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Giunta S, Mannino G, Sideli L, Quattropani MC, Lenzo V. Reflective functioning mediates the relationship between insecure adult attachment and the severity of prolonged grief symptoms. Health Psychol Res 2024; 12:122543. [PMID: 39228864 PMCID: PMC11368632 DOI: 10.52965/001c.122543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Accepted: 02/13/2024] [Indexed: 09/05/2024] Open
Abstract
Background This study aimed to investigate the mediation role of reflective functioning (i.e., certainty and uncertainty about mental states) in the relationship between insecure attachment (i.e., attachment avoidance and attachment anxiety ) and the severity of prolonged grief symptoms. Methods A cross-sectional study was conducted with 329 bereaved participants (51.7% females, mean age= 46.94 ± 14.62 years). Participants completed the Prolonged Grief Scale (PG-13), the Attachment Style Questionnaire (ASQ), and the Reflective Functioning Questionnaire (RFQ). Demographic and bereavement-related information were also collected. Results Certainty about mental states fully mediated the relationship between both the attachment avoidance and attachement anxiety and severity of prolonged grief symptoms. Conclusions The findings of this study indicate that reflective functioning impairment, specifically certainty about mental states of self and others, mediate the paths from insecure attachment to prolonged grief symptoms. This suggests that improving reflective functioning may contribute to the treatment bereaved individuals at risk of PGD.
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Affiliation(s)
- Serena Giunta
- Department of Law Economics and Communication LUMSA Santa Silvia University
| | - Giuseppe Mannino
- Department of Law Economics and Communication LUMSA Santa Silvia University
| | - Lucia Sideli
- Department of Human Sciences Libera Università Maria SS. Assunta
| | | | - Vittorio Lenzo
- Department of Educational Sciences University of Catania
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2
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Chang YH, Yang MH, Yang CT, Goh J, Lin SH, Hsieh S. Alternation of psychological resilience may moderate mentalization toward mental health conditions from macro- and microstructure aspects. Neuroimage 2024; 299:120810. [PMID: 39181193 DOI: 10.1016/j.neuroimage.2024.120810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2024] [Revised: 07/30/2024] [Accepted: 08/22/2024] [Indexed: 08/27/2024] Open
Abstract
OBJECTIVE We aim to investigate the interplay between mentalization, brain microstructure, and psychological resilience as potential protective factors against mental illness. METHOD Four hundred and twenty-six participants (mean age 40.12±16.95; 202 males, 224 females), without psychiatric or neurological history, completed assessments: Dissociative Process Scale (DPS), Peace of Mind (PoM), Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), Resilience Scale for Adults (RSA), and Magnetic Resonance Imaging (MRI) structures with selected regions of interest, and Diffusion Tensor Imaging (DTI) maps from various tracts in the right hemisphere and connection to the frontal areas, including anterior thalamic radiation (ATR), Cingulum (hippocampus) (CH), Corticospinal tract (CST), Superior longitudinal fasciculus (SLF), Inferior fronto-occipital fasciculus (IFOF), and Uncinate fasciculus (UF) were analyzed. RESULTS Two clusters, representing hypomentalization (HypoM) and hypermentalization (HyperM), were identified based on DPS, CPSS, and RFQ responses. One-way ANOVA showed no significant age or gender differences between clusters. The HypoM group exhibited lower PoM scores, higher BDI and BAI scores, and lower RSA scores (ps< 0.05). Structural brain metric comparison showed significant differences in GMV in the right caudal middle frontal gyrus (rcMFG), right superior frontal gyrus (rsFG), and right frontal pole (rFP) between groups. In addition, the HyperM individuals with a higher risk of depression and a higher ratio of intrapersonal to interpersonal factors of resilience were found with reduced GMV on the rcMFG. Additionally, analyses of DTI metrics revealed significant differences between two groups in rATR and rSLF in terms of fractional anisotropy (FA) values; rATR, rCST, rUF, rSLF, rCH and rIFOF in terms of mean diffusivity (MD) values, and radial diffusivity (RD) (corrected p = 0.05). Moreover, the positive correlation between different domains of resilience and white matter (WM) integrity implied further enhancement of intrapersonal or interpersonal resilience factors that are different for people with different mentalization. CONCLUSIONS The findings underscore the importance of considering both intrapersonal and interpersonal factors in understanding the interactions between psychological resilience and mental health conditions relevant to brain mechanisms.
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Affiliation(s)
- Yun-Hsuan Chang
- Institute of Gerontology, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Institute of Behavioral Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Psychology, National Cheng Kung University, Tainan, Taiwan; Department of Psychiatry, National Cheng Kung University Hospital, Douliu Branch, Yunlin, Taiwan; Graduate Institute of Genomics and Bioinformatics, College of Life Sciences, National Chung Hsing University, Taichung, Taiwan.
| | - Meng-Heng Yang
- Department of Psychology, National Cheng Kung University, Tainan, Taiwan
| | - Cheng-Ta Yang
- Department of Psychology, National Cheng Kung University, Tainan, Taiwan; Institute of Allied Health Sciences, National Cheng Kung University, Tainan, Taiwan; Department of Education and Humanities in Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Joshua Goh
- Graduate Institute of Brain and Mind Sciences, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Sheng-Hsiang Lin
- Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Biostatistics Consulting Center, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Shulan Hsieh
- Department of Psychology, National Cheng Kung University, Tainan, Taiwan; Institute of Allied Health Sciences, National Cheng Kung University, Tainan, Taiwan; Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
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Varallo G, Zagaria A, Baldini V, Schianchi A, Brscic M, Panero M, Franceschini C, Schimmenti A, Musetti A. Predictors of suicidal ideation in Italian veterinarians. Sci Rep 2024; 14:17504. [PMID: 39080454 PMCID: PMC11289289 DOI: 10.1038/s41598-024-68330-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Accepted: 07/22/2024] [Indexed: 08/02/2024] Open
Abstract
Suicide represents a significant problem for healthcare professionals such as veterinarians. Previous studies showed that contextual and individual risk factors can contribute to suicidality among veterinarians. In the present study, self-report measures on exposure to animal euthanasia, substance abuse, reflective functioning, and suicidal ideation were administered to 1556 Italian veterinarians aged 24-74 years old. Structural equation modelling revealed that failures in reflective functioning and substance abuse were associated with suicidal ideation. Prevention programs focusing on improving reflective functioning and decreasing substance abuse might reduce suicide risk among veterinarians.
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Affiliation(s)
- Giorgia Varallo
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Andrea Zagaria
- Department of Psychology, Sapienza University of Rome, Rome, Italy
| | - Valentina Baldini
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy.
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy.
| | | | - Marta Brscic
- Department of Animal Medicine, Production and Health (MAPS), University of Padova, Viale dell'Università 16, 35020, Legnaro, PD, Italy
| | - Matteo Panero
- Department of Neuroscience "Rita Levi Montalcini", Eating Disorders Center, University of Turin, Turin, Italy
| | | | - Adriano Schimmenti
- Faculty of Human and Social Sciences, UKE - Kore University of Enna, Enna, Italy
| | - Alessandro Musetti
- Department of Humanities, Social Sciences and Cultural Industries, University of Parma, Parma, Italy.
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Kochanska G, Bendel-Stenzel L, An D, Sivagurunathan N. Early relational origins of Theory of Mind: A two-study replication. J Child Psychol Psychiatry 2024. [PMID: 39024124 DOI: 10.1111/jcpp.14029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/22/2024] [Indexed: 07/20/2024]
Abstract
BACKGROUND Research implies early relational factors - parental appropriate mind-mindedness (MM) and mutually responsive orientation (MRO) - as antecedents of children's Theory of Mind (ToM), yet the longitudinal path is unclear. Furthermore, little is known about the process in father-child relationships. In two studies of community families in a Midwestern state in United States, we tested a path from parental appropriate MM in infancy to parent-child MRO in toddlerhood to children's ToM at preschool age in mother- and father-child relationships, using comparable observational measures at parallel ages. METHODS In Children and Parents Study (CAPS) of children born in 2017 and 2018, we collected data at 8 months (N = 200, 96 girls), 38 months, age 3 (N = 175, 86 girls), and 52 months, age 4.5 (N = 177, 86 girls). In Family Study (FS) of children born mostly in 2001, we collected data at 7 months (N = 102, 51 girls), 38 months, age 3 (N = 100, 50 girls), and 52 months, age 4.5 (N = 99, 49 girls). Parental MM (verbal comments aligned with the infant's psychological state) was observed in infancy, MRO (parent and child responsiveness to each other and shared positive affect) at age 3, and ToM (false belief tasks) at age 4.5. RESULTS The findings supported the proposed indirect effects of parents' MM on children's ToM, mediated by MRO, for fathers and children in both studies, and for mothers and children, in CAPS. In FS, mothers' MM predicted MRO and ToM, but there was no mediation. CONCLUSIONS This investigation, testing a path from MM to MRO to ToM in both mother- and father-child relationships in two longitudinal studies, adds to the literature that has described relations among those constructs but rarely integrated those in one model.
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Affiliation(s)
- Grazyna Kochanska
- Department of Psychological and Brain Sciences, The University of Iowa, Iowa City, IA, USA
| | - Lilly Bendel-Stenzel
- Department of Psychological and Brain Sciences, The University of Iowa, Iowa City, IA, USA
| | - Danming An
- Department of Psychology, Lehigh University, Bethlehem, PA, USA
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Slade A, Sleed M. Parental Reflective Functioning on the Parent Development Interview: A narrative review of measurement, association, and future directions. Infant Ment Health J 2024; 45:464-480. [PMID: 38650168 DOI: 10.1002/imhj.22114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 01/25/2024] [Accepted: 03/14/2024] [Indexed: 04/25/2024]
Abstract
A caregiver's capacity to mentalize is thought to be one of the most important features of secure parent-child relationships. Parental mentalizing can be measured using the Reflective Functioning (RF) coding system applied to the Parent Development Interview (PDI). In this narrative review, we summarize the research using this measure and synthesize what has been learnt about the predictors, correlates and sequelae of parental RF. Studies have consistently shown that PRF on the PDI is associated with both parent and child attachment and is an important factor in the intergenerational transmission of attachment. It is also related to the quality of parental representations, parent-child interactions, and child outcomes. While a number of social and clinical risk factors are associated with lower PRF, it is difficult to disentangle the unique contribution of each of these. We discuss these findings and present the direction of future work that is planned to expand and refine the PRF scale for the PDI.
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Affiliation(s)
- Arietta Slade
- Child Study Center, Yale University, New Haven, Connecticut, USA
| | - Michelle Sleed
- Child Attachment and Psychological Therapies Research Unit (ChAPTRe), Anna Freud Centre and University College London, London, UK
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Ulvestad DA, Johansen MS, Kvarstein EH, Pedersen G, Wilberg T. Minding mentalizing - convergent validity of the Mentalization Breakdown Interview. Front Psychiatry 2024; 15:1380532. [PMID: 38974920 PMCID: PMC11224478 DOI: 10.3389/fpsyt.2024.1380532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Accepted: 06/03/2024] [Indexed: 07/09/2024] Open
Abstract
Objectives Mentalizing difficulties are central to borderline personality disorder (BPD), have severe consequences, and are an explicit focus in mentalization-based treatment. The significance of mentalizing capacity as a predictor or mediator of change is however still uncertain due to a scarcity of research. The Mentalization Breakdown Interview (MBI) was developed as a time saving tool for studying psychotherapy processes and outcome in borderline pathology. This study aimed to investigate the convergent validity of reflective functioning (RF) ratings based on the MBI (MBI-RF) by a comparison with the gold standard, i.e., RF assessments based on the Adult Attachment Interview (AAI-RF). A secondary aim was to investigate how MBI-RF relates to core symptoms of BPD, levels of functional impairment and symptom distress compared with AAI-RF. Method Forty-five patients with BPD or significant BPD traits were included. MBI-RF and AAI-RF were rated using the Reflective Functioning Scale. Levels of MBI-RF and AAI-RF and the correlation between the measures were calculated, as well as their associations with the Difficulties in Emotion Regulation Scale, Levels of Personality Functioning-Brief Form 2.0, Work and Social Adjustment Scale, Patient Health Questionnaire, Depression, Generalized Anxiety Disorder-7, self-harm, suicide attempts, and PD diagnostics. Results The correlation between MBI-RF and AAI-RF was 0.79 (p<0.01), indicating high convergent validity. There were few significant associations between MBI-RF and AAI-RF and clinical measures. Conclusions The study provides support for the convergent validity of the MBI as a BPD-focused RF assessment method. The MBI has the potential as a time saving, reliable and valid method to be applied in treatment research on patients with borderline pathology. The results indicate that measures of MBI-RF and AAI-RF are different from clinical symptoms. Clinical trial registration ClinicalTrials.gov ID NCT04157907.
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Affiliation(s)
- Dag Anders Ulvestad
- Outpatient Clinic for Specialized Treatment of Personality Disorders, Section for Personality Psychiatry and Specialized Treatments, Department for National and Regional Functions, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Merete Selsbakk Johansen
- Outpatient Clinic for Specialized Treatment of Personality Disorders, Section for Personality Psychiatry and Specialized Treatments, Department for National and Regional Functions, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
- South-Eastern Norway Regional Health Authority, Oslo, Norway
| | - Elfrida Hartveit Kvarstein
- Section for Personality Psychiatry and Specialized Treatments, Department for National and Regional Functions, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Geir Pedersen
- Network for Personality Disorders, Section for Personality Psychiatry and Specialized Treatments, Department for National and Regional Functions, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
- Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
| | - Theresa Wilberg
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Section for Treatment Research, Department for Research and Innovation, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
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Schwarzer NH, Heim N, Gingelmaier S, Fonagy P, Nolte T. Mentalizing as a Predictor of Well-Being and Emotion Regulation: Longitudinal Evidence from a Community Sample of Young Adults. Psychol Rep 2024:332941241261902. [PMID: 38876977 DOI: 10.1177/00332941241261902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2024]
Abstract
Background: In recent years, mentalizing - the capacity to understand one's own and others' intentional mental states in social contexts - has been considered to be a protective capacity that enables adaptive processing of stress-related emotional arousal, benefits general well-being and underpins adaptive emotion regulation. Objective: Several studies using cross-sectional research designs have demonstrated the potential health-promoting effect of mentalizing in non-clinical samples. However, longitudinal evidence is scarce. The present study aimed to investigate whether mentalizing predicts well-being and emotion regulation strategies in a non-clinical sample of mainly young adults using a prospective longitudinal design. Methods: In a prospective research design, 135 participants completed questionnaires assessing well-being, psychological symptom severity and mentalizing capacity at baseline (T1). Twelve months later (T2), emotion regulation strategies (suppression and cognitive reappraisal), well-being and psychological symptom severity were assessed by self-report. The data were analyzed using multivariate linear regression analysis. Results: Impairments in mentalizing were a significant negative predictor of well-being 12 months later. Furthermore, impairments in mentalizing positively predicted suppression of emotional states at T2. No association was found between deficits in mentalizing and cognitive reappraisal of emotional states over the course of 1 year. Conclusion: The findings indicate that mentalizing is longitudinally associated with mental health indicators in a non-clinical adult sample. Specifically, ineffective mentalizing was associated with impaired psychological well-being and a tendency to suppress intense emotional states over a period of 1 year. Future research should replicate these findings using multiple measurement timepoints to etablish causality.
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Affiliation(s)
- Nicola-Hans Schwarzer
- Institut für Sonderpädagogik, Fakultät für Erziehungs- und Sozialwissenschaften, Pädagogische Hochschule Heidelberg, Heidelberg, Germany
| | - Nikolas Heim
- International Psychoanaytic University Berlin, Berlin, Germany
| | - Stephan Gingelmaier
- Abteilung soziale und emotionale Entwicklung, Fakultät III für Sonderpädagogik, Pädagogische Hochschule Ludwigsburg, Ludwigsberg, Germany
| | - Peter Fonagy
- Anna Freud Centre, London, UK
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - Tobias Nolte
- Anna Freud Centre, London, UK
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
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8
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Springer N, Lueger-Schuster B. Navigating foster care: how parental drug use and caregiver attitudes shape children's mentalization processes-an exploratory longitudinal follow-up study: study protocol. Front Psychol 2024; 15:1295809. [PMID: 38939232 PMCID: PMC11210450 DOI: 10.3389/fpsyg.2024.1295809] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2023] [Accepted: 05/28/2024] [Indexed: 06/29/2024] Open
Abstract
Background The current research concept of mentalization is used in the study to clearly identify affective and cognitive abilities of the caregiver-child dyad with the aim of compensating deficits on both sides with psychological-psychotherapeutic strategies. Methods The objective of this explorative, longitudinal intervention study is to provide an in-depth understanding of the psycho-social background of 30 children aged 6-12 years living in institutional or family-centered foster care. Data will be collected at three time points: before, after and 12 months after participating in the newly developed group intervention, which intends to address the particular needs of children of drug abusing parents living in foster care in the latency period. The study is conducted at the Faculty of Psychology of the University of Vienna in collaboration with the Association "Dialogue" (Verein Dialog). The treatment duration spans 5 months, during which two specifically trained psychotherapists conduct 10 group sessions for children and three group sessions for foster caregivers. All statistical analyses will consider the type of data available. Therefore, the primary outcome of the study will be assessed via the Friedman test due to the ordinal dependent variable as it is the non-parametric alternative to the one-way ANOVA for repeated measures. In addition, the Mann-Whitney U test is used to compare differences between two independent groups (children living in institutional foster care vs. family foster care). To assess potential correlations regarding the child and caregivers' capacity to mentalize, Spearman correlations (ρ) are conducted. To examine the secondary outcome, apart from the methods previously outlined, we will also utilize qualitative thematic analysis. Discussion The present study uses the current research concept of mentalization to identify affective and cognitive abilities of the caregiver-child dyad with the aim of compensating deficits on both sides with psychological-psychotherapeutic strategies. There are some limitations of the study to mention: the small sample size does not allow to generalize the results. Due to the lack of a comparison group, a randomized control study (RCT) was not conducted. The authors are aware of these limitations. However, the studies' findings, will help to deduce research questions for further studies.
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Affiliation(s)
- Nadja Springer
- Dialog – Individuelle Suchthilfe, Vienna, Austria
- Unit of Psychotraumatology, Faculty of Psychology, University of Vienna, Vienna, Austria
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Kasper LA, Hauschild S, Berning A, Holl J, Taubner S. Development and validation of the Mentalizing Emotions Questionnaire: A self-report measure for mentalizing emotions of the self and other. PLoS One 2024; 19:e0300984. [PMID: 38709789 PMCID: PMC11073734 DOI: 10.1371/journal.pone.0300984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Accepted: 03/07/2024] [Indexed: 05/08/2024] Open
Abstract
Mentalizing describes the ability to imagine mental states underlying behavior. Furthermore, mentalizing allows one to identify, reflect on, and make sense of one's emotional state as well as to communicate one's emotions to oneself and others. In existing self-report measures, the process of mentalizing emotions in oneself and others was not captured. Therefore, the Mentalizing Emotions Questionnaire (MEQ; current version in German) was developed. In Study 1 (N = 510), we explored the factor structure of the MEQ with an Exploratory Factor Analysis. The factor analysis identified one principal (R2 = .65) and three subfactors: the overall factor was mentalizing emotions, the three subdimensions were self, communicating and other. In Study 2 (N = 509), we tested and confirmed the factor structure of the 16-items MEQ in a Confirmatory Factor Analysis (CFI = .959, RMSEA = .078, SRMR = .04) and evaluated its psychometric properties, which showed excellent internal consistency (α = .92 - .95) and good validity. The MEQ is a valid and reliable instrument which assesses the ability to mentalize emotions provides incremental validity to related constructs such as empathy that goes beyond other mentalization questionnaires.
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Affiliation(s)
- Lea A. Kasper
- Psychological Institute, University Heidelberg, Heidelberg, Germany
- Institute for Psychosocial Prevention, University Hospital Heidelberg, Heidelberg, Germany
| | - Sophie Hauschild
- Institute for Psychosocial Prevention, University Hospital Heidelberg, Heidelberg, Germany
| | - Anna Berning
- Psychological Institute, University Heidelberg, Heidelberg, Germany
- Institute for Psychosocial Prevention, University Hospital Heidelberg, Heidelberg, Germany
| | - Julia Holl
- Psychological Institute, University Heidelberg, Heidelberg, Germany
- Institute for Psychosocial Prevention, University Hospital Heidelberg, Heidelberg, Germany
| | - Svenja Taubner
- Psychological Institute, University Heidelberg, Heidelberg, Germany
- Institute for Psychosocial Prevention, University Hospital Heidelberg, Heidelberg, Germany
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Kochanska G, An D. The parent's and the child's internal working models of each other moderate cascades from child difficulty to socialization outcomes: Preliminary evidence for dual moderation? Dev Psychopathol 2024; 36:504-517. [PMID: 36751863 PMCID: PMC10406975 DOI: 10.1017/s0954579422001365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
Infants' difficulty, typically characterized as proneness to negative emotionality, is commonly considered a risk for future maladaptive developmental trajectories, mostly because it often foreshadows increased parental power assertion, typically linked to future negative child outcomes. However, growing evidence of divergent developmental paths that unfold from infant difficulty has invigorated research on causes of such multifinality. Kochanska et al. (2019) proposed that parent and child Internal Working Models (IWMs) of each other are key, with the parent's IWM of the child moderating the link between child difficulty and parental power assertion, and the child's IWM of the parent moderating the link between power assertion and child outcomes. In Children and Parents Study (200 community mothers, fathers, and children), child difficulty was observed at 8 months, parents' power assertion at 16 months, and children's outcomes rated by parents at age 3. Parents' IWMs were assessed with a mentalization measure at 8 months and children's IWMs were coded from semi-projective narratives at age 3. The cascade from infant difficulty to maternal power assertion to negative child outcomes was present only when both the mother's and the child's IWMs of each other were negative. We did not support the model for father-child dyads.
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Affiliation(s)
- Grazyna Kochanska
- Department of Psychological and Brain Sciences, The University of Iowa, Iowa City, IA52242-1407, USA
| | - Danming An
- Department of Psychological and Brain Sciences, The University of Iowa, Iowa City, IA52242-1407, USA
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11
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Firk C, Großheinrich N. Infant carrying: Associations with parental reflective functioning, parental bonding and parental responses to infant crying. Infant Ment Health J 2024; 45:263-275. [PMID: 38288564 DOI: 10.1002/imhj.22106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Revised: 01/12/2024] [Accepted: 01/13/2024] [Indexed: 02/27/2024]
Abstract
Infant carrying may have beneficial effects on the parent-infant relationship but only limited research has been conducted in this area. Therefore, the main aim of the current study was to investigate whether infant carrying is associated with parental reflective functioning, parental bonding, and parental (emotional) and behavioral responses to infant crying, key elements within the parent-infant relationship, promoting infant development. Parents reporting high levels (N = 389) of infant carrying (six times a week or daily) and parents reporting low levels (N = 128) of infant carrying (less than once a week or not at all) who participated in an online survey about the developing parent-infant relationship in Germany were included in the present study. Standardized questionnaires were used to assess parental reflective functioning, parental bonding impairments, and emotional responses to infant crying. Further insensitive (non-responsive and hostile) behaviors in response to infant crying were assessed. Parents with high levels of infant carrying showed better parental reflective functioning, lower parental bonding problems, less negative emotions, and less insensitive behaviors in response to infant crying.
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Affiliation(s)
- Christine Firk
- Department of Social Sciences, Catholic University of Applied Sciences of North Rhine-Eestphalia, Aachen, Germany
- Institute of Health Research and Social Psychiatry, Catholic University of Applied Sciences of North Rhine-Westphalia, Aachen, Germany
| | - Nicola Großheinrich
- Institute of Health Research and Social Psychiatry, Catholic University of Applied Sciences of North Rhine-Westphalia, Aachen, Germany
- Department of Social Sciences, Catholic University of Applied Sciences of North Rhine-Eestphalia, Cologne, Germany
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12
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Wendelboe KI, Stuart AC, Smith-Nielsen J, Linkhorst TB, Væver MS. Offline and online parental mentalizing in mothers with symptoms of postpartum depression: Examining the association between self-reported parental reflective functioning and interactional mind-mindedness. Infant Ment Health J 2024; 45:301-317. [PMID: 38446014 DOI: 10.1002/imhj.22109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 10/10/2023] [Accepted: 02/14/2024] [Indexed: 03/07/2024]
Abstract
Mentalizing is, to a certain extent, considered context specific. However, research on the association between parents' abilities to reflect upon their infant's mental states outside social interaction (offline) versus during ongoing parent-infant interaction (online) is currently limited. This study investigated the association between self-reported offline and online mentalizing in a sample of primarily ethnically Danish mothers (N = 142), with symptoms of postpartum depression, and their 1-11-month-old infants. Offline mentalizing was assessed with the Parental Reflective Functioning Questionnaire-Infant Version (PRFQ-I) and online mentalizing was assessed with interactional mind-mindedness. Ordinal logistic regressions showed that a higher score on the PRFQ-I prementalizing subscale was negatively related to number of overall mind-related comments and appropriate mind-related comments produced by mothers during interaction with their infant. Our results indicate partial overlaps between self-reported parental reflective functioning and mind-mindedness, that is, that particularly offline maladaptive mentalizing is associated with lower levels of mentalizing during interaction in mothers with symptoms of depression. Post-hoc examination of the interaction effect of postpartum depression showed that this association was only evident in mothers with medium to high levels of depression. Findings and implications are discussed.
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Affiliation(s)
- Katrine I Wendelboe
- Department of Psychology, Center for Early Intervention and Family Studies, University of Copenhagen, Copenhagen, Denmark
| | - Anne C Stuart
- Department of Psychology, Center for Early Intervention and Family Studies, University of Copenhagen, Copenhagen, Denmark
| | - Johanne Smith-Nielsen
- Department of Psychology, Center for Early Intervention and Family Studies, University of Copenhagen, Copenhagen, Denmark
| | - Thea B Linkhorst
- Department of Psychology, Center for Early Intervention and Family Studies, University of Copenhagen, Copenhagen, Denmark
| | - Mette Skovgaard Væver
- Department of Psychology, Center for Early Intervention and Family Studies, University of Copenhagen, Copenhagen, Denmark
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Bergman YS, Weissberger GH. Ageist attitudes and psychological distress in older adults: The moderating role of reflective functioning. Stress Health 2024:e3408. [PMID: 38661019 DOI: 10.1002/smi.3408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Revised: 03/09/2024] [Accepted: 04/08/2024] [Indexed: 04/26/2024]
Abstract
Ageist attitudes have been associated with various aspects of psychological functioning in older adults. According to Terror Management Theory, older adults may be seen as a reminder of human demise and death, and research has demonstrated links between ageist attitudes and compromised abilities to seek and maintain close personal relationships, which ward off awareness of one's mortality. Accordingly, the current work examined whether reflective functioning, or the ability to comprehend one's own and others' mental states, mitigates the negative psychological manifestations of ageist attitudes in older adults. Data was collected from 686 participants aged 60-94 (Mage = 72.64, SD = 6.28), who completed scales assessing ageist attitudes, reflective functioning, and psychological distress, as well as relevant socio-demographic information. Results indicated that ageist attitudes were linked with low levels of reflective functioning and enhanced psychological distress. Moreover, reflective functioning moderated the ageist attitudes-distress link, which was not significant in individuals reporting high levels of reflective functioning. This study provides insight into how the ability to comprehend others' mental states mitigates the adverse psychological effects of ageist attitudes and highlights the importance of examining relationship-enhancing personal factors within the context of negative ageing perceptions and psychological distress.
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Affiliation(s)
- Yoav S Bergman
- Faculty of Social Work, Ashkelon Academic College, Ashkelon, Israel
| | - Gali H Weissberger
- Department of Social and Health Sciences, Bar-Ilan University, Ramat-Gan, Israel
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14
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Zeeck A, Lau I, Endorf K, Schaefer L, Euler S, Lahmann C, Hartmann A. Mentalizing in psychotherapeutic processes of patients with eating disorders. Front Psychiatry 2024; 15:1367863. [PMID: 38707623 PMCID: PMC11067051 DOI: 10.3389/fpsyt.2024.1367863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Accepted: 04/04/2024] [Indexed: 05/07/2024] Open
Abstract
Background Improvement in the capacity to mentalize (i.e., reflective functioning/RF) is considered both, an outcome variable as well as a possible change mechanism in psychotherapy. We explored variables related to (in-session) RF in patients with an eating disorder (ED) treated in a pilot study on a Mentalization-Based Treatment (MBT) - oriented day hospital program. The research questions were secondary and focused on the psychotherapeutic process: What average RF does the group of patients show in sessions and does it change over the course of a single session? Are differences found between sections in which ED symptomatology is discussed and those in which it is not? Does RF increase after MBT-type interventions? Methods 1232 interaction segments from 77 therapy sessions of 19 patients with EDs were rated for RF by reliable raters using the In-Session RF Scale. Additionally, content (ED symptomatology yes/no) and certain MBT interventions were coded. Statistical analysis was performed by mixed models. Results Patients showed a rather low RF, which increased on average over the course of a session. If ED symptomatology was discussed, this was associated with significantly lower RF, while MBT-type interventions led to a significant increase in RF. Conclusions Results suggest that in-session mentalizing can be stimulated by MBT-typical interventions. RF seems to be more impaired when disorder-specific issues are addressed. Further studies have to show if improving a patient´s ability to mentalize their own symptoms is related to better outcomes.
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Affiliation(s)
- Almut Zeeck
- Department of Psychosomatic Medicine und Psychotherapy, Center for Mental Health, Faculty of Medicine, University of Freiburg, Freiburg im Breisgau, Germany
| | - Inga Lau
- Department of Psychosomatic Medicine und Psychotherapy, Center for Mental Health, Faculty of Medicine, University of Freiburg, Freiburg im Breisgau, Germany
| | - Katharina Endorf
- Department of Psychosomatic Medicine und Psychotherapy, Center for Mental Health, Faculty of Medicine, University of Freiburg, Freiburg im Breisgau, Germany
| | - Laura Schaefer
- Department of Psychosomatic Medicine und Psychotherapy, Center for Mental Health, Faculty of Medicine, University of Freiburg, Freiburg im Breisgau, Germany
| | - Sebastian Euler
- Department of Consultation Psychiatry and Psychosomatics, University Hospital Zürich, Zürich, Switzerland
| | - Claas Lahmann
- Department of Psychosomatic Medicine und Psychotherapy, Center for Mental Health, Faculty of Medicine, University of Freiburg, Freiburg im Breisgau, Germany
| | - Armin Hartmann
- Department of Psychosomatic Medicine und Psychotherapy, Center for Mental Health, Faculty of Medicine, University of Freiburg, Freiburg im Breisgau, Germany
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15
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Hüwe L, Laser L, Andreas S. Observer-based and computerized measures of the patient's mentalization in psychotherapy: A scoping review. Psychother Res 2024; 34:419-433. [PMID: 37356814 DOI: 10.1080/10503307.2023.2226812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 05/15/2023] [Accepted: 06/14/2023] [Indexed: 06/27/2023] Open
Abstract
OBJECTIVE In recent decades, mentalizing has found its permanent place both in therapeutic practice and in psychotherapy research. Inconsistent results and null results are often found. Therefore, the different methodological approaches should be examined in more detail. A scoping review was conducted to provide an overview of the approaches that measure the patient's mentalizing ability based on therapy sessions or in the course of psychotherapy. METHOD For the scoping review, a literature search was conducted in four databases. A total of 3217 records were identified. RESULTS We included 84 publications from 43 independent studies. Most studies used the Reflective Functioning Scale and applied the scale to therapy sessions or the Adult Attachment Interview. The other identified approaches used a computerized text analysis measure or clinician-report measures. Mostly good psychometric properties of the measures were reported. The Reflective Functioning Scale applied to the Adult Attachment Interview was the only measure that proved to be sensitive to change. CONCLUSION More economical variants to the time-consuming Reflective Functioning Scale applied to the Adult Attachment Interview are being developed continuously. In some cases, there is no standardized approach, or the measures are used only sporadically and require further and more comprehensive psychometric evaluations.
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Affiliation(s)
- Lotta Hüwe
- Department of Clinical Psychology, Psychotherapy and Psychoanalysis, University of Klagenfurt, Klagenfurt am Wörthersee, Austria
| | - Levin Laser
- Department of Clinical Psychology, Psychotherapy and Psychoanalysis, University of Klagenfurt, Klagenfurt am Wörthersee, Austria
| | - Sylke Andreas
- Department of Clinical Psychology, Psychotherapy and Psychoanalysis, University of Klagenfurt, Klagenfurt am Wörthersee, Austria
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16
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Castellini G, Tarchi L, Cassioli E, Ricca V, Abbate Daga G, Aguglia A, Albert U, Atti A, Barlati S, Blasi G, Carmassi C, Carrà G, De Fazio P, De Panfilis C, Di Lorenzo G, Ferrari S, Goracci A, Gramaglia C, Luciano M, Martinotti G, Menchetti M, Menculini G, Nanni MG, Nivoli A, Pinna F, Pompili M, Rosso G, Sambataro F, Sampogna G, Sani G, Serafini G, Signorelli MS, Tosato S, Ventriglio A, Viganò C, Volpe U, Fiorillo A. The interplay between mentalization, personality traits and burnout in psychiatry training: Results from a large multicenter controlled study. Acta Psychiatr Scand 2024; 149:177-194. [PMID: 38167781 DOI: 10.1111/acps.13649] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 11/05/2023] [Accepted: 12/10/2023] [Indexed: 01/05/2024]
Abstract
BACKGROUND A better characterization of educational processes during psychiatry training is needed, both to foster personal resilience and occupational proficiency. METHODS An adequate coverage of medical residents at the national level was reached (41.86% of the total reference population, 29 out of 36 training centers-80.55%). Controls were recruited among residents in other medical specialties. All participants were assessed by questionnaires to evaluate early life experiences, attachment style, personality traits, coping strategies, emotional competencies. A Structural Equation Model (SEM) framework was employed to investigate the interplay between individual factors. RESULTS A total sample of 936 people was recruited (87.9% response-rate; 645 residents in psychiatry, 291 other medical residents). Psychiatry trainees reported a higher prevalence of adverse childhood experiences (emotional abuse, emotional neglect, physical neglect), greater attachment insecurity (anxious or avoidant) in comparison to other medical trainees. Psychiatry residents also reported higher social support-seeking as a coping strategy, lower problem-orientation, and lower transcendence. Lower neuroticism, higher openness to experience, and higher emotional awareness were also observed in psychiatry trainees. Psychiatry training was associated with a redefinition of conflict management skills as a function of seniority. The SEM model provided support for an interplay between early traumatic experiences, mentalization skills (coping strategies, emotion regulation), interpersonal competencies and occupational distress. CONCLUSIONS The findings of the present study supported a theoretical model based on mentalization theory for the interactions between personal and relational competencies in psychiatry training, thus providing potential target of remodulation and redefinition of this specific process of education.
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Affiliation(s)
- Giovanni Castellini
- Psychiatry Unit, Department of Health Sciences, University of Florence, Florence, Italy
| | - Livio Tarchi
- Psychiatry Unit, Department of Health Sciences, University of Florence, Florence, Italy
| | - Emanuele Cassioli
- Psychiatry Unit, Department of Health Sciences, University of Florence, Florence, Italy
| | - Valdo Ricca
- Psychiatry Unit, Department of Health Sciences, University of Florence, Florence, Italy
| | | | - Andrea Aguglia
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, and Maternal and Child Health, Psychiatry Section, University of Genoa, IRCCS San Martino, Genoa, Italy
| | - Umberto Albert
- Department of Medicine, Surgery and Health Sciences, University of Trieste and Department of Mental Health, Trieste, Italy
| | - Annarita Atti
- Section of Psychiatry, Department of Medical and Surgical Sciences, Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - Stefano Barlati
- Department of Clinical and Experimental Sciences, University of Brescia and Department of Mental Health and Addiction Services, ASST Spedali Civili of Brescia, Brescia, Italy
| | - Giuseppe Blasi
- Department of Translational Biomedicine and Neuroscience, University of Bari Aldo Moro, Bari, Italy
| | - Claudia Carmassi
- Department of Clinical and Experimental Medicine, Psychiatric Clinic, Azienda Ospedaliero-Universitaria Pisana, University of Pisa, Pisa, Italy
| | - Giuseppe Carrà
- Department of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - Pasquale De Fazio
- Department of Health Sciences, University Magna Graecia of Catanzaro, Catanzaro, Italy
| | - Chiara De Panfilis
- Unit of Neuroscience, Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Giorgio Di Lorenzo
- Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Silvia Ferrari
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Arianna Goracci
- Department of Molecular and Developmental medicine, University of Siena, Siena, Italy
| | - Carla Gramaglia
- Department of Translational Medicine, Università del Piemonte Orientale, Novara, Italy
| | - Mario Luciano
- Department of Psychiatry, University of Campania "L. Vanvitelli", Naples, Italy
| | - Giovanni Martinotti
- Department of Neurosciences, Imaging and Clinical Sciences, 'G. D'Annunzio' University, Chieti, Italy
| | - Marco Menchetti
- Section of Psychiatry, Department of Medical and Surgical Sciences, Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | | | - Maria Giulia Nanni
- Department of Neuroscience and Rehabilitation, Institute of Psychiatry, University of Ferrara, Ferrara, Italy
| | - Alessandra Nivoli
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
| | - Federica Pinna
- Section of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Maurizio Pompili
- Department of Neurosciences, Mental Health, and Sensory Organs, Faculty of Medicine and Psychology, Suicide Prevention Centre, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy
| | - Gianluca Rosso
- Department of Neurosciences, University of Turin, Turin, Italy
| | - Fabio Sambataro
- Department of Neuroscience (DNS), University of Padova, Padua, Italy
| | - Gaia Sampogna
- Department of Psychiatry, University of Campania "L. Vanvitelli", Naples, Italy
| | - Gabriele Sani
- Department of Neuroscience, Section of Psychiatry, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Gianluca Serafini
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, and Maternal and Child Health, Psychiatry Section, University of Genoa, IRCCS San Martino, Genoa, Italy
| | - Maria Salvina Signorelli
- Psychiatry Unit, Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Sarah Tosato
- Section of Psychiatry, Department of Neuroscience, Biomedicine and Movement, University of Verona, Verona, Italy
| | - Antonio Ventriglio
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Caterina Viganò
- Department of Biomedical and Clinical Sciences, Luigi Sacco and Aldo Ravelli Center for Neurotechnology and Brain Therapeutic, University of Milan, Milano, Italy
| | - Umberto Volpe
- Unit of Clinical Psychiatry, Department of Neurosciences/DIMSC, School of Medicine and Surgery, Polytechnic University of Marche, Ancona, Italy
| | - Andrea Fiorillo
- Department of Psychiatry, University of Campania "L. Vanvitelli", Naples, Italy
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17
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Insua-Summerhays B, Knowles Bevis B, Barlow PJ. What tools should be used to identify women in need of additional support in pregnancy? J Reprod Infant Psychol 2024; 42:234-268. [PMID: 35930009 DOI: 10.1080/02646838.2022.2103525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Accepted: 07/13/2022] [Indexed: 10/16/2022]
Abstract
OBJECTIVE This study aimed to identify and inform recommendation of self-report and interview-based instruments that are feasible, reliable and valid to evaluate the quality of the maternal-fetal relationship (MFR). BACKGROUND Several constructs predicting parent-infant interaction and later infant adjustment are used to assess mothers' thoughts and feelings towards their unborn baby, including reflective functioning, mind-mindedness, representation, and fetal attachment. As yet, there is no existing review comparing the quality and accessibility of instruments across each of these constructs. METHODS A systematic literature review was undertaken to synthesise psychometric information on measures reporting on the MFR. Searches of six databases were conducted. English articles were selected based on inclusion and exclusion criteria. The QATSDD checklist was used to assess study quality. RESULTS Of 669 studies identified, 28 met inclusion criteria. Thirteen different instruments were identified for evaluation. Reported reliability and validity varied significantly across instruments, as well as availability for research and/or clinical use. CONCLUSION Suggestions for research and clinical practice include further evaluation of the psychometric properties of tools, particularly for self-report measures of reflective functioning, use of interviews to scaffold reflexivity, and development of clinical policies and procedures to clarify care pathways for expectant mothers needing further support.
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Affiliation(s)
- Bryony Insua-Summerhays
- Department of Social Policy and Intervention, Oxford Institute of Clinical Psychology Training and Research, Isis Education Centre, Warneford Hospital, Headington, UK
| | - Becca Knowles Bevis
- Department of Social Policy and Intervention, Oxford Institute of Clinical Psychology Training and Research, Isis Education Centre, Warneford Hospital, Headington, UK
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18
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Kivity Y, Levy KN, Johnson BN, Rosenstein LK, LeBreton JM. Mentalizing in and out of awareness: A meta-analytic review of implicit and explicit mentalizing. Clin Psychol Rev 2024; 108:102395. [PMID: 38320421 DOI: 10.1016/j.cpr.2024.102395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Revised: 01/25/2024] [Accepted: 01/29/2024] [Indexed: 02/08/2024]
Abstract
BACKGROUND Mentalizing, making sense of mental states, is hypothesized to have a central role in self-organization and social learning. Findings support this notion, but the extent of the association between mentalizing and various correlates has not been meta-analyzed. Furthermore, mentalizing presumably occurs with (explicit) and without (implicit) awareness but few studies have attempted to disentangle these aspects. We conducted a meta-analysis of implicit and explicit mentalizing in relation to the domains of attachment security, personality, affect, psychopathology, and functioning. METHODS We searched for studies of adult mentalizing in PsycINFO and in related reviews. Overall, 511 studies (N = 78,733) met criteria and were analyzed using multi-level meta-analysis. RESULTS Implicit (r = 0.19-0.29) and explicit (r = 0.26-0.40) mentalizing were moderately correlated with psychopathology, functioning, personality, affect, and attachment security. The correlations of implicit mentalizing were stronger with more objectively measured correlates (b = 0.02, p < .001) while the correlations of explicit mentalizing were not (b = -0.07, p = .21). CONCLUSIONS Mentalizing is associated with better intra- and interpersonal functioning. Implicit mentalizing is more strongly associated with objectively measured correlates. These findings underscore the importance of an integrative approach considering both implicit and explicit mentalizing.
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Affiliation(s)
- Yogev Kivity
- Department of Psychology, Bar Ilan University, Israel.
| | - Kenneth N Levy
- Department of Psychology, Pennsylvania State University, USA.
| | - Benjamin N Johnson
- School of Psychology and Counseling, Fairleigh Dickinson University, USA
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Luyten P, Campbell C, Moser M, Fonagy P. The role of mentalizing in psychological interventions in adults: Systematic review and recommendations for future research. Clin Psychol Rev 2024; 108:102380. [PMID: 38262188 DOI: 10.1016/j.cpr.2024.102380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 12/20/2023] [Accepted: 01/05/2024] [Indexed: 01/25/2024]
Abstract
Mentalizing is the human capacity to understand actions of others and one's own behavior in terms of intentional mental states, such as feelings, wishes, goals and desires. Mentalizing is a transtheoretical and transdiagnostic concept that has been applied to understanding vulnerability to psychopathology and has attracted considerable research attention over the past decades. This paper reports on a pre-registered systematic review of evidence concerning the role of mentalizing as a moderator and mediator in psychological interventions in adults. Studies in adults were reviewed that address the following questions: (a) does pre-treatment mentalizing predict treatment outcome; (b) do changes in mentalizing across treatment predict outcome; (c) does adherence to the principles or protocol of mentalization-based treatment predict outcome; and (d) does strengthening in-session mentalizing impact the therapeutic process via improved alliance, alleviated symptoms, or improved interpersonal functioning? Results suggest that mentalizing might be a mediator of change in psychotherapy and may moderate treatment outcome. However, the relatively small number of studies (n = 33 papers based on 29 studies, totaling 3124 participants) that could be included in this review, and the heterogeneity of studies in terms of design, measures used, disorders included, and treatment modalities, precluded a formal meta-analysis and limited the ability to draw strong conclusions. Therefore, theoretical and methodological recommendations for future research to improve the quality of existing research in this area are formulated.
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Affiliation(s)
- Patrick Luyten
- Faculty of Psychology and Educational Sciences, KU Leuven, Tiensestraat 102, Pobox 3722, Leuven 3000, Belgium; Research Department of Clinical, Educational and Health Psychology, University College London, 1-19 Torrington Place, London WC1E 7HB, UK.
| | - Chloe Campbell
- Research Department of Clinical, Educational and Health Psychology, University College London, 1-19 Torrington Place, London WC1E 7HB, UK
| | - Max Moser
- Research Department of Clinical, Educational and Health Psychology, University College London, 1-19 Torrington Place, London WC1E 7HB, UK
| | - Peter Fonagy
- Research Department of Clinical, Educational and Health Psychology, University College London, 1-19 Torrington Place, London WC1E 7HB, UK
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20
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Duque A, Picado G, Salgado G, Salgado A, Palacios B, Chaves C. Validation of the Edited Tromsø Infant Faces Database (E-TIF): A study on differences in the processing of children's emotional expressions. Behav Res Methods 2024; 56:2507-2518. [PMID: 37369938 PMCID: PMC10991014 DOI: 10.3758/s13428-023-02163-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/05/2023] [Indexed: 06/29/2023]
Abstract
Images of emotional facial expressions are often used in emotion research, which has promoted the development of different databases. However, most of these standardized sets of images do not include images from infants under 2 years of age, which is relevant for psychology research, especially for perinatal psychology. The present study aims to validate the edited version of the Tromsø Infant Faces Database (E-TIF) in a large sample of participants. The original set of 119 pictures was edited. The pictures were cropped to remove nonrelevant information, fitted in an oval window, and converted to grayscale. Four hundred and eighty participants (72.9% women) took part in the study, rating the images on five dimensions: depicted emotion, clarity, intensity, valence, and genuineness. Valence scores were useful for discriminating between positive, negative, and neutral facial expressions. Results revealed that women were more accurate at recognizing emotions in children. Regarding parental status, parents, in comparison with nonparents, rated neutral expressions as more intense and genuine. They also rated sad, angry, disgusted, and fearful faces as less negative, and happy expressions as less positive. The editing and validation of the E-TIF database offers a useful tool for basic and experimental research in psychology.
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Affiliation(s)
- Almudena Duque
- Facultad de Psicología, Universidad Pontificia de Salamanca, C/ Compañía 5, 37002, Salamanca, Spain
| | - Gonzalo Picado
- Facultad de Psicología, Universidad Pontificia de Salamanca, C/ Compañía 5, 37002, Salamanca, Spain
| | - Gloria Salgado
- Facultad de Psicología, Universidad Complutense de Madrid, Campus de Somosaguas s/n, 28223, Pozuelo de Alarcón, Spain
| | - Alfonso Salgado
- Facultad de Psicología, Universidad Pontificia de Salamanca, C/ Compañía 5, 37002, Salamanca, Spain
| | - Beatriz Palacios
- Facultad de Psicología, Universidad Pontificia de Salamanca, C/ Compañía 5, 37002, Salamanca, Spain
| | - Covadonga Chaves
- Facultad de Psicología, Universidad Complutense de Madrid, Campus de Somosaguas s/n, 28223, Pozuelo de Alarcón, Spain.
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21
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Weissberger GH, Bergman YS. Reflective Functioning and Financial Exploitation Vulnerability in Older Adults: The Importance of Significant Others. Clin Gerontol 2024:1-10. [PMID: 38389427 DOI: 10.1080/07317115.2024.2320921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/24/2024]
Abstract
OBJECTIVES Financial exploitation of older adults results in devastating economic, social, and psychological losses to older adults, their families, and society at large. This study examined the relationship between reflective functioning and financial exploitation vulnerability (FEV) and whether relationship status moderated the association. METHODS A community-based sample of 156 Israeli older adults age 60 and over responded to demographic questions and questionnaires assessing reflective functioning and FEV. RESULTS A hierarchical linear regression analysis covarying for age, sex, education, income, and sum of illnesses, revealed that higher reflective functioning was associated with lower FEV (p = .011). A main effect of relationship status was not found, but a significant interaction of reflective functioning × relationship status was discovered (p = .008), adding 4.2% to the total variance of the model. Probing the interaction revealed that the reflective functioning-FEV association was significant only for older adults not in a relationship. CONCLUSIONS Findings suggest that low reflective functioning may be associated with increased risk of financial exploitation, specifically in certain populations of older adults. CLINICAL IMPLICATIONS Care providers of older adults may consider assessing for, and identifying older adults with low reflective functioning, in order to prevent or intervene in the event of a potentially exploitative situation.
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Affiliation(s)
- Gali H Weissberger
- Department of Social and Health Sciences, Bar-Ilan University, Ramat-Gan, Israel
| | - Yoav S Bergman
- Faculty of Social Work, Ashkelon Academic College, Ashkelon, Israel
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22
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Kjaersdam Telléus G, Simonsen CB, Jakobsen AG, Dalgaard MK, Rasmussen SM, Nilsson KK. A multifaceted approach to assessment of mentalization: the mentalization profile in patients with eating disorders. Nord J Psychiatry 2024; 78:146-152. [PMID: 38134216 DOI: 10.1080/08039488.2023.2291177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Accepted: 11/30/2023] [Indexed: 12/24/2023]
Abstract
Purpose: The existing literature, however sparse, suggests an association between eating disorders (ED) and mentalization ability. The aim of this study was to investigate the mentalization profile (MP) in patients with ED. It was hypothesized that patients with ED would have a lower degree of mentalization ability compared to healthy controls (HC).Materials and methods: The study is based on a cross-sectional survey on a sample of patients diagnosed with ED compared to a HC group.Results and conclusion: A total of 88 participants, distributed between patients with ED (N = 30) and HC (N = 58) were included.Results: The study results show statistically significant differences between patients with ED and HC. Thus, patients with an ED scored significantly higher on Reflective Functioning Questionnaire (uncertainty about mental states) (RFQ-U) (mean difference: 0.31, p = 0.048) and Toronto Alexithymia Scale (TAS-20) (mean difference: 0.44, p = 0.019) compared to the HC. Furthermore, the results indicated that patients with Bulimia Nervosa (BN) may have a lower ability to mentalize about oneself as well as a generally lower ability to mentalize across different dimensions of the mentalization profile as the BN group scored significantly higher on RFQ-U (mean difference: 0.71, p = 0.023) and TAS-20 (mean difference: 0.89, p = 0.006) compared to the Anorexia Nervosa (AN) group. Further research should be conducted to gain knowledge on the mentalization ability in patients with an ED.
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Affiliation(s)
- Gry Kjaersdam Telléus
- Psychiatry, Aalborg University Hospital, Aalborg, Denmark
- Institute of Communication and Psychology, Psychology, Aalborg University, Aalborg, Denmark
| | - Caroline Bach Simonsen
- Psychiatry, Aalborg University Hospital, Aalborg, Denmark
- Institute of Communication and Psychology, Psychology, Aalborg University, Aalborg, Denmark
| | | | | | - Sofie Martine Rasmussen
- Psychiatry, Aalborg University Hospital, Aalborg, Denmark
- Department of Clinical Medicine, Faculty of Medicine, Aalborg University, Aalborg, Denmark
| | - Kristine Kahr Nilsson
- Institute of Communication and Psychology, Psychology, Aalborg University, Aalborg, Denmark
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Bendel-Stenzel LC, An D, Kochanska G. Elucidating mechanisms linking mothers' and fathers' mind-mindedness in infancy with children's self-regulation at early preschool age. J Exp Child Psychol 2024; 238:105782. [PMID: 37783014 PMCID: PMC10843086 DOI: 10.1016/j.jecp.2023.105782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Revised: 08/30/2023] [Accepted: 09/06/2023] [Indexed: 10/04/2023]
Abstract
Extensive research has examined factors that contribute to individual differences in children's self-regulation (SR), a key social-emotional competence crucial to adjustment and mental health. Those differences become salient and measurable at late toddler age. In the CAPS (N = 200 community families), we examined mothers' and fathers' appropriate mind-mindedness (MM)-the ability to view the child as a psychological agent and correctly interpret his or her mental states-as a predictor of children's SR. MM was observed in parent-child interactions at 8 months, and SR was observed as the capacity for deliberate delay in standard tasks at 3 years. Reflecting a family system perspective, processes both within and across mother-child and father-child relationships were examined in one model. Parent-child mutual responsiveness, observed during interactions at 16 months, was modeled as a mediator of the paths from MM to SR. Fathers' MM had a significant, direct positive effect on SR; in addition, it enhanced mutual responsiveness in both father-child and mother-child dyads and promoted child SR through enhanced mother-child mutual responsiveness. The findings elucidate relatively poorly understood mechanisms linking parental MM in infancy with SR at early preschool age, highlight similarities and differences in the processes unfolding in mother-child and father-child relationships, and emphasize interparental dynamics in socialization.
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Affiliation(s)
- Lilly C Bendel-Stenzel
- Department of Psychological and Brain Sciences, University of Iowa, Iowa City, IA 52242, USA.
| | - Danming An
- Department of Psychological and Brain Sciences, University of Iowa, Iowa City, IA 52242, USA
| | - Grazyna Kochanska
- Department of Psychological and Brain Sciences, University of Iowa, Iowa City, IA 52242, USA
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Smith-Nielsen J, Stuart AC, Wendelboe KI, Egmose I, Roos CO, Væver MS. The significance of parental mentalizing for four-year-old children's solitary pretend play. PLoS One 2024; 19:e0297671. [PMID: 38295066 PMCID: PMC10830029 DOI: 10.1371/journal.pone.0297671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 01/11/2024] [Indexed: 02/02/2024] Open
Abstract
BACKGROUND Pretend play is a signature behavior of early childhood and is considered to reflect the child's emerging symbolic function, enabling the interpretation of social signals, language development, and emotion understanding. While theory links parental mentalizing with children's pretend play, only a few studies have investigated this association. These studies are limited to infancy and early toddlerhood, and child pretend play is assessed during play with an adult (social play). Based on the assumption that child solitary pretend play reflects the child's 'baseline' pretend play ability, in this study, we investigated children's pretend play at its peak, i.e., during the preschool age, without the facilitation of another player. The overall objective was to investigate if parental mentalizing increases pretend play complexity in children. METHODS The sample consisted 99 Danish mothers and their 4-year-old children. Employing a cross-sectional design, we hypothesized that parental mental state language, as an indicator of 'online' mentalizing during interaction with the child, is a mechanism through which 'offline' mentalizing, measured as parental reflective functioning, is associated with child solitary pretend play. Child pretend play complexity was observed and coded with an adapted version of the 12-Step Play Scale. Maternal offline mentalizing was assessed with the Parental Reflective Functioning Questionnaire, and maternal online mentalizing was assessed by coding the mothers' mental state language during interaction with the child using a modified version of the mind-mindedness coding scheme. RESULTS While there was no direct effect of maternal offline reflective functioning on child pretend play, online mental state language mediated the link between offline maternal reflective functioning and child pretend play. CONCLUSIONS These results provide support for the theoretically assumed link between parental mentalizing and children's capacity for pretend play. Furthermore, our study contributes to the literature on parental mentalization, suggesting that parental mentalizing facilitates child development only if the parent can translate this ability into 'mentalizing in action'.
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Affiliation(s)
| | | | | | - Ida Egmose
- Department of Psychology, University of Copenhagen, Copenhagen, Denmark
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Volkert J, Ilagan GS, Iliakis EA, Ren B, Schröder-Pfeifer P, Choi-Kain LW. What predicts psychosocial functioning in borderline personality disorder? Investigating the association with reflective functioning. Psychol Psychother 2024. [PMID: 38214456 DOI: 10.1111/papt.12516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Revised: 11/21/2023] [Accepted: 12/18/2023] [Indexed: 01/13/2024]
Abstract
OBJECTIVES The aim of this study was to investigate factors associated with functioning in participants with and without borderline personality disorder (BPD). In particular, we were interested whether mentalizing and related social cognitive capacities, as factors of internal functioning, are important in predicting psychosocial functioning, in addition to other psychopathological and sociodemographic factors. METHOD This is a cross-sectional study with N = 53 right-handed females with and without BPD, without significant differences in age, IQ, and socioeconomic status, who completed semi-structured diagnostic and self-report measures of social cognition. Mentalizing was assessed using the Reflective Functioning Scale based on transcribed Adult Attachment Interviews. A regularized regression with the elastic net penalty was deployed to investigate whether mentalizing and social cognition predict psychosocial functioning. RESULTS Borderline personality disorder symptom severity, sexual abuse trauma, and social and socio-economic factors ranked as the most important variables in predicting psychosocial functioning, while reflective functioning (RF) was somewhat less important in the prediction, social cognitive functioning and sociodemographic variables were least important. CONCLUSIONS Borderline personality disorder symptom severity was most important in determining functional impairment, alongside trauma related to sexual abuse as well as social and socio-economic factors. These findings verify that BPD symptoms themselves most robustly predict functional impairment, followed by history of sexual abuse, then contextual factors (e.g. housing, financial, physical health), and then RF. These results lend marginal support to the conceptualization that mentalizing may enhance psychosocial functioning by facilitating social learning, but emphasize symptom reduction and stabilization of life context as key intervention targets.
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Affiliation(s)
- Jana Volkert
- Clinic for Psychosomatic Medicine and Psychotherapy, University of Ulm, Ulm, Germany
| | | | - Evan A Iliakis
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Boyu Ren
- Laboratory for Psychiatric Biostatistics, McLean Hospital, Belmont, Massachusetts, USA
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA
| | - Paul Schröder-Pfeifer
- Institute for Psychosocial Prevention, University of Heidelberg, Heidelberg, Germany
| | - Lois W Choi-Kain
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA
- Gunderson Personality Disorders Institute, McLean Hospital, Belmont, Massachusetts, USA
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Kasper LA, Hauschild S, Schrauf LM, Taubner S. Enhancing mentalization by specific interventions within mentalization-based treatment of adolescents with conduct disorder. Front Psychol 2024; 14:1223040. [PMID: 38259532 PMCID: PMC10800920 DOI: 10.3389/fpsyg.2023.1223040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 12/08/2023] [Indexed: 01/24/2024] Open
Abstract
Objective Mentalization is discussed as a mechanism of change in psychotherapy due to its positive effects on psychological functioning. In order to specifically apply mentalization-based interventions, a better understanding of the relationship between interventions and in-session mentalization is needed. The study aimed to explore the association between interventions and effective mentalizing. Method Fifteen therapy sessions of three therapies with male adolescents with conduct disorder were transcribed and rated with the Reflective Functioning (RF) Scale and a newly developed Mentalization-based Treatment (MBT) intervention coding manual. The coded interventions were categorized into intervention levels according to the MBT manual. Fisher's exact tests were performed to test differences in frequencies of interventions in high-RF sequences (RF score ≥ 4) compared with remaining therapy sequences (RF score ≤ 3). Results Specific MBT interventions such as demand questions, affectelaboration, empathic validation, change of subject, challenge, patienttherapist relation and mentalizing for the patient were related to effective mentalizing. Moreover, intervention levels such as supportive & empathic, basic- mentalizing & affect mode and relational mentalizing were positively associated with effective mentalizing. Conclusion MBT interventions seem to promote effective mentalizing at various intervention levels. Interventions that enhance effective mentalizing seem to be patient specific. In line with MBT theory, their effect on effective mentalizing might depend on various variables, such as the patients' arousal and pre-mentalizing mode.
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Affiliation(s)
- Lea A. Kasper
- Institute for Psychosocial Prevention, University Hospital Heidelberg, Heidelberg, Germany
- Psychological Institute, University of Heidelberg, Heidelberg, Germany
| | - Sophie Hauschild
- Institute for Psychosocial Prevention, University Hospital Heidelberg, Heidelberg, Germany
- Psychological Institute, University of Heidelberg, Heidelberg, Germany
| | - Lisa M. Schrauf
- Institute for Psychosocial Prevention, University Hospital Heidelberg, Heidelberg, Germany
| | - Svenja Taubner
- Institute for Psychosocial Prevention, University Hospital Heidelberg, Heidelberg, Germany
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Wall KM, Penner F, Dell J, Lowell A, Potenza MN, Mayes LC, Rutherford HJV. Maternal psychological risk and the neural correlates of infant face processing: A latent profile analysis. Dev Psychobiol 2024; 66:e22445. [PMID: 38131237 PMCID: PMC10783861 DOI: 10.1002/dev.22445] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 10/31/2023] [Accepted: 11/07/2023] [Indexed: 12/23/2023]
Abstract
Maternal psychological factors, including anxiety, depression, and substance use, may negatively affect parenting. Previous works with mothers have often assessed each of these factors in isolation despite their frequent co-occurrence. Psychological factors have also been associated with neural processing of facial stimuli, specifically the amplitude (i.e., size) and latency (i.e., timing) of the face-specific N170 event-related potential. In the current study, 106 mothers completed measures assessing maternal psychological factors-anxiety, depression, and substance use. A latent profile analysis was used to identify profiles of psychological factors and assess profile associations with the N170 elicited by infant faces and with parental reflective functioning (PRF) as a measure related to caregiving. Two profiles (termed high and low psychological risk) were identified, with the higher risk profile associated with delayed N170 latency responses to infant faces. An exploratory analysis evidenced an indirect effect between the higher psychological risk profile and lower PRF through delayed N170 latency responses to infant faces. Taken together, maternal psychological risk across multiple indicators may together shape neural processing of infant faces, which may have downstream consequences for caregiving.
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Affiliation(s)
- Kathryn M Wall
- Yale Child Study Center, Yale University School of Medicine, New Haven, Connecticut, USA
- Interdepartmental Neuroscience Program, Yale University, New Haven, Connecticut, USA
| | - Francesca Penner
- Yale Child Study Center, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Jaclyn Dell
- Department of Psychology, University of South Florida St Petersburg, St. Petersburg, Florida, USA
| | - Amanda Lowell
- Yale Child Study Center, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Marc N Potenza
- Yale Child Study Center, Yale University School of Medicine, New Haven, Connecticut, USA
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA
- Department of Neuroscience, Yale School of Medicine, New Haven, Connecticut, USA
- The Connecticut Mental Health Center, New Haven, Connecticut, USA
- The Connecticut Council on Problem Gambling, Wethersfield, Connecticut, USA
- The Wu Tsai Institute, Yale University, New Haven, Connecticut, USA
| | - Linda C Mayes
- Yale Child Study Center, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Helena J V Rutherford
- Yale Child Study Center, Yale University School of Medicine, New Haven, Connecticut, USA
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Carone N, Mirabella M, Innocenzi E, Quintigliano M, Antoniucci C, Manzi D, Fortunato A, Giovanardi G, Speranza AM, Lingiardi V. The intergenerational transmission of attachment during middle childhood in lesbian, gay, and heterosexual parent families through assisted reproduction: The mediating role of reflective functioning. Attach Hum Dev 2023:1-27. [PMID: 38078384 DOI: 10.1080/14616734.2023.2292053] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Accepted: 12/04/2023] [Indexed: 12/20/2023]
Abstract
The present study examined the attachment patterns distribution of 60 lesbian mothers, 50 gay fathers, and 42 heterosexual parents through assisted reproduction and their 76 children, using the Adult Attachment Interview (AAI) and the Friends and Family Interview (FFI), respectively. The study also explored the intergenerational transmission of attachment through reflective functioning (AAI-RF). All families lived in Italy and children were aged 6-12 years (Myears = 8.11, SD = 2.17; 48.68% assigned female at birth). The AAI patterns distribution was similar across family types and did not significantly differ from international and national normative data. Similarly, children's FFI attachment patterns were evenly distributed between family types, and no significant differences emerged in comparison to international and national normative data referring to middle childhood samples. Mediational models revealed that, in all three family types, parents with greater AAI coherence of mind exhibited higher AAI-RF, which, in turn, was associated with increased FFI attachment security in children. Furthermore, parents' AAI coherence of mind directly influenced children's FFI attachment security. The results support and expand hypotheses regarding the intergenerational transmission of attachment in lesbian, gay, and heterosexual parent families through assisted reproduction, while offering unique indications to support these families during middle childhood.
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Affiliation(s)
- Nicola Carone
- Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Marta Mirabella
- Department of Dynamic and Clinical Psychology, and Health Studies, Sapienza University of Rome, Rome, Italy
| | - Eleonora Innocenzi
- Department of History, Culture and Society, "Tor Vergata" University of Rome, Rome, Italy
| | - Maria Quintigliano
- Department of Dynamic and Clinical Psychology, and Health Studies, Sapienza University of Rome, Rome, Italy
| | - Chiara Antoniucci
- Department of Developmental and Social Psychology, Sapienza University of Rome, Rome, Italy
| | - Demetria Manzi
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Alexandro Fortunato
- Department of Dynamic and Clinical Psychology, and Health Studies, Sapienza University of Rome, Rome, Italy
| | - Guido Giovanardi
- Department of Dynamic and Clinical Psychology, and Health Studies, Sapienza University of Rome, Rome, Italy
| | - Anna Maria Speranza
- Department of Dynamic and Clinical Psychology, and Health Studies, Sapienza University of Rome, Rome, Italy
| | - Vittorio Lingiardi
- Department of Dynamic and Clinical Psychology, and Health Studies, Sapienza University of Rome, Rome, Italy
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Benfante A, Cisarò F, Ribaldone DG, Castelli L, Sandroni N, Romeo A. Inflammatory Bowel Disease and Irritable Bowel Syndrome: What Differences in Mentalization Abilities? A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:7125. [PMID: 38063555 PMCID: PMC10706729 DOI: 10.3390/ijerph20237125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Revised: 11/24/2023] [Accepted: 11/28/2023] [Indexed: 12/18/2023]
Abstract
Mentalization is a psychological process that enables individuals to understand the self and others in terms of intentional mental states. The aim of this scoping review was to provide an overview of the findings on mentalization in patients with inflammatory bowel disease (IBD) and irritable bowel syndrome (IBS). A literature search, in line with the Preferred Reporting Items for Systematic Review and Meta-analysis Protocols extension for Scoping Review guidelines, was conducted in the following bibliographic databases: PubMed, PsycINFO, and Scopus. Databases were queried using the following strings (with Boolean operators): ("mentaliz*" OR "metacogniti*" OR "theory of mind" OR "ToM" OR "reflective function*") AND ("irritable bowel syndrome" OR "IBS" OR "inflammatory bowel disease" OR "IBD"). In line with the eligibility criteria, seven articles were included. Results showed that no significant differences in metacognitive ability were found between patients in the IBD and IBS groups. This review revealed the mentalizing difficulties for patients with IBD and IBS. These results should be interpreted with caution since they are based on a few studies that used different instruments to assess mentalizing processes. Future studies are needed to clarify the role of mentalization in patients with these gastrointestinal conditions.
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Affiliation(s)
- Agata Benfante
- Department of Psychology, University of Turin, 10124 Turin, Italy; (L.C.); (N.S.); (A.R.)
| | - Fabio Cisarò
- Division of Digestive Endoscopy, Città della Salute e della Scienza University-Hospital, 10126 Turin, Italy;
| | - Davide Giuseppe Ribaldone
- Division of Gastroenterology, Città della Salute e della Scienza University-Hospital, 10126 Turin, Italy;
- Department of Medical Sciences, University of Turin, 10126 Turin, Italy
| | - Lorys Castelli
- Department of Psychology, University of Turin, 10124 Turin, Italy; (L.C.); (N.S.); (A.R.)
| | - Nikolas Sandroni
- Department of Psychology, University of Turin, 10124 Turin, Italy; (L.C.); (N.S.); (A.R.)
| | - Annunziata Romeo
- Department of Psychology, University of Turin, 10124 Turin, Italy; (L.C.); (N.S.); (A.R.)
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Schwarzer NH, Dietrich L, Gingelmaier S, Nolte T, Bolz T, Fonagy P. Mentalizing partially mediates the association between attachment insecurity and global stress in preservice teachers. Front Psychol 2023; 14:1204666. [PMID: 37671112 PMCID: PMC10475550 DOI: 10.3389/fpsyg.2023.1204666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 07/27/2023] [Indexed: 09/07/2023] Open
Abstract
Objective Considering the fact that the teaching profession is a highly stressful occupation and that teachers' ineffective coping strategies contribute to higher levels of stress, the objective of the present study was to investigate whether insecure attachment is related to global stress experiences in preservice student teachers. Furthermore, it was examined whether this link is mediated by the preservice teachers' mentalizing-the capacity to perceive and consider one's own and others' behavior based on intentional mental states. Methods Data of this cross-sectional study came from 202 preservice student teachers using self-report instruments (attachment: Expectation in Close Relationships; mentalizing: Reflective Functioning Questionnaire; stress: Trier Inventory of Chronic Stress). The hypotheses were tested using structural equation modelling. Results Anxious attachment was positively related to stress and impairments in mentalizing. In addition, the link between attachment-related anxiety and stress was partially mediated by mentalizing. Avoidant attachment was not associated with stress or mentalizing. Discussion Results indicate that anxious attachment is associated with higher perceived stress in preservice student teachers. Consequently, attachment-related anxiety may be a risk factor which, in turn, may foster perceptions of higher global stress experiences. Conclusion Additional research needs to focus on exploring the link between attachment insecurity and global stress experiences among preservice student teachers. An examination of preservice student teachers' own attachment experiences proves to be useful, for example in the context of mentalization-based supervision or reflective practice.
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Affiliation(s)
| | - Lars Dietrich
- Humboldt University of Berlin, Berlin, Baden-Wurttemberg, Germany
| | | | - Tobias Nolte
- Anna Freud National Centre for Children and Families, London, United Kingdom
| | - Tijs Bolz
- University of Oldenburg, Oldenburg, Lower Saxony, Germany
| | - Peter Fonagy
- University College London, London, England, United Kingdom
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Orr RI, Gilead M. Development and validation of the Mental-Physical Verb Norms (MPVN): A text analysis measure of mental state attribution. Behav Res Methods 2023; 55:2501-2521. [PMID: 35879502 DOI: 10.3758/s13428-022-01911-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/17/2022] [Indexed: 11/08/2022]
Abstract
Attribution of mental states to self and others, i.e., mentalizing, is central to human life. Current measures are lacking in the ability to directly gauge the extent to which individuals engage in spontaneous mentalizing. Focusing on natural language use as an expression of inner psychological processes, we developed the Mental-Physical Verb Norms (MPVN). These norms are participant-derived ratings of the extent to which common verbs reflect mental (vs physical) activities and occurrences, covering a majority of verbs appearing in a given English text. Content validity was assessed against existing expert-compiled dictionaries of mental states and cognitive processes, as well as against normative ratings of verb concreteness. Criterion Validity was assessed through natural text analysis of both experimental data, and natural language use in a real-world online setting. Finally, incremental validity was assessed through a classification analysis. Results indicate the unique contribution of the MPVN ratings as a measure of the degree to which individuals adopt the intentional stance in describing targets, by describing both self and others in mental, opposite physical, terms. We discuss potential uses for future research across various psychological and neurocognitive disciplines, as well as theoretical implications regarding the use of mentalizing language within spontaneous contexts.
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Ensink K, Bégin M, Martin-Gagnon G, Biberdzic M, Berthelot N, Normandin L, Fonagy P, Bernazzani O, Borelli JL. Post-traumatic-stress in the context of childhood maltreatment: pathways from attachment through mentalizing during the transition to parenthood. Front Psychol 2023; 14:919736. [PMID: 37359870 PMCID: PMC10289889 DOI: 10.3389/fpsyg.2023.919736] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Accepted: 05/17/2023] [Indexed: 06/28/2023] Open
Abstract
Introduction This study aimed to clarify the role of mentalizing in pathways from attachment to Post Traumatic Stress Symptoms (PTSS) in survivors of childhood maltreatment (CM). We focused on the transition to parenting, a critical period for reworking parenting representations to reduce intergenerational maltreatment cycles. Method Study participants included 100 pregnant CM survivors. We assessed PTSS with the SCID and attachment and mentalizing with the Adult Attachment Interview (AAI), which was rated for Attachment and Reflective Functioning (RF). Results Regarding Re-experiencing trauma symptoms, the results of the path analysis were consistent with mediation. CM survivors' mentalizing about their early relationships with their parents (RF-Other) directly impacted Re-experiencing trauma symptoms, and attachment had an effect on Re-experiencing trauma symptoms through mentalizing (RF-Other). Regarding Arousal/Reactivity symptoms, the results of the pathways analysis were consistent with partial mediation by mentalizing about early relationships with parents (RF-Other). In addition to the pathway from attachment via mentalizing (RF-Other) to Arousal/Reactivity, the pathway between attachment and Arousal/Reactivity also remained significant. Discussion This study provides new evidence of a mentalizing and attachment model of PTSS in CM survivors. The findings indicate that increased mentalizing about early relationships with parents is an important process associated with lower PTSS. Finally, we discuss the implications of developing interventions for CM survivors to reduce PTSS. Scaffolding the development of mentalizing regarding attachment relationships in which CM occurred may help CM survivors reduce the intrusion of traumatic memories and decrease trauma-related arousal and reactivity symptoms. Interventions to help CM survivors mentalize regarding parents and attachment relationships in which trauma occurred may be particularly important during the transition to parenting when activation of representations of parenting can trigger PTSS.
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Affiliation(s)
- Karin Ensink
- École de Psychologie, Université Laval, Québec, QC, Canada
| | - Michaël Bégin
- Département de Psychologie, Université de Sherbrooke, Québec, QC, Canada
| | | | - Marko Biberdzic
- Department of Psychology, University of Wollongong, Wollongong, NSW, Australia
| | - Nicolas Berthelot
- Department of Nursing, Université du Québec à Trois-Rivières, Québec, QC, Canada
| | - Lina Normandin
- École de Psychologie, Université Laval, Québec, QC, Canada
| | - Peter Fonagy
- Division of Psychology and Language Sciences, University College London, London, United Kingdom
| | - Odette Bernazzani
- Department of Psychiatry, Université de Montréal, Québec, QC, Canada
| | - Jessica L. Borelli
- Department of Psychological Science, University of California, Irvine, Irvine, CA, United States
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Helle J, Vøllestad J, Schanche E, Hjelen Stige S. From seeing difficult behaviour to recognizing legitimate needs - A qualitative study of mothers' experiences of participating in a Circle of Security Parenting program in a public mental health setting. Psychother Res 2023; 33:482-493. [PMID: 36314235 DOI: 10.1080/10503307.2022.2132888] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/03/2023] Open
Abstract
OBJECTIVE Mental health challenges can interfere with caregivers' self-efficacy and their ability to engage with their children in developmentally appropriate ways. The goal of this study was to explore whether the intervention Circle of Security Parenting (COS-P) was experienced as a meaningful adjunct to psychological treatment. METHOD Individual qualitative semi-structured interviews were conducted with twelve female COS-P participants, exploring how taking part in COS-P had changed the way they related to themselves and others. Data were analyzed using a team-based, reflexive thematic analysis. RESULTS The analysis resulted in three main themes: (i) Connecting dots: A new perspective on one's past, (ii) Seeing oneself more clearly: Increased capacity to recognize and tend to own needs, and (iii) Gaining a map: Becoming a more competent parent. CONCLUSION Taking part in COS-P as an adjunct to psychological treatment positively impacted participants' sense of competence as mothers. They used the COS-P framework to make sense of their interaction with their child, enabling them to understand the child's behaviour and communication as expressing legitimate attachment needs. They also experienced that the course strengthened central psychological capacities, such as insight into their own developmental histories as well as increased self-awareness and self-care. Implications are discussed.
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Affiliation(s)
- Jorunn Helle
- Solli District Psychiatric Centre (DPS), Nesttun, Norway
| | - Jon Vøllestad
- Department of Clinical Psychology, University of Bergen, Bergen, Norway
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Sidis A, Bøe T, Karlsson B, Lidbom P, Moore A, Pickard J, Deane F. In defence of loose ends: Psychotherapy process research in the real world. NEW IDEAS IN PSYCHOLOGY 2023. [DOI: 10.1016/j.newideapsych.2023.101011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
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Goulter N, Balanji S, Davis BA, James T, McIntyre CL, Smith E, Thornton EM, Craig SG, Moretti MM. Psychometric Evaluation of the Affect Regulation Checklist: Clinical and Community Samples, Parent-Reports and Youth Self-Reports. JOURNAL OF RESEARCH ON ADOLESCENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR RESEARCH ON ADOLESCENCE 2023; 33:344-360. [PMID: 35699159 DOI: 10.1111/jora.12779] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
The Affect Regulation Checklist (ARC) was designed to capture affect dysregulation, suppression, and reflection. Importantly, affect dysregulation has been established as a transdiagnostic mechanism underpinning many forms of psychopathology. We tested the ARC psychometric properties across clinical and community samples and through both parent-report and youth self-report information. Clinical sample: Participants included parents (n = 814; Mage = 43.86) and their child (n = 608; Mage = 13.98). Community sample: Participants included independent samples of parents (n = 578; Mage = 45.12) and youth (n = 809; Mage = 15.67). Exploratory structural equation modeling supported a three-factor structure across samples and informants. Dysregulation was positively associated with all forms of psychopathology. In general, suppression was positively associated with many forms of psychopathology, and reflection was negatively associated with externalizing problems and positively associated with internalizing problems.
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Horváth Z, Demetrovics O, Paksi B, Unoka Z, Demetrovics Z. The Reflective Functioning Questionnaire-Revised- 7 (RFQ-R-7): A new measurement model assessing hypomentalization. PLoS One 2023; 18:e0282000. [PMID: 36827243 PMCID: PMC9956064 DOI: 10.1371/journal.pone.0282000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Accepted: 02/03/2023] [Indexed: 02/25/2023] Open
Abstract
Although it is a widely used questionnaire, limitations regarding the scoring procedure and the structural validity of the eight-item Reflective Functioning Questionnaire (RFQ-8) were raised. The present study aimed to examine further the latent dimensionality of the RFQ-8 and to examine linear and non-linear associations between mentalization difficulties and maladaptive psychological characteristics. Data from two separate representative samples of young adults (N = 3890; females: 51.68%; mean age: 27.06 years [SD = 4.76]) and adults (N = 1385; females: 53.20%; mean age: 41.77 years [SD = 13.08]) were used. In addition to the RFQ-8, standardized questionnaires measured the levels of impulsivity, sensation seeking, rumination, worry and well-being. Confirmatory factor analysis (CFA) was used to test the model fit of competing measurement models. CFA revealed that a revised, seven-item version of the RFQ (RFQ-R-7) with a unidimensional structure showed the most optimal levels of model fit in both samples. Impulsivity, sensation seeking, rumination and worry consistently presented significant, positive, linear associations with general mentalization difficulties in both samples. Significant quadratic associations were also identified, but these relationships closely followed the linear associations between the variables and increased only marginally the explained variance. The supported unidimensional measurement model and the associations between the general mentalization difficulties factor and maladaptive psychological characteristics indicated that the RFQ-R-7 captures a dimension of hypomentalization ranging between low and high levels of uncertainty. Increasing levels of hypomentalization can indicate a risk for less adaptive psychological functioning. Further revisions of the RFQ-8 might be warranted in the future to ensure adequate measurement for hypermentalization.
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Affiliation(s)
- Zsolt Horváth
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
- Centre of Excellence in Responsible Gaming, University of Gibraltar, Gibraltar, Gibraltar
- * E-mail:
| | | | - Borbála Paksi
- Institute of Education, ELTE Eötvös Loránd University, Budapest, Hungary
| | - Zsolt Unoka
- Department of Psychiatry and Psychotherapy, Semmelweis University, Budapest, Hungary
| | - Zsolt Demetrovics
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
- Centre of Excellence in Responsible Gaming, University of Gibraltar, Gibraltar, Gibraltar
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Letourneau N, Anis L, Novick J, Pohl C, Ntanda H, Hart M. Impacts of the Attachment and Child Health (ATTACH TM) Parenting Program on Mothers and Their Children at Risk of Maltreatment: Phase 2 Results. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3078. [PMID: 36833770 PMCID: PMC9961631 DOI: 10.3390/ijerph20043078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 02/01/2023] [Accepted: 02/01/2023] [Indexed: 06/18/2023]
Abstract
Early adversity (e.g., family violence, parental depression, low income) places children at risk for maltreatment and negatively impacts developmental outcomes. Optimal parental reflective function (RF), defined as the parent's ability to think about and identify thoughts, feelings, and mental states in themselves and in their children, is linked to secure attachment and may protect against suboptimal outcomes. We present the results of Phase 2 randomized control trials (RCTs) and quasi-experimental studies (QES) of the Attachment and Child Health (ATTACHTM) parental RF intervention for families with children at risk for maltreatment. Phase 2 parents experiencing adversity, along with their children aged 0-5 years (n = 45), received the 10-12-week ATTACHTM intervention. Building on completed Phase 1 pilot data, Phase 2 examined outcomes of long-standing interest, including parental RF and child development, as well as new outcomes, including parental perceived social support and executive function, and children's behavior, sleep, and executive function. RCTs and QES revealed significant improvements in parents' RF, perception of social support, and executive function, children's development (i.e., communication, problem-solving, personal-social, and fine motor skills), and a decrease in children's sleep and behavioral problems (i.e., anxiety/depression, attention problems, aggressive behavior, and externalizing problems), post-intervention. ATTACH™ positively impacts parental RF to prevent negative impacts on children at risk of maltreatment.
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Affiliation(s)
- Nicole Letourneau
- Owerko Centre for Children’s Neurodevelopment and Mental Health, Alberta Children’s Hospital Research Institute, Faculty of Nursing, and Cumming School of Medicine, Departments of Pediatrics, Psychiatry and Community Health Sciences, University of Calgary, Calgary, AB T2N 1N4, Canada
| | - Lubna Anis
- Owerko Centre for Children’s Neurodevelopment and Mental Health, Alberta Children’s Hospital Research Institute, University of Calgary, Calgary, AB T2N 1N4, Canada
| | - Jason Novick
- Owerko Centre for Children’s Neurodevelopment and Mental Health, Alberta Children’s Hospital Research Institute, University of Calgary, Calgary, AB T2N 1N4, Canada
| | - Carrie Pohl
- Owerko Centre for Children’s Neurodevelopment and Mental Health, Alberta Children’s Hospital Research Institute, University of Calgary, Calgary, AB T2N 1N4, Canada
| | - Henry Ntanda
- Owerko Centre for Children’s Neurodevelopment and Mental Health, Alberta Children’s Hospital Research Institute, University of Calgary, Calgary, AB T2N 1N4, Canada
| | - Martha Hart
- Owerko Centre for Children’s Neurodevelopment and Mental Health, Alberta Children’s Hospital Research Institute, University of Calgary, Calgary, AB T2N 1N4, Canada
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Brugnera A, Zarbo C, Scalabrini A, Compare A, Mucci C, Carrara S, Tasca GA, Hewitt P, Greco A, Poletti B, Esposito R, Cattafi F, Zullo C, Lo Coco G. Attachment anxiety, reflective functioning and well-being as predictors of burn-out and psychological distress among psychotherapists: A longitudinal study. Clin Psychol Psychother 2023. [PMID: 36610037 DOI: 10.1002/cpp.2823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 12/09/2022] [Accepted: 01/04/2023] [Indexed: 01/09/2023]
Abstract
OBJECTIVE This study aims to longitudinally investigate the effects of individual's factors on subsequent burn-out/psychological distress in a sample of mental health practitioners, testing if higher attachment anxiety and avoidance and lower reflective functioning (i.e., certainty and uncertainty of mental states) and well-being at baseline may lead to a greater psychological distress and burn-out 1 year later. METHODS The sample consisted of 40 experienced psychotherapists (females: 72.5%; mean age: 47.40 ± 9.48 years) who completed a battery of questionnaires at baseline and 1 year later. Statistical analyses were conducted with Bayesian multiple linear regressions. RESULTS Greater attachment anxiety and certainty about mental states and lower individual's well-being at baseline predicted greater burn-out 1 year later. Similarly, greater attachment anxiety and lower individual's well-being at baseline predicted psychological distress at 1 year follow-up. Of note, uncertainty of mental states and avoidant attachment were not associated with outcomes. CONCLUSION These findings suggest that the levels of burn-out and psychological distress among psychotherapists may be alleviated with interventions targeting attachment insecurity, specific aspects of reflective functioning (i.e., certainty about mental states) and well-being.
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Affiliation(s)
- Agostino Brugnera
- Department of Human and Social Sciences, University of Bergamo, Bergamo, Italy
| | - Cristina Zarbo
- Department of Human and Social Sciences, University of Bergamo, Bergamo, Italy
| | - Andrea Scalabrini
- Department of Human and Social Sciences, University of Bergamo, Bergamo, Italy
| | - Angelo Compare
- Department of Human and Social Sciences, University of Bergamo, Bergamo, Italy
| | - Clara Mucci
- Department of Human and Social Sciences, University of Bergamo, Bergamo, Italy
| | - Silvia Carrara
- Department of Human and Social Sciences, University of Bergamo, Bergamo, Italy
| | | | - Paul Hewitt
- University of British Columbia, Vancouver, British Columbia, Canada
| | - Andrea Greco
- Department of Human and Social Sciences, University of Bergamo, Bergamo, Italy
| | - Barbara Poletti
- Department of Neurology and Laboratory of Neuroscience, IRCCS Istituto Auxologico Italiano, Milan, Italy
| | - Rosy Esposito
- Department of Human and Social Sciences, University of Bergamo, Bergamo, Italy
| | - Francesco Cattafi
- Department of Human and Social Sciences, University of Bergamo, Bergamo, Italy
| | - Claudio Zullo
- U.O.C. of Clinical Psychology, Local Health Authority 1 of Naples, Naples, Italy
| | - Gianluca Lo Coco
- Department of Psychological Sciences, University of Palermo, Palermo, Italy
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Zerach G. Posttraumatic Stress Symptoms and Parenting Competence among Israeli Male Veterans: The Mediating Roles of Experiential Avoidance and Parental Reflective Functioning. JOURNAL OF CHILD AND FAMILY STUDIES 2023; 32:301-313. [PMID: 35350596 PMCID: PMC8945870 DOI: 10.1007/s10826-022-02288-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 02/27/2022] [Indexed: 05/17/2023]
Abstract
Although empirical studies have documented associations between posttraumatic stress symptoms (PTSS) and parenting among various high-risk populations, there is a relatively limited amount of research on paternal parenting among veterans. Moreover, the understanding of possible mechanisms which may account for this effect is severely lacking. This study examined associations between military related PTSS and parenting sense of competence (PSOC) among veteran fathers. Furthermore, we examined the mediating role of experiential avoidance (EA) and parental reflective functioning (PRF) in the association between PTSS and PSOC. Participants were 189 Israel Defense Forces (IDF) male combat veterans (mean age = 30.03) who completed a set of validated self-report questionnaires in a cross-sectional design study. Results showed negative associations between PTSS and PSOC-parental satisfaction but not parental efficacy. Furthermore, EA mediated the association between PTSS and parental satisfaction and efficacy; PRF- Pre mentalizing modes mediated the association between PTSS and parental satisfaction. Our findings imply that EA and PRF may serve as mechanisms of the association between PTSS and PSOC among veteran fathers. These findings are discussed in light of a psychological trauma perspective, and clinical implications to increase fathers' mentalization and psychological flexibility are suggested.
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Affiliation(s)
- Gadi Zerach
- Department of Psychology, Ariel University, Ariel, Israel
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40
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Meier AF, Zeeck A, Taubner S, Gablonski T, Lau I, Preiter R, Gläser H, Zipfel S, Herzog W, Wild B, Friederich HC, Resmark G, Giel K, Teufel M, Burgmer M, Dinkel A, Herpertz S, Löwe B, Tagay S, von Wietersheim J, De Zwaan M, Hartmann A. Mentalization-enhancing therapeutic interventions in the psychotherapy of anorexia nervosa: An analysis of use and influence on patients’ mentalizing capacity. Psychother Res 2022; 33:595-607. [DOI: 10.1080/10503307.2022.2146542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Affiliation(s)
- Alexander Ferdinand Meier
- Department Of Psychosomatic Medicine und Psychotherapy, Center for Mental Health, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Almut Zeeck
- Department Of Psychosomatic Medicine und Psychotherapy, Center for Mental Health, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Svenja Taubner
- Institute for Psychosocial Prevention, Center for Psychosocial Medicine, University Hospital, Heidelberg, Germany
| | - Thorsten Gablonski
- Department for Psychology, Psychotherapy and Psychoanalysis, Institute for Psychology, University of Klagenfurth, Klagenfurth, Austria
| | - Inga Lau
- Department Of Psychosomatic Medicine und Psychotherapy, Center for Mental Health, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Romi Preiter
- Department for Clinical Psychology and Psychotherapy, Institute of Psychology, University of Freiburg, Freiburg, Germany
| | - Hannes Gläser
- Department for Clinical Psychology and Psychotherapy, Institute of Psychology, University of Freiburg, Freiburg, Germany
| | - Stephan Zipfel
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tuebingen, Tuebingen, Germany
| | - Wolfgang Herzog
- Department of General Internal Medicine and Psychosomatics, Center for Psychosocial Medicine, Heidelberg University Hospital, Heidelberg, Germany
| | - Beate Wild
- Department of General Internal Medicine and Psychosomatics, Center for Psychosocial Medicine, Heidelberg University Hospital, Heidelberg, Germany
| | - Hans-Christoph Friederich
- Department of General Internal Medicine and Psychosomatics, Center for Psychosocial Medicine, Heidelberg University Hospital, Heidelberg, Germany
| | - Gaby Resmark
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tuebingen, Tuebingen, Germany
| | - Katrin Giel
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tuebingen, Tuebingen, Germany
| | - Martin Teufel
- Department of Psychosomatic Medicine and Psychotherapy, LVR Universityhospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Markus Burgmer
- Department of Psychosomatics and Psychotherapy, LWL-Hospital Muenster and University Hospital Muenster, Muenster, Germany
| | - Andreas Dinkel
- Department of Psychosomatic Medicine and Psychotherapy, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany
| | - Stephan Herpertz
- Department of Psychosomatic Medicine and Psychotherapy, LWL-University Clinic, Ruhr-University Bochum, Bochum, Germany
| | - Bernd Löwe
- Department for Psychosomatic Medicine and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Sefik Tagay
- TH Köln, University of Applied Sciences, Köln, Germany
| | - Jörn von Wietersheim
- Department of Psychosomatic Medicine and Psychotherapy, Ulm University Medical Center, Ulm, Germany
| | - Martina De Zwaan
- Department of Psychosomatic Medicine and Psychotherapy, Hannover Medical School, Hannover, Germany
| | - Armin Hartmann
- Department Of Psychosomatic Medicine und Psychotherapy, Center for Mental Health, Faculty of Medicine, University of Freiburg, Freiburg, Germany
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[Mentalization ability and treatment success in psychosomatic rehabilitation]. ZEITSCHRIFT FUR PSYCHOSOMATISCHE MEDIZIN UND PSYCHOTHERAPIE 2022; 68:397-413. [PMID: 36511574 DOI: 10.13109/zptm.2022.68.4.397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Objectives: Psychosomatic rehabilitation clinics represent an important branch of care with good treatment results in Germany. So far, however, it is largely unclear which processes underlie the treatment successes. In the partial evaluations of the Hersfeld catamnesis study presented here, recourse is made to the construct of mentalizing ability, which has become very important in recent psychotherapy research. Methods: The mentalization ability of a large sample (N = 559) was assessed with the help of the Mentalization Questionnaire (MZQ), and psychological and somatic complaints were assessed with HEALTH-PSB scale from HEALTH-49 at three points in time, namely at admission, at discharge and in a 6-month catamnesis. Results: Both the total score of the MZQ and all subscores show significant reductions in mentalization deficits in the small effect size range, the HEALTH-PSB in the high effect size range and the catamnesis in the medium effect size range. A regression analysis shows that the reduction in mentalization deficits has a high predictive power for symptom improvement. Conclusions: The results indicate that the construct of mentalization ability is a central target variable in psychosomatic rehabilitation.
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An D, Bendel‐Stenzel LC, Kochanska G. Negative internal working models as mechanisms that link mothers' and fathers' personality with their parenting: A short-term longitudinal study. J Pers 2022; 90:1004-1020. [PMID: 35211984 PMCID: PMC9402795 DOI: 10.1111/jopy.12711] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Revised: 01/06/2022] [Accepted: 02/15/2022] [Indexed: 12/30/2022]
Abstract
OBJECTIVE Research on associations between parents' personality and parenting has a long history, but mechanisms that explain them remain unsettled. We examined parents' explicit and implicit negative internal working models (IWMs) of the child, assessed at toddler age, as linking parental personality and parenting. METHOD Mothers and fathers from 200 community families provided personality self-reports (Neuroticism, Agreeableness, Empathy, and Anger/Hostility) when their children were infants. When children were toddlers, the explicit negative IWMs included self-reported low-mentalizing reflective functioning and resentment regarding the child. The implicit negative IWMs were coded as negative relational schemas from parental interviews. Parental positive affect, responsiveness, and power-assertive control were observed in lengthy interactions. Measures were parallel for mother- and father-child dyads. RESULTS Mothers' implicit IWMs linked the association between low Empathy and more power-assertive control. Fathers' explicit IWMs linked the associations between high Neuroticism and low Agreeableness and lower responsiveness. Additionally, fathers' Agreeableness and Empathy directly predicted their parenting. Two paths (Agreeableness → implicit IWMs, and explicit IWMs → responsiveness) significantly differed between mothers and fathers. CONCLUSIONS IWMs may link parental personality with parenting. The findings integrate and inform several bodies of literature in personality, social cognition, and developmental psychology.
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Affiliation(s)
- Danming An
- Department of Psychological and Brain SciencesThe University of IowaIowa CityIowaUSA
| | | | - Grazyna Kochanska
- Department of Psychological and Brain SciencesThe University of IowaIowa CityIowaUSA
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Wendelboe KI, Nielsen JS, Stuart AC, Væver MS. The parental reflective functioning questionnaire: Infant version in fathers of infants and association with paternal postpartum mental health. Infant Ment Health J 2022; 43:921-937. [PMID: 36228620 PMCID: PMC9828265 DOI: 10.1002/imhj.22023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Accepted: 06/27/2022] [Indexed: 01/12/2023]
Abstract
The parents' capacity to reflect upon the psychological processes in their child, termed parental reflective functioning (PRF) can be impaired by parental mental health problems. The present study aimed to investigate the factor structure of an infant version of the Parental Reflective Functioning Questionnaire (PRFQ-I) in a low-risk sample of 259 Danish fathers of 1-11-month-old infants to investigate measurement invariance of the PRFQ-I between fathers and mothers; and to examine the association between PRF and paternal depressive symptoms, psychological distress, and parenting stress. Confirmatory factor analysis supported a three-factor model of the PRFQ-I. Multi-group factor analysis indicated partial measurement invariance. Multiple linear regressions showed that paternal depressive symptoms were not associated with PRF. There was an interaction effect of paternal depressive symptoms and general psychological distress on paternal interest and curiosity in their infant's mental state and certainty of infant mental state. Increased parenting stress was associated with impaired PRF on all three subscales of the PRFQ-I. These results provide further evidence for a multidimensional, brief assessment of paternal reflective skills and insight into how variability in paternal psychological functioning relates to impaired PRF in the postpartum period.
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Affiliation(s)
- Katrine Isabella Wendelboe
- Center for Early Intervention and Family Studies, Department of PsychologyUniversity of CopenhagenCopenhagenDenmark
| | - Johanne Smith Nielsen
- Center for Early Intervention and Family Studies, Department of PsychologyUniversity of CopenhagenCopenhagenDenmark
| | - Anne Christine Stuart
- Center for Early Intervention and Family Studies, Department of PsychologyUniversity of CopenhagenCopenhagenDenmark
| | - Mette Skovgaard Væver
- Center for Early Intervention and Family Studies, Department of PsychologyUniversity of CopenhagenCopenhagenDenmark
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Ulvestad DA, Selsbakk Johansen M, Hartveit Kvarstein E, Pedersen G, Wilberg T. A borderline focused Reflective Functioning measure - Interrater reliability of the Mentalization Breakdown Interview. Nord J Psychiatry 2022; 77:360-366. [PMID: 36244024 DOI: 10.1080/08039488.2022.2123040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
OBJECTIVE Mentalizing difficulties can be considered the core psychopathology of borderline personality disorder (BPD). Typical failures of mentalizing are targets in therapy for BPD. They are related to severe distress, relational problems, self-destructive behaviors, violence, or substance misuse. A major obstacle in BPD treatment research is the lack of suitable and easily administrated methods to assess mentalizing ability during treatment. The Mentalization Breakdown Interview (MBI) is a new method for capturing episodic mentalizing difficulties occurring in close relationships. Interviews are videotaped and scored in accordance with the Reflective Functioning Scale (MBI-RF). In this way the patients' ability to retrospectively reflect over such episodes are evaluated. This study investigates the interrater reliability of MBI-RF. METHODS The study includes videotapes of MBIs from 32 patients with BPD in an outpatient clinic specialized on mentalization-based treatment (MBT). The MBIs were performed by MBT therapists. Three certified raters scored MBI-RF. RESULTS The interrater reliability was good for MBI-RF. CONCLUSIONS The MBI is promising as a BPD-focused method for the assessment of Reflective Functioning.
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Affiliation(s)
- Dag Anders Ulvestad
- Section for Personality Psychiatry and Specialized Treatments, Department for National and Regional Functions, Division of Mental Health and Addiction, Outpatient Clinic for Specialized Treatment of Personality Disorders, Oslo University Hospital, Oslo, Norway
| | - Merete Selsbakk Johansen
- Section for Personality Psychiatry and Specialized Treatments, Department for National and Regional Functions, Division of Mental Health and Addiction, Outpatient Clinic for Specialized Treatment of Personality Disorders, Oslo University Hospital, Oslo, Norway
| | - Elfrida Hartveit Kvarstein
- Section for Personality Psychiatry and Specialized Treatments, Department for National and Regional Functions, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway.,Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Geir Pedersen
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Network for Personality Disorders, Section for Personality Psychiatry and Specialized Treatments, Department for National and Regional Functions, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Theresa Wilberg
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Section for Treatment Research, Department for Research and Innovation, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
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Giannotti M, Bentenuto A, Venuti P, de Falco S. Explicit and implicit attachment representations in cognitively able school-age children with autism spectrum disorder: A window to their inner world. Clin Child Psychol Psychiatry 2022; 27:1048-1064. [PMID: 35794823 DOI: 10.1177/13591045221113390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The few studies available on quality of attachment in school-age children with autism spectrum disorder (ASD) exclusively used questionnaires assessing explicit attachment representations. Thus, in the current study we assessed both explicit and implicit attachment representations in 23 children with ASD (without intellectual disability), 22 with learning disabilities and 27 with typical development aged from 7 to 13 years. A self-reported measure on the quality of attachment to parents and a semi-structured interview were administered to the children. In addition, a developmental assessment of the child including measures of intelligence and social-communication impairment was conducted. Despite the lack of group differences on explicit attachment representations, we found that children with ASD showed higher rates of at-risk self-protective strategies and psychological trauma compared to the TD group. Children with SLD also showed a high level of at-risk implicit attachment representations than TD, albeit to a lesser extent compared to children with ASD. These results may be related to several factors associated with ASD impairment and developmental pathways, such as the atypical learning process which occur at interpersonal level, the difficulties in social information processing and reflective functioning. Our findings suggested that children with ASD may experience difficulties in the construction of balanced implicit attachment representations. Thus, a more comprehensive assessment of attachment including both implicit and explicit representations is recommended.
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Affiliation(s)
- Michele Giannotti
- Department of Psychology and Cognitive Sciences, 19034University of Trento, Trento, Italy
| | - Arianna Bentenuto
- Department of Psychology and Cognitive Sciences, 19034University of Trento, Trento, Italy
| | - Paola Venuti
- Department of Psychology and Cognitive Sciences, 19034University of Trento, Trento, Italy
| | - Simona de Falco
- Department of Psychology and Cognitive Sciences, 19034University of Trento, Trento, Italy
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Archer M, Shnyien A, Mansfield S, Draycott S. Mentalizing in first-episode psychosis: Correlates with symptomatology and traits of borderline personality disorder. Early Interv Psychiatry 2022. [PMID: 36181363 DOI: 10.1111/eip.13356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Revised: 07/13/2022] [Accepted: 09/18/2022] [Indexed: 11/28/2022]
Abstract
AIM To explore the associations between mentalizing, positive and negative symptoms of psychosis, and traits of borderline personality disorder, in a sample of patients with first-episode psychosis, and in a non-clinical sample. METHODS A quantitative cross-sectional design was employed. Thirty-two adults with first-episode psychosis and 148 non-clinical participants were assessed using the reflective functioning questionnaire. The questionnaire measures two dimensions of mentalizing, certainty and uncertainty about mental states. Traits of borderline personality disorder and symptoms of psychosis were measured using the self-report version of the Zanarini rating scale, the Community Assessment of Psychotic Experiences, and the Green et al., paranoid thought scale. RESULTS Patients with first-episode psychosis reported increased mentalizing impairments, characterized as hypomentalizing tendencies, compared to the non-clinical group. Regression analysis showed significant associations between higher scores on the uncertainty about mental states scale and negative symptoms of psychosis in both groups. No associations were found between mentalizing impairments and traits of borderline personality disorder in the clinical sample, although associations were found in the non-clinical sample. CONCLUSIONS The present findings suggests that impairments in mentalizing may be associated with negative symptoms of psychosis across both clinical and non-clinical samples. Mentalizing impairments was found to be associated with traits of borderline personality disorder, but this finding was only confirmed in the non-clinical sample. Mentalizing should therefore be considered in the early assessment and treatment of patients experiencing difficulties with negative symptoms of psychosis.
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Affiliation(s)
| | - Ali Shnyien
- University of Surrey, Guildford, England, UK
| | - Sarah Mansfield
- South West London and St George's Mental Health Trust, London, England, UK
| | - Simon Draycott
- University of Surrey, Guildford, England, UK.,West London NHS Trust, London, England, UK
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47
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Musetti A, Pingani L, Zagaria A, Uberti D, Meli S, Lenzo V, Gori A, Franceschini C, Galeazzi GM. Insecure adult attachment and reflective functioning as mechanisms of the relationship between traumatic life events and suicidal ideation: A path analysis. Front Psychol 2022; 13:985148. [PMID: 36248502 PMCID: PMC9561888 DOI: 10.3389/fpsyg.2022.985148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2022] [Accepted: 09/13/2022] [Indexed: 11/13/2022] Open
Abstract
The relationship between traumatic life events and increased suicide risk has been well reported in literature. However, the complex nature of suicidality phenomena still hinders our ability to comprehend the mediation mechanism underlying this association. In this study, we examined the mediating role of adult attachment and reflective functioning in the relationship between traumatic life events and suicidal ideation. Nine hundred and fifty Italian adults completed an online survey evaluating traumatic life events, adult attachment, reflective functioning and suicidal ideation. The path analysis showed that the positive relationship between traumatic life events and suicidal ideation was partially mediated by attachment anxiety and reflective functioning. From a clinical point of view, these results support the relevance of evaluating and improving patients’ ability to mentalize as a part of psychotherapeutic intervention aimed at reducing suicidality in people with a history of traumatic experiences and attachment anxiety.
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Affiliation(s)
- Alessandro Musetti
- Department of Humanities, Social Sciences and Cultural Industries, University of Parma, Parma, Italy
- *Correspondence: Alessandro Musetti,
| | - Luca Pingani
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
- Dipartimento ad attività integrata Salute Mentale e Dipendenze Patologiche, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Andrea Zagaria
- Department of Psychology, Sapienza University of Rome, Roma, Italy
| | - Daniele Uberti
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Salvatore Meli
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Vittorio Lenzo
- Dipartimento di Scienze della Società e della Formazione d’Area Mediterranea, Università per Stranieri Dante Alighieri, Reggio Calabria, Italy
| | - Alessio Gori
- Department of Health Sciences, School of Psychology, University of Florence, Firenze, Italy
| | | | - Gian Maria Galeazzi
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
- Dipartimento ad attività integrata Salute Mentale e Dipendenze Patologiche, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
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Conceptualisation and Measurement of Reflective Process in Psychotherapy: A Systematic Scoping Review. JOURNAL OF CONTEMPORARY PSYCHOTHERAPY 2022. [DOI: 10.1007/s10879-022-09568-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
AbstractPsychological therapies use talk as a means to produce change for individuals who are experiencing distress. Despite a significant body of research comparing approaches, there is little evidence for the superiority of one model over another. The process of reflection has been suggested as a common factor across modalities, and research aiming to measure this phenomenon is emerging. This scoping review is focussed on the conceptualisations, measurement and process outcomes of reflective talk as it occurs during therapy. Twenty-two studies were selected from a total of 3712 papers identified following a systematic search of SCOPUS, MEDLINE, PsychINFO and Web of Science databases. A variety of descriptors emerged: intrapersonal constructs such as mentalization and metacognition tended to view reflectivity as an individually acquired skill or trait, where other descriptors adopted an interpersonal understanding of reflection as co-constructed through dialogue. Our findings suggest a shift from individual to intersubjective understandings of reflecting processes in therapy may be a valuable area for future research.
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García-Anaya M, Caballero-Romo A, González-Macías L. Maintaining Factors of Anorexia Nervosa Addressed from a Psychotherapeutic Group for Parents: Supplementary Report of a Patient's Therapeutic Success. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11396. [PMID: 36141668 PMCID: PMC9517022 DOI: 10.3390/ijerph191811396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Revised: 08/07/2022] [Accepted: 08/11/2022] [Indexed: 06/16/2023]
Abstract
(1) Background: Anorexia nervosa is an eating disorder (ED) where up to 30% of individuals remain unresponsive to treatments, whether they partially respond, or do respond and later relapse. It has been broadly reported how presenting maladaptive family functioning and communication style contributes to treatment drop-out, poor treatment compliance, and poor long-term outcomes. We studied the mother and father of a patient with AN, binge-purge subtype (according to DSM-IV TR) who achieved remission after her parents but not her attended an intervention through a psychotherapy group for parents (PGP). (2) Methods: We previously reported this patient's case report, and now, through an Interpretative Phenomenological Analysis (IPA) approach, we aimed to explore the understanding and meanings ascribed by the mother and father to their experience at the PGP and to their daughter's clinical and functional improvement. (3) Results: We identified two main stages along the process: one related to the presence of maintaining factors of their daughter's disorder, and the other related to the emergence of a reflective function and to the implementation of behavioral, emotional and cognitive changes. (4) Conclusions: The interview revealed both parents' experience at the PGP promoted a change process, where they were able to modify their previous style of communication and functioning, and to identify them as a contributors to maintain their daughter's disorder. Reflective function (RF) emerged in the mother and father throughout the psychotherapeutic process. Both parents also revealed some elements that were intergenerationally transmitted, that affected three generations and contributed to maintaining the ED. We observed the multilevel open-group structure of the PGP, enhancing the mother's and father's change process.
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Affiliation(s)
- María García-Anaya
- Clinical Research Division, National Institute of Psychiatry Ramón de la Fuente Muñiz, Mexico City 14370, Mexico
| | - Alejandro Caballero-Romo
- Eating Disorders Clinic, Clinical Services Division, National Institute of Psychiatry Ramón de la Fuente Muñiz, Mexico City 14370, Mexico
| | - Laura González-Macías
- Eating Disorders Clinic, Clinical Services Division, National Institute of Psychiatry Ramón de la Fuente Muñiz, Mexico City 14370, Mexico
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50
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An D, Kochanska G. Mothers' and fathers' attachment styles and power-assertive control: Indirect associations through parental representations. JOURNAL OF FAMILY PSYCHOLOGY : JFP : JOURNAL OF THE DIVISION OF FAMILY PSYCHOLOGY OF THE AMERICAN PSYCHOLOGICAL ASSOCIATION (DIVISION 43) 2022; 36:975-985. [PMID: 34694837 PMCID: PMC9842511 DOI: 10.1037/fam0000930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Research on adults' self-reported attachment styles, investigated mostly in social and personality psychology, has rarely been bridged with research on parenting, studied mostly in developmental psychology. We proposed that parents' attachment insecurity (avoidance and anxiety) has an indirect association with their power-assertive control, mediated through their negative representations, or internal working models (IWM) of the child. In 200 community families from a Midwestern state (mothers, fathers, and children), we collected multimethod, parallel data for mother-child and father-child relationships. When children were infants, parents completed self-reports of their own attachment styles. When children were toddlers, we assessed parents' IWMs of the child in an interview and observed parental power-assertive control in structured, naturalistic discipline contexts in the laboratory. Mothers' avoidance showed a unique association with their IWM of their child. Consequently, there was an indirect association from the mother's avoidance to negative IWM to power-assertive control. Mothers' anxiety was associated directly with more power-assertive control. Fathers' avoidance and anxiety were also associated with their IWMs, but there were no unique associations, and the impact on parenting was limited. Forging a rapprochement between social and personality research on adults' attachment and developmental research on parenting, this work elucidates a potential mechanism of the intergenerational transmission of adaptive and maladaptive parenting in families. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
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Affiliation(s)
- Danming An
- Department of Psychological and Brain Sciences
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