Young Adults and Early-Onset Psychosis: A Grounded Theory Study of Experiences of Identity Development

Authors

Katherine Hayden-Lewis, Luminescent Therapeutics and Consultation, Oregon, USAFollow
Deborah Rubel, Oregon State University, Corvallis, Oregon, USAFollow

Abstract

While identity development is a crucial task for young individuals ages 15-25, current research inadequately centralizes identity development in the context of first-time psychosis related to schizophrenia spectrum disorders. This study addresses the knowledge gap by exploring the grand research question, “How does a young person experience their identity development after the first episode of psychosis?”. Constructivist grounded theory methods influenced by critical frameworks were used to collect and analyze data with seven young adults engaged in first episode psychosis programs. Participants were young adults, between the ages of 19-24, that at the time of the study were enrolled in or had completed two-year early intervention for psychosis outpatient mental health treatment programs in the Pacific Northwest. Data analysis resulted in a theory based on their lived experiences highlighting identity construction patterns. The theory frames identity construction as a continuous, nonlinear meaning-making and relational process. The theory revealed two potential pathways as consequences of the central meaning-making process, making sense of psychosis, called integrated identity and restricted identity. Research and practice recommendations are provided.

Keywords

first episode psychosis, young adult identity, identity development, stigma, psychosis, schizophrenia spectrum disorders, grounded theory

Author Bio(s)

Katie Hayden-Lewis Ph.D. LPC is a clinical consultant, educator, advocate, and program designer in community mental health. iShe has extensive experience in the early intervention for psychosis field as an innovative designer of program models, therapeutic practices, and collaborative community partnerships. Her professional interests include rural healthcare, healing-centered compassionate treatment approaches and building capacity across professions and community members to uplift the wellbeing of their communities. Please direct correspondence to katie@luminescenttherapeutics.com .

Deborah Rubel Ph.D. is a professor of counselor education at Oregon State University with 21 years of experience. Her research interests are qualitative methods, group work, anti-oppression, and mental health stigma.

Acknowledgements

The authors wish to acknowledge the generous contributions of participants lived experiences to the authors understanding of the study's central question, as well as their personal and professional growth. We are humbled and indebted to them for their willingness to share their stories and build a new understanding about holistic identity development for young people who experience psychosis. The authors are grateful to the people in their lives who offered them supportive and validating relationships, inviting them to make choices about how best to integrate their experiences, in purposeful ways, into their sense of identity.

Publication Date

11-30-2025

Creative Commons License

This work is licensed under a Creative Commons Attribution-Noncommercial-Share Alike 4.0 International License.

DOI

10.46743/2160-3715/2025.6762

Recommended APA Citation

Hayden-Lewis, K., & Rubel, D. (2025). Young adults and early-onset psychosis: A grounded theory study of experiences of identity development. The Qualitative Report, 30(11), 4550-4572. https://doi.org/10.46743/2160-3715/2025.6762

ORCID ID

0000-0003-0893

ResearcherID

JEP-5748-2023