ABSTRACT This work explores the identity construction of Tradwives, twenty-first century women who embrace traditional gender roles and prioritize domestic life. We argue that these women navigate seemingly contradictory ideologies of traditionalism and feminism. To achieve our aim, we analyze publically available YouTube videos of self-identifying Tradwives. We use Marcia’s identity theory as a framework for examining and understanding exploration and commitment processes that underlie their identity construction. We found that the women actively explore and question experiences of work pressure and its intersection with feminism. They come to use conceptualizations of gendered complementary and gender essentialism to regain a positive sense of self in their ultimate commitment to traditionalism to remedy the stress and expectations associated with modern roles. At the same time, their narratives echo key elements of feminism, including empowerment, agency, self-worth, choice, and continuous learning. Overall, Tradwives integrate and navigate these paradoxes, constructing a positive identity that offers a sense of stability and fulfillment. We discuss how the principles that underlie the Tradwife identity nevertheless bring notions of freedom and autonomy within traditionalism into question.

Building on a growing body of evidence addressing the impact of hearing lived experience stories, this study explored the experiences of individuals sharing stories at live storytelling events. The central aim was to better understand speakers' experiences and to consider what, if any, impact taking part in such events might have on their lives. The project benefited from a co-produced study design, following an interpretative phenomenological analysis framework. Eight participants shared their experiences in semi-structured interviews. Three superordinate themes were developed to explain their experiences: 'connecting with a sense of primal humanity', 'a path to cathartic transformation', and 'the fires of purpose'. These themes outlined experiences of connection with others, unburdening from shame, transforming sense of self, reframing experiences, and connecting with a newfound sense of purpose. Parallels are drawn with similar research, suggesting how this paper can extend current understanding of the experience and impact of storytelling. This includes identifying links between storytelling and trauma therapies, with conclusions drawn about storytelling events' potential to kick-start post-traumatic growth for speakers. This prompts consideration of the potential that community programmes and partnerships might have for affecting positive change.

Self-concept clarity, the degree to which an individual has a well-defined and stable sense of self, is a well-documented factor in mental health conditions, particularly eating disorders. Difficulties with self-concept clarity are also reported among gender diverse and neurodivergent people, who are overrepresented in eating disorder populations. This cross-sectional study examined associations between self-concept clarity (Self-Concept Clarity Scale), autistic traits (Autism Spectrum Quotient), ADHD traits (Adult ADHD Self-Report Scale), gender diversity (Gender Self-Report), and disordered eating, a pattern of atypical eating behaviors and attitudes including food restriction and binge eating (Eating Disorder Examination Questionnaire). Gender diversity was assessed as binary (identity opposite to sex assigned at birth) and nonbinary traits (identity neither female nor male). Participants were 492 UK adults (324 assigned female at birth; 98.6% cisgender, 1.2% trans/gender diverse, 0.2% preferred not to say; M age = 41.44years, SD = 13.11) recruited online. Correlational and path analysis investigated direct and indirect relations between gender diversity, neurodivergent traits, and disordered eating through self-concept clarity. Autistic traits were indirectly related to disordered eating through self-concept clarity, while ADHD traits showed both direct and indirect associations. Greater binary and nonbinary gender diverse traits were correlated with higher levels of disordered eating but were no longer significantly related once neurodivergent traits, age, and sex assigned at birth were controlled. Findings suggest low self-concept clarity may provide a mechanism for increased disordered eating in individuals with higher levels of neurodivergent traits, but not among those with gender diverse traits when covariates are considered.

Objective Homelessness has a profound impact on health and is often framed as an extreme form of social exclusion. In Japan, policies and support programs have promoted stable housing as a pathway to independence, contributing to a marked decline in the number of individuals experiencing homelessness. Nevertheless, the homeless population has aged, and homelessness has become prolonged; among this population, the avoidance of support services and return to street homelessness remain notable challenges. While previous studies have emphasized structural factors and formal outcomes, such as facility entry, reasons for discharge, and housing acquisition, the subjective experiences of individuals transitioning into housing remain underexplored. The objective of this study was to qualitatively describe how individuals experiencing long-term homelessness perceive homelessness and obtaining housing within the context of their relationships with others in society.Methods This was an exploratory qualitative study. Participants were recruited through a support organization in the Tokyo metropolitan area. The study included four men who had experienced homelessness for more than 10 years and had been living in apartments for at least 1 year at the time of the interviews. Semi-structured interviews were conducted between July and August 2023. The interview transcripts were analyzed using a phenomenological approach, focusing on lived experiences, context, and meaning through an iterative interpretive process.Results Three major themes were identified. "Becoming 'no one'" described experiences of disengaging from social roles and expectations tied to family, work, and community, resulting in the loss of a socially defined sense of self. "Living as oneself while being accepted " referred to practices through which participants sustained their lives during homelessness by finding specific spaces or relationships in which they were not judged based on their social status or roles. "Being required to become 'someone' again" captured the experience of obtaining housing, in which institutional rules, social expectations, and relationships re-entered daily life, destabilizing previously viable ways of living.Conclusions Experiencing homelessness and obtaining housing were not defined by the presence or absence of housing; rather, they involved relationships with others and shifts in those relationships. In providing support, it is necessary to recognize that relational changes accompanying housing acquisition may create new difficulties. Support should therefore be attentive to individual experiences, accompanying individuals in accepting such changes and building new relationships. This study suggests directions for homelessness support that extend beyond the provision of physical housing.

ABSTRACT In humanitarian work, data play an increasingly important role in programming and decision-making for population assessments, resource allocation and aid prioritisation. Based on qualitative field research conducted in Uganda, the study examines how ‘data-driven’ vulnerability assessment tools mediate social life in the Nakivale and Oruchinga refugee settlements. Drawing on literature from feminist science and technology studies, refugee studies, critical humanitarianism and social policy research, this study reveals how assessment tools that rely on standardised and quantitative methods have constitutive effects, generating new forms of social arrangements, subjectivities and precarity through their assumptions, logic and design. The main argument is that current prioritised assistance functions less as an assessment of vulnerability and more as a mechanism to identify households considered ‘stable’ enough to be excluded from assistance. The normative and gendered notions about the refugee household underpinning assessment tools such as the household questionnaire, eligibility criteria and the database work to restructure familialrelationships in problematic ways, introducing new insecurities as evidenced by increased family violence, child abandonment and further marginalisation through secondary uses of data. Ultimately, these tools do more than determine access to scarce resources. They reconfigure refugee livelihoods, sense of self, social and community standing and their relationships.

Illness identity, or how an individual integrates their disease into their sense of self, is an important psychological concept for medical populations. According to one model, there are four proposed dimensions of illness identity: Acceptance, Rejection, Enrichment, and Engulfment. Acceptance and Enrichment describe an individual's ability to embrace their illness and regard it as a source of positive meaning-making, while Rejection and Engulfment describe an individual's inclination to disregard or be preoccupied by their illness in unhelpful ways. This study aimed to describe illness identity in a sample of adults with symptomatic sickle cell disease (SCD) and examine how domains of illness identity correlate with physical and mental health variables. Forty-six adults with symptomatic SCD preparing to undergo nonmyeloablative hematopoietic transplants completed a baseline evaluation that included the Illness Identity Questionnaire (IIQ) and measures of depression, anxiety, fatigue, sleep disturbance, physical functioning, and pain. Levels of Enrichment were significantly higher than other dimensions of illness identity (Acceptance, Rejection, and Engulfment). Engulfment scores were positively correlated with sleep disturbance and pain, while Rejection scores were positively correlated with depression and negatively correlated with pain. Results suggest that illness identity is nuanced in adults with SCD. Clinicians and researchers should explore how psychosocial interventions can promote Enrichment and reduce Engulfment.

ObjectiveSystemic lupus erythematosus (SLE) flares are psychosocially influenced, but there are few culturally sensitive models. This study aims to explore psychosocial factors contributing to lupus flares in women and co-construct a novel framework, grounded in their lived experiences, to guide clinical practice.MethodsUtilizing Charmaz's constructivist grounded theory, we conducted a comprehensive study that included semi-structured interviews with 20 Iranian women who have SLE. Iterative open, focused, and theoretical coding was used to analyze data, with reflexive practices applied to address researchers' cultural assumptions and maintain rigor. Thematic saturation was achieved, situating the developing model within participants' lived experiences.ResultsA new four-domain model was constructed, representing a cyclical process reflecting lupus flare susceptibility. Predisposing Conditions consisted of marital dissatisfaction (e.g., felt spousal invalidation) and extrinsic stressors, with low socio-cultural status (economic distress, cultural divorce taboos) and stressful life events (infidelity, coerced marriages) shaping heightened distress. Mediating Factors-unresolved grief, sleep disturbance, and alexithymia-were viewed to exacerbate emotional and physiological reactions, with sleep disturbance often described by participants as coinciding with inflammatory markers. Responses included non-adaptive illness perception (e.g., "it is uncontrollable and there is no cure"), damaged sense of self, and conflicted parental roles, capturing socio-cultural effects. The Implication was difficulty in psychological adjustment to illness, linked with flare. Participants' accounts highlighted a recurring theme linking relational stressors to illness misperceptions, shaped by marital conflict and perceived lack of support.ConclusionsThis culturally informed model reveals new associations among socio-cultural stressors, such as divorce taboos, and lupus flare vulnerability among Iranian women. While acknowledging limitations (the potential influence of anti-inflammatory medications on participants' lived experiences, and also most participants were from lower socio-economic backgrounds), it suggested interventions (e.g., couple therapy, sleep therapy, grief counseling) and research on inflammatory markers. Reflexive grounding underpins equitable progress in SLE care.

Experiencing psychosis can impact all areas of aperson's life, causing significant changes to thoughts, perceptions, mood, behaviour, and sense of self. Details of the specific barriers to recovery experienced by women with psychosis and how these barriers may relate to both sex and gender remain unknown. To identify and conceptualise barriers to recovery, a qualitative secondary analysis was undertaken of 31 semi-structured interviews from a primary anthropological study focused on women's lived experiences of a first episode of psychosis. Participants were recruited from Early Intervention Services in England, UK, between 2010 and 2015. Reflexive thematic analysis demonstrated various barriers to recovery, including internal conflicts with identity, the constraining ofmoral agency, inadequate support to address past traumas, structural factors, and stigma. Each of these barriers intersects with both sex and gender norms in a number of ways. Barriers to recovery must be addressed within mental health services to ensure that women have the best chance of moving forward with, and finding new meaning in, their lives after psychosis. Consideration of past experiences as well as normative gender roles, and other structural barriers is needed. Future research should develop and evaluate sex- and gender-specific interventions and consider integrating these into clinical practice.

ABSTRACT This is a critical examination of cisheteronormative beliefs and practices through the lens of the lived experiences of Vuyo, a transgender Xhosa man “oliwele” who is the twin of a cisgender male. Drawing upon an in-depth interview with Vuyo, we explore how cisgenderism and heteronormativity were reinforced as norms within his traditional Xhosa upbringing and community. We further examine what impact this had on his sense of self and identity from a young age when he identified as male despite being assigned female at birth. Vuyo's narrative highlights the immense challenges, stigma and ostracization faced by those who transgress cisheteronormative expectations. Simultaneously it points to the resilience, resistance and self-determination required to live authentically. This case study troubles dominant assumptions about the naturalness and immutability of the gender binary. The study further illuminates the regulatory power of cultural rituals and practices in enforcing compulsory cisnormativity and heteronormativity. Vuyo's journey of becoming a man through and against the backdrop of his twin brother's seamless alignment with Xhosa manhood reveals the complex intersections of gender identity, kinship, culture and spirituality. His story captures the paradoxical erasure and animation of his masculinity through the death of his cisgender twin and the cultural inheritance of the male spirit. This article advances theoretical and empirical knowledge on the lived realities of transgender subjectivities within an African socio-cultural context and the critical importance of troubling cisheteronormativity in all its manifestations.

This paper examines the complex interplay of identity and desire in the selected novels of Namita Gokhale, with particular reference to Paro: Dreams of Passion and Things to Leave Behind. Situated within the broader framework of Indian English literature, the study explores how women characters negotiate their sense of self within shifting socio-cultural and historical contexts. While Paro: Dreams of Passion portrays the lives of urban women navigating modernity, sexuality, and social performance, Things to Leave Behind presents women embedded in the rigid structures of nineteenth-century colonial society marked by caste, tradition, and reformist influences. Through a comparative analysis, the paper highlights the continuity and transformation in women’s experiences across time. It argues that despite differences in setting, both novels reveal the persistent influence of patriarchal norms that shape female identity and regulate desire. The study further demonstrates that Gokhale’s female protagonists are neither passive victims nor wholly liberated individuals; instead, they occupy complex spaces of negotiation where agency is expressed through both resistance and accommodation. Drawing upon feminist and socio-cultural perspectives, the paper analyses how desire emotional, intellectual, and sexual functions as a driving force in the construction of identity. It also examines how cultural frameworks, whether traditional or modern, simultaneously enable and constrain women’s choices. Ultimately, the study establishes that Gokhale’s fiction offers a nuanced portrayal of women’s lived realities, revealing the layered processes through which identity is continuously shaped, challenged, and redefined.

To investigate the experiences of individuals attending an online hearing voices peer support group (HVG) conducted within the UK's National Health Service (NHS). The purpose of the study was to assess acceptability of the HVG in an NHS context and to understand relational dynamics within the group. A nested qualitative study was conducted within a non-randomised feasibility trial of an online HVG. All participants (N = 9) completed baseline and end-of-study qualitative interviews about their voice hearing and group experiences. Interviews were analysed using framework analysis. Data were organised into four themes. Participants described two orientation tendencies within the group, both with associated subthemes: (1) seeking connection (shame and isolation spurred interest in the group, active digital participation and engagement facilitated a sense of connection, value of an alternative); and (2) seeking to learn (searching for solutions, cameras enabled the modulation of engagement but inhibited group ownership, a useful addition to care). Participants likewise described (3) voices' experiences in the group; and (4) the impact of the group (impact on voices, impact on sense of self and hope for the future). Despite their differing expectations for the group, experiences in the group and relationship with the online medium of the group, both the participants seeking connection and those seeking to learn reported benefits from group attendance in terms of self-acceptance and hope for the future. Further research is needed to understand how to incorporate this survivor-led approach into the NHS.

Children of parents with addiction often develop a strong dependency on the family system, assuming various maladaptive roles to maintain a fragile sense of balance. While such adaptations may provide short-term coping mechanisms, they can significantly disrupt identity development and the formation of a stable sense of self. This qualitative study aimed to explore the lived experiences of adult women raised in families affected by parental substance use in a Hungarian sample, with a particular focus on how these early environments shape identity and self-concept in adulthood. Participants were recruited through social media platforms and the mailing lists of Hungarian ACA (Adult Children of Alcoholics) groups. Semi-structured interviews were conducted with a purposive sample of 15 participants, and Interpretative Phenomenological Analysis (IPA) was applied to identify recurring patterns. Three master themes emerged: Main Theme 1: “I Pretended Nothing Was Wrong”, Main Theme 2: “The Question of the Right to Exist”, and Main Theme 3: “The ‘Homeless’ Inner Child”. These findings highlight the long-term psychological impact of growing up in addiction-affected households, including difficulties with self-acceptance, boundary-setting, and autonomy. The study underscores the therapeutic potential of approaches addressing the “inner child” to process unresolved losses—summarised as the loss of childhood—and to strengthen self-identity. By deepening understanding of these processes, the findings may inform targeted interventions for young children and adult children of parents with addiction.

Purpose Self-identity is disrupted when encountering significant life changes such as an acquired brain injury (ABI). Use of social media can facilitate self-expression, providing an opportunity for identity exploration. For people living with other neurological conditions, online self-expression has been described as being beneficial for sense of self, advocacy, and connection. We aimed to learn more about online self-identity after an ABI to inform rehabilitation approaches. Materials and Methods In this qualitative study, we interviewed 11 people with ABI and used reflexive thematic analysis to explore their self-expression on social media platforms and factors that influenced this. Results Individuals described how they used social media for belonging, support, and visibility. Some people revealed their ABI in their online identity, whilst others concealed this due to perceived stigma. Social media was used as a way to control their self-narrative in varying ways, sharing only fragments of their identity, often to appear more positive, resilient, and capable. Conclusions Online self-identity is complex and multifaceted, with people often employing a ‘balancing act’ as they navigate reconstruction of self after their brain injury. Social media has potential to be used during rehabilitation for self-discovery and to showcase self-narrative, supporting people in their recovery journey.

ABSTRACT Dutch Caribbean (DC) students face challenges in the racialized Dutch educational context that negatively affect their mental wellbeing and study success. To address this issue, this study aimed to develop need-based intervention(s) to foster resilience and sense of belonging among DC students. A Participatory Action Research (PAR) approach was used to develop and implement five reflexive workshops and one impact event over three years to foster and improve individual and community resilience among DC students. The interventions provided reflexive and healing spaces for students to share racialized experiences, feel connected, and (re)build a sense of self and community. More culturally appropriate interventions were recommended to empower DC students to connect and cope with their emotions and foster resilience. The findings warrant the need for more safe reflexive spaces for racialized students to connect, share experiences, and build both personal and communal resilience – as anti-racist transformative praxis.

Little is known as to what drives feelings of grief and relief observed following the late identification of neurodivergence, and its significance as it relates to sense of self and self-understanding. As such, this study considers how grief is understood and experienced by neurodivergent individuals in the context of late identification. This study used qualitative content analysis to identify themes from 225 public social media posts discussing grief and relief in relation to a late identification. With a sample focused mainly on autism, attention deficit hyperactivity disorder, and both co-occurring, four main themes, under an overarching theme and process, titled the Grief, Relief, and Belief Cycle, were identified: (1) The Life I Could Have Had; (2) Grieving for My Younger Self; (3) Feeling Gratitude; and (4) Post-Diagnosis Burnout. Overall, this study calls for a paradigm shift in how we understand and support neurodivergent individuals diagnosed in adulthood, seeing diagnosis as a first step, rather than a terminal component of a service, emphasising the need for comprehensive, individualised, wraparound care that addresses the emotional and practical aspects of their lives before, during, and beyond diagnosis.Lay AbstractLittle is known as to why some individuals may experience feelings of grief and relief following late identification, by clinical diagnosis or self-identification, of neurodivergence (e.g. autism or attention deficit hyperactivity disorder), and how this relates to their sense of self. This study looks at how grief is understood and experienced by late-identified neurodivergent individuals using qualitative content analysis to analyse social media posts discussing grief in relation to late identification. A total of 225 public social media posts were analysed. These posts were mostly made by people who identified as autistic, having attention deficit hyperactivity disorder, or both. Four main themes and one overarching theme and process were identified. The overarching theme was named the Grief, Relief, and Belief Cycle, and the four themes were (1) The Life I Could Have Had; (2) Grieving for My Younger Self; (3) Feeling Gratitude; and (4) Post-Diagnosis Burnout. Theme 1 highlights the sense of loss and regret some late-identified neurodivergent individuals' experience. Theme 2 explores the ways in which late identified neurodivergent individuals look at their past experiences with this newfound understanding of their neurodivergence. Theme 3 highlights the experiences of relief and gratitude these individuals have for the self-understanding that they discuss coming with their diagnosis. Theme 4 emphasises the intense emotional and physical toll and lack of available support that people can experience when their neurodivergence is identified later in life. Overall, this study emphasises the need for comprehensive, individualised, and ongoing care that addresses the emotional and practical aspects of individuals' lives before, during, and beyond diagnosis.

People with autism often face mental health difficulties at rates far exceeding those of the general population. How autistic individuals relate to their autism classification and the autistic community, also known as social identity, may form a protective factor for mental health. However, validated tools to assess social identity in autistic populations are lacking. This study aims to evaluate the Dutch version of the 14-item Social Identity in Autism Questionnaire (SIAQ) and examine associations between social identity and demographic, autism-related, and mental health variables. A total of 1443 autistic individuals from the Netherlands (mean age = 47 years, 54% women, 98% Dutch) completed the SIAQ and measures assessing demographics, autism characteristics, and mental health. Factor analyses revealed a four-factor structure: solidarity (three items, feelings of connection to people with autism), satisfaction (four items, positive feelings about being autistic), centrality (three items, the importance of autism to one's sense of self), and self-definition (four items, perceived similarity to other autistic people and within the autistic community). Internal consistency was acceptable to excellent. Measurement invariance (scalar level) was found across age, gender, education level, ethnicity, and autism traits. Furthermore, the four factors of social identity were differentially related to age, gender, language preference, time since diagnosis, and autism traits. Higher satisfaction and lower centrality were related to better mental health. To conclude, the SIAQ forms a robust tool to assess social identity in autistic individuals in the Netherlands.Lay AbstractPeople with autism experience mental health challenges much more often than people in the general population. Understanding how autistic people relate to their autism and the autistic community - called autistic social identity - may form an important factor for mental health. However, the lack of reliable tools to measure social identity in autistic people led to this study evaluating the Dutch version of the Social Identity in Autism Questionnaire (SIAQ). Associations between social identity and demographics, autism traits, and mental health were studied. Autistic individuals from the Netherlands (n = 1443, average age = 47 years; 54% women; 98% Dutch) completed the SIAQ. The results showed that the questionnaire captures four key aspects of social identity: solidarity (feeling connected to other autistic people), satisfaction (positive feelings about being autistic), centrality (how central autism is to one's identity), and self-definition (seeing oneself as similar to other autistic people and perceiving the autistic community as relatively similar). The questionnaire was reliable as well as suitable to use across diverse groups, including variations in age, gender, education level, ethnicity, and autism traits. Several aspects of social identity were related to gender, age, language preference, time since diagnosis, and autism traits. Importantly, higher satisfaction and lower centrality were associated with better mental health. These findings suggest that in the Netherlands, the SIAQ is a useful tool for understanding how autistic people relate to their autism and the autistic community, and how this relates to wellbeing.

Previous research has suggested potential phenotypic similarities between autism and borderline personality disorder (BPD). We aimed to identify overlapping and differentiating characteristics of the two diagnostic groups in women and people assigned female at birth (PAFAB). Women and PAFAB with an autism diagnosis (n = 51) or a BPD diagnosis (n = 51), who had few or subclinical traits of the comparator diagnosis, completed a range of self-report questionnaires. Emotional reactivity, emotional dysregulation, identity disruption, difficulties being alone and rejection sensitivity were significantly more characteristic of BPD-diagnosed participants, with identity disruption representing the biggest difference from autistic participants (d = -1.36, 95% confidence interval [CI] = [-1.79, -0.92]). Autistic participants scored significantly more highly on measures of sensory processing, social cognition and behaviour, preference for sameness and repetitive motor behaviour, with sensory processing representing the biggest difference from BPD-diagnosed participants (d = 1.19, 95% CI = [0.76, 1.60]). Group differences in social cognition, social camouflaging, identity disruption, impulsivity and coping with being alone, together correctly classified 95.1% of participants (area under the curve [AUC] = 0.98). However, comparison with measure scores in previous research suggests more complex phenotypic similarities, whereby autistic individuals may show more BPD-aligned characteristics than the general population and vice versa.Lay AbstractAutism can look similar to borderline personality disorder (BPD), leading to misdiagnosis. For example, both diagnostic groups may experience difficulties in regulating their emotions. To improve diagnosis, we wanted to understand similarities and differences between autism and BPD in adult women and people assigned female at birth (PAFAB). We asked two groups of people to complete online questionnaires: (1) 51 women/PAFAB with an autism diagnosis, who do not meet diagnostic criteria for BPD and (2) 51 women/PAFAB diagnosed with and meeting diagnostic criteria for BPD, who are not autistic. The questionnaires asked participants how they experience their emotions, how they interact and relate with other people, how they experience their identity and self-concept, how they react to sensory input, for example, sounds and smells, and how they use repetitive movements, as well as their preferences for sticking to familiar ways of doing things. We found more differences than we expected between autistic people and people meeting diagnostic criteria for BPD. For example, autistic people described being more sensitive to sensory input, described 'masking' more during social interactions and described more challenges in understanding the social behaviour of non-autistic people, compared to people meeting diagnostic criteria for BPD. People meeting diagnostic criteria for BPD described more difficulties with emotion regulation and with their sense of self ('knowing who I am'), were more likely to behave impulsively and found being on their own more difficult, compared to autistic people. Clinicians, and people with a BPD diagnosis who think they may be autistic, can use these findings to better understand the differences between the two diagnoses. Even though we found lots of differences, it is still likely that autistic people experience more similarities with BPD than non-autistic people do and vice versa.

Caregiver burden has many definitions in aging research. To better understand how caregivers conceptualize and describe challenges in their own words, we analyzed Reddit posts about the difficulties of caring for an older adult. Inductive content analysis of a stratified random sample of posts from five subreddit communities from December 2022 to December 2023 (r/dementia, r/AgingParents, r/CaregiverSupport, r/caregivers and r/caregiving); included posts described any negative experience about caregiving. We excluded posts written by paid caregivers and those caring for persons identified as younger than 65. We coded themes and narratively synthesized findings with a focus on how findings could inform the theory and measurement of caregiver burden. We identified 387 posts from 315 unique caregivers caring for 352 care recipients. Where reported, mean caregiver age was 40 (SD 13.7) and 60% were female, and mean care recipient age was 79 (10.4 SD) and 61% were female. 69% of caregivers were children. Users provided intense descriptions of the challenges of caregiving. Analysis yielded five themes, illustrating how caregiving is difficult when it: (1) disrupts the caregiver's sense of self, (2) leads to resentment, (3) leads to burnout, (4) strains family relationships and (5) encounters challenges navigating the long-term care system. In unstructured qualitative data, caregivers describe their challenges in terms other than burden and include frustrations with family members and the long-term care system. Results could inform dimensions of caregiver strain to include in caregiver burden measures and targeted intervention.

Losing oneself: Lack of self in depression and its recurrence.

Beyond the extra-musical connotations observed in much late eighteenth-century music, pattern recurrence sometimes appears to be associated with a strongly narrative meaning. As an example, certain late works of Beethoven possess a sense of self-'awareness' via self-referentiality. There is the potential for seeing this as the manifestation by music of a degree of independence from the composer's consciousness, one driven (in a view informed by the memetic theory of cultural evolution) by the musical patterns involved. Such music is manifesting a form of agency — a consciousness-of-itself (CoI) — 'reflecting' on its structure and its generative processes in a way that is not strongly evident in earlier musical traditions. The notion of CoI is partly based on Dennett's conception of consciousness as a form of millisecond-level evolution, with evolution, conversely, being a glacially slow form of consciousness. Tying these ideas together, my underpinning question is: how can evolutionary theory and the structural and functional alignments between music and language illuminate our understanding of consciousness? Addressing this question can help illuminate the evolutionary relationships between music and language, the cultural evolution of music, and the nature of consciousness itself.