Stability and change of illness identity in Belgian youth with type 1 diabetes: a latent transition analysis

Youth with type 1 diabetes (T1D) are tasked with integrating their illness into their identity, a process conceptualized as illness identity. To date, longitudinal person-centered studies are lacking that substantiate qualitative research capturing illness identity as a process.

First, the current study examined patterns of stability and change among illness identity profiles in youth with T1D. Second, the study investigated how these profiles and patterns are related to background and medical characteristics, psychological, and contextual variables.

This 4-wave longitudinal study (covering 3 years) included 558 adolescents and emerging adults with T1D at baseline recruited from the Belgian Diabetes Registry (age range = 14-26 years, 54% female). Latent transition analysis was used to examine (1) illness identity profiles and (2) patterns of stability and change among these profiles. Multinomial logistic regression models examined the profiles' and patterns' associations with the background and medical characteristics, psychological, and contextual variables.

Three illness identity profiles emerged: the more-integrated profile, the less-integrated profile, and the least-integrated profile. Although most individuals remained within their profile across 3 years, several meaningful transitions occurred as well. Age, self-esteem, diabetes distress, and psychological control were related to profile membership, whereas only illness duration was related to transitional patterns.

The present study informed both theory and clinical practice on how illness identity is experienced by youth with T1D from a person-centered perspective. In addition, the results provided insight into which aspects are meaningfully related to illness identity integration, supporting tailored interventions for youth with T1D.