The present study addresses identity distress and identity status in adolescents with clinical diagnoses, and their caregivers. There were 88 adolescent participants (43.2% female) ranging in age from 11 to 20 (mean =14.96; SD =1.85) who were recruited from community mental health centers in Volusia and Orange Counties. The 63 caregiver participants included mothers (82.5%), fathers (7.9%), grandmothers (7.9%), and grandfathers (1.6%), ranging in age from 28-70 (mean = 40.24; SD = 9.16). A significant proportion of adolescents (22.7%) met criteria for Identity Problem in the Diagnostic and Statistical Manual of Mental Disorders (4th ed., text rev.; American Psychiatric Association, 2000) and 9.5% of the adolescents' caregivers met criteria for Identity Problem. Regarding identity status, 68.2% of adolescents and 27.0% of caregivers reported being in the diffused status. Additionally, 25.0% of adolescents and 54.0% of caregivers met criteria for the foreclosed status. Significant associations were found among adolescent and caregiver psychological symptoms and identity variables. Further examination of the psychological symptom variables found that obsessive-compulsive and paranoid ideation symptoms significantly predicted identity distress. In addition, caregiver identity commitment significantly predicted adolescent identity distress over and above the adolescents' identity variables. These findings and implications are discussed in further detail.