods: Electronic databases were searched up to April 2020. Studies about identity changes among people with psychotic disorders were analyzed using narrative synthesis by a collaborative review team, including researchers from different disciplines, clinicians, and people who have experienced psychosis. Results: Of 10 389 studies screened, 59 were eligible. Identity changes are understood in 5 ways as (1) characteristics of psychosis, (2) consequences of altered cognitive functioning, (3) consequences of internalized stigma, (4) consequences of lost roles and relationships, and (5) reflections of personal growth. These 5 understandings are not mutually exclusive. Across a heterogeneous literature, identity changes were mostly framed in terms of loss. Conclusions: Our conceptual framework, comprising 5 understandings, highlights the complexity of studying identity changes and suggests important implications for practice and research. For clinicians, this framework can inform new therapeutic approaches where the experience and impact of identity changes are acknowledged and addressed as part of treatment. For researchers, the conceptual framework offers a way of locating their understandings of identity changes when undertaking research in this area.
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- Authors
- Conneely, M., McNamee, P., Gupta, V., Richardson, J., Priebe, S., Jones, J. M., & Giacco, D.
- Affiliations
- Queen Mary University of London (GB)
- University of Liverpool (GB)
- Corresponding author
- Conneely, Maev
- ORCID
- Venue
- Schizophrenia Bulletin
- Publisher
- Oxford University Press (OUP)
- Published
- 2020-09-29
- Volume
- 47
- Issue
- 2
- Pages
- 309-322
- ISSN
- 0586-7614 (ISSN-L)
- 1745-1701
- PMC
- PMC7965068
- OpenAlex
- W3085049977
- Cited by
- 60
- References
- 151
- Citations by year
- 2026: 8 · 2025: 12 · 2024: 7 · 2023: 13 · 2022: 10 · 2021: 9 · 2020: 1
- FWCI
- 1.37
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Schizophrenia Bulletin (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Warwick Research Archive Portal (University of Warwick) (acceptedVersion)
- e-space (Manchester Metropolitan University) (acceptedVersion)
- UCL Discovery (University College London) (submittedVersion)
- Queen Mary Research Online (Queen Mary University of London) (submittedVersion, cc-by)
- Funders
- Economic and Social Research Council
- Queen Mary University of London
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Social Sciences › Arts and Humanities › Philosophy › Mental Health and Psychiatry
- Social Sciences › Psychology › Developmental and Educational Psychology › Identity, Memory, and Therapy
- Keywords
- personal transformation, psychosis
- MeSH terms
- Humans, Psychotic Disorders, Schizophrenia, Schizophrenic Psychology, Self Concept, Social Stigma, Cognitive Dysfunction
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