Ego development in the face of death: How being HIV positive affects movement through Erikson's adult stages of development

Erikson's epigenetic model of psychosocial development posits that each of eight stages unfolds in a particular sequence, and each becomes the primary issue of concern at specified times in the life cycle. Erikson does not address, nor could any empirical studies be located, exploring how the emergence of these eight stages might be affected by a diagnosis of terminal illness. The purpose of this study was to understand how an HIV-positive diagnosis affected movement through Erikson's stages of development. In-depth interviews were conducted with a sample of 18 HIV-positive men and women under 45 years of age. Analysis of the qualitative data revealed three findings regarding Erikson's stages: (1) The fifth stage of idenitity versus role confusion was revisted and the sense of self is redefined; (2) the three adulthood stages of intimacy versus isolation, generativity versus stagnation, and ego integrity versus depair were dealt with simulataneously and, in most cases, resolved favorably; and (3) intimacy and generativity enabled and supported the resolution of the tasks of identity and ego integrity.