Examining the relationship between self-defining activities, flow state, and identity development among individuals with serious mental illness

Individuals with serious mental illness (SMI) are at risk for developing illness identity, which can be detrimental to physical health, social and vocational functioning, and psychiatric symptomatology. Positive identity development is essential to mental health recovery, but few studies or clinical interventions address this. Eudaimonistic identity theory (EIT) offers a framework for attaining eudaimonic well-being through engagement in self-defining activities and experiencing flow state. While EIT is supported in the general population, it has not been examined among individuals with SMI. This study applies EIT to a clinical sample to determine if it offers a pathway to eudaimonic well-being and inhibits illness identity.Method and Procedures. This study employs a cross-sectional survey design with validated measures of self-defining activities, flow state, illness identity, and eudaimonic well-being. Participants (n = 209) completed the Engagement in Meaningful Activities Survey (EMAS), Swedish Flow Proneness Questionnaire (SFPQ), Internalized Stigma of Mental Illness Inventory-9 (ISMI), Questionnaire for Eudaimonic Well-Being (QEWB), European Quality of Life 5 Dimensions 3 Level Version (EQ-5D-3L), and a demographic questionnaire. Canonical correlation analysis was used to test the association between two groups of variables that represent the components of EIT and identity outcomes. Bivariate correlations were subsequently performed to further analyze the relationships between variables in the study.Results. Overall, the predictors accounted for nearly half (48.5%) of the variance in the identity outcome variables. Being older, engaging in more self-defining activity, and experiencing greater levels of flow state were associated with better identity outcomes. Flow state and self-defining activity were the greatest contributors to the model. The relationships between flow state, self-defining activity, and eudaimonic well-being were stronger in this sample than in previous studies of the general population. Eudaimonic well-being and illness identity were inversely related.Implications. EIT offers a viable pathway to positive identity outcomes among individuals with SMI. Interventions that embed positive psychology strategies within psychiatric rehabilitation services may help individuals with SMI identify self-defining activities and experience a flow state. Policy and advocacy efforts within behavioral health organizations or systems of care can be informed by the value of self-defining activities and flow state.