Loss and growth: Identity processes with distinct and complementary impacts on well-being among those living with chronic illness

Abstract

The diagnosis and treatment of any chronic illness are a major source of stress for most individuals. Although many individuals living with chronic illness report experiencing growth that arises from this experience, studies have revealed mixed results regarding the association between reported growth and other aspects of psychological well-being. This pilot study examines the complementary and buffering influences of self-growth on self-loss in perceptions of physical and mental health among individuals living with HIV (N = 60). The sample was comprised of a racially/ethnically diverse sample of men and women ranging in age from 27 to 62. Measures included impact of illness on Self-Concept Scale, the Medical Outcomes Study HIV Health Survey, the HIV Symptom Index, and the Center for Epidemiological Studies Depression Scale. Regression analyses were conducted to examine the impact of self-growth and self-loss on self-reported bothersome symptoms and depression, controlling for demographic covariates and physical health. Self-loss accounted for a significant proportion of variance in both bothersome symptom reports and depression, after controlling for physical health. In multivariate analysis, self-growth appeared to buffer the negative impact of self-loss on bothersome symptoms, but not on depression. These data suggest that self-loss is a critical construct in understanding adaptation to chronic illness, and that identity processes may influence symptom perception and mental health outcomes above and beyond the impact of traditional measures of health status.

Keywords:

• benefit-finding
• self-loss
• adaptation to chronic illness
• HIV
• identity

Acknowledgments

This research was supported in part by the Hunter College Center for HIV Educational Studies & Training (CHEST). Jonathon Rendina was supported by a Ruth L. Kirchstein National Research Service Award Individual Predoctoral Fellowship from the National Institute of Mental Health (F31 MH095622; H. Jonathon Rendina, PI; Sarit A. Golub, Sponsor; Jeffrey T. Parsons, Co-Sponsor). The authors would like to thank Dr Julia Tomassilli, Dr Jeffrey Parsons, Michael Adams, and the research participants who gave their time and energy to the project.