Direct and indirect effects of childhood adversity on psychopathology: Investigating parallel mediation via self-concept clarity, self-esteem and intolerance of uncertainty.

Objectives: The aim was to extend previous work on the identity disruption model (IDM) of adult psychological distress. According to the IDM, aversive childhood experiences (ACEs) disrupt the development of identity, resulting in an unclear sense of self and a reliance on external sources of self-definition, leading to psychological distress in adulthood. In line with this model, self-concept clarity (SCC) in parallel with self-esteem (SE) and intolerance of uncertainty (IU) has been shown to mediate the relationship between childhood adversity and depression and anxiety. The current study examined if SCC, SE and IU mediated the influence of childhood adversity on depression, anxiety and hypomania.

Methods: A community sample of 159 adults completed online measures of childhood adversity, self-esteem, self-concept clarity, intolerance of uncertainty, depression, anxiety and hypomania. Structured equation modelling using bias corrected bootstrapping was used to test the mediation model.

Results: Direct effects of childhood adversity were found for depression and anxiety, but not hypomania. The influence of ACEs on depression and anxiety was mediated by self-concept clarity and self-esteem. Self-concept clarity also mediated the influence of ACEs on hypomania, which is an important novel finding. The indirect effect of childhood adversity via intolerance of uncertainty was limited to anxiety.

Conclusions: Results suggest that the identity disruption model generalizes to hypomania. The clinical implications are that interventions to improve clarity of the self-concept might be useful in reducing psychopathology.