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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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Jankowsky K, Krakau L, Schroeders U, Zwerenz R, Beutel ME. Predicting treatment response using machine learning: A registered report. BRITISH JOURNAL OF CLINICAL PSYCHOLOGY 2024; 63:137-155. [PMID: 38111213 DOI: 10.1111/bjc.12452] [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: 10/18/2022] [Accepted: 11/27/2023] [Indexed: 12/20/2023]
Abstract
OBJECTIVE Previous research on psychotherapy treatment response has mainly focused on outpatients or clinical trial data which may have low ecological validity regarding naturalistic inpatient samples. To reduce treatment failures by proactively screening for patients at risk of low treatment response, gain more knowledge about risk factors and to evaluate treatments, accurate insights about predictors of treatment response in naturalistic inpatient samples are needed. METHODS We compared the performance of different machine learning algorithms in predicting treatment response, operationalized as a substantial reduction in symptom severity as expressed in the Patient Health Questionnaire Anxiety and Depression Scale. To achieve this goal, we used different sets of variables-(a) demographics, (b) physical indicators, (c) psychological indicators and (d) treatment-related variables-in a naturalistic inpatient sample (N = 723) to specify their joint and unique contribution to treatment success. RESULTS There was a strong link between symptom severity at baseline and post-treatment (R2 = .32). When using all available variables, both machine learning algorithms outperformed the linear regressions and led to an increment in predictive performance of R2 = .12. Treatment-related variables were the most predictive, followed psychological indicators. Physical indicators and demographics were negligible. CONCLUSIONS Treatment response in naturalistic inpatient settings can be predicted to a considerable degree by using baseline indicators. Regularization via machine learning algorithms leads to higher predictive performances as opposed to including nonlinear and interaction effects. Heterogenous aspects of mental health have incremental predictive value and should be considered as prognostic markers when modelling treatment processes.
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Affiliation(s)
| | - Lina Krakau
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Mainz, Mainz, Germany
| | | | - Rüdiger Zwerenz
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Mainz, Mainz, Germany
| | - Manfred E Beutel
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Mainz, Mainz, Germany
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Gamoran A, Lieberman L, Gilead M, Dobbins IG, Sadeh T. Detecting recollection: Human evaluators can successfully assess the veracity of others' memories. Proc Natl Acad Sci U S A 2024; 121:e2310979121. [PMID: 38781212 PMCID: PMC11145205 DOI: 10.1073/pnas.2310979121] [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: 07/03/2023] [Accepted: 04/06/2024] [Indexed: 05/25/2024] Open
Abstract
Humans have the highly adaptive ability to learn from others' memories. However, because memories are prone to errors, in order for others' memories to be a valuable source of information, we need to assess their veracity. Previous studies have shown that linguistic information conveyed in self-reported justifications can be used to train a machine-learner to distinguish true from false memories. But can humans also perform this task, and if so, do they do so in the same way the machine-learner does? Participants were presented with justifications corresponding to Hits and False Alarms and were asked to directly assess whether the witness's recognition was correct or incorrect. In addition, participants assessed justifications' recollective qualities: their vividness, specificity, and the degree of confidence they conveyed. Results show that human evaluators can discriminate Hits from False Alarms above chance levels, based on the justifications provided per item. Their performance was on par with the machine learner. Furthermore, through assessment of the perceived recollective qualities of justifications, participants were able to glean more information from the justifications than they used in their own direct decisions and than the machine learner did.
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Affiliation(s)
- Avi Gamoran
- Department of Psychology, Ben-Gurion University of the Negev, Beer Sheva8410501, Israel
| | - Lilach Lieberman
- Department of Cognitive and Brain Sciences, Ben-Gurion University of the Negev, Beer Sheva8410501, Israel
- Zelman School of Brain Sciences and Cognition, Ben-Gurion University of the Negev, Beer Sheva8410501, Israel
| | - Michael Gilead
- School of Psychological Sciences, Tel Aviv University, Tel Aviv6997801, Israel
- Sagol School of Neuroscience, Tel Aviv University, Tel Aviv6997801, Israel
| | - Ian G. Dobbins
- Department of Psychological and Brain Sciences, Washington University in Saint Louis, St. Louis, MO63130
| | - Talya Sadeh
- Department of Psychology, Ben-Gurion University of the Negev, Beer Sheva8410501, Israel
- Department of Cognitive and Brain Sciences, Ben-Gurion University of the Negev, Beer Sheva8410501, Israel
- Zelman School of Brain Sciences and Cognition, Ben-Gurion University of the Negev, Beer Sheva8410501, Israel
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Winquist A, Rönnlund M. A time to reflect: deviations from the balanced time perspective are associated with hypomentalization. Front Psychol 2024; 15:1379585. [PMID: 38860048 PMCID: PMC11163059 DOI: 10.3389/fpsyg.2024.1379585] [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: 01/31/2024] [Accepted: 05/08/2024] [Indexed: 06/12/2024] Open
Abstract
Introduction Poor mentalization, or lack of capacity to reflect on self and others in terms mental states, thoughts, and feelings, and time perspective biases were both related to mental disorders and lower wellbeing in separate studies. Expanding one prior study, we examined the relationship of mentalization and time perspective, including a measure known as deviations from the balanced time perspective (DBTP) that summarizes time perspective biases across the past, present, and future time frames. Method A convenience sample of 258 participants responded to a version of the Reflective Functioning Questionnaire (RFQ-8) and a six-dimensional version of the Zimbardo Time Perspective Inventory (S-ZTPI). Given recent evidence that the original two-factor structure of the RFQ may need to be reconsidered, we used confirmatory factor analyses (CFA) to compare alternative models for RFQ as a first step. Results In line with several recent studies, the CFA favored a unitary model of RFQ-8 reflecting hypomentalization (or uncertainty). The total score showed significant associations with Past Negative, Present Fatalistic, and Future Negative dimensions of S-ZTPI, while hypomentalization was negatively associated with Future Positive. Of major interest, DBTP and hypomentalization showed a strong positive correlation (r = 0.64 for latent constructs; r = 0.62 in an adjusted model). Conclusion Deviations from the balanced time perspective were substantially related to hypomentalization. Further research is required to examine the generalizability of the finding (e.g., to measures of mentalization focused on others) and to provide a better understanding of the theoretical basis of the link. Potentially shared associations in development (e.g., attachment style) and mindfulness, that may influence both time perspective and mentalization is of interest in this regard.
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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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Stefana A, Jolić Marjanović Z, Dimitrijević A. The Brief Version of the Mentalization Scale (MentS-12): Evidence-Based Assessment of Mentalizing Capacity. J Pers Assess 2024:1-10. [PMID: 38591956 DOI: 10.1080/00223891.2024.2326884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Accepted: 02/20/2024] [Indexed: 04/10/2024]
Abstract
Recognizing the need for a concise self-report measure of mentalizing capacity, we developed a 12-item iteration of the well-established Mentalization Scale (MentS). Using college student and community samples of Serbian adults (N = 566), we performed a precise selection of items and then examined the psychometric attributes of the shortened scale (MentS-12). The new scale maintains the original three-dimensional structure: self-related mentalization, other-related mentalization, and motivation to mentalize. MentS-12 proves to be both reliable and structurally consistent. To improve its utility in therapeutic contexts, we determined clinical change thresholds for both the complete and abbreviated forms. We hope that its feasibility stimulates the integration of the MentS-12 in longitudinal research projects and real-world clinical settings.
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Affiliation(s)
- Alberto Stefana
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
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Ohse L, Zimmermann J, Kerber A, Kampe L, Mohr J, Schierz R, Rentrop M, Dziobek I, Hörz-Sagstetter S. Impairments in Cognitive and Emotional Empathy as Markers of General versus Specific Personality Pathology. Psychopathology 2023; 57:136-148. [PMID: 37906996 DOI: 10.1159/000533861] [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: 05/11/2023] [Accepted: 08/25/2023] [Indexed: 11/02/2023]
Abstract
INTRODUCTION The alternative model for personality disorders (AMPD) of the Diagnostic and Statistical Manual of Mental Disorders - 5th edition (DSM-5) considers impairments in empathy a basic feature of personality disorders (PDs). In contrast, the AMPD pathological personality trait model and the categorical DSM-5 Section II PD model associate deficits in empathy to specific forms of personality pathology. The present study investigated to what extent impairments in cognitive and emotional empathy are markers of general versus specific personality pathology. METHODS In a clinical sample (n = 119), the Multifaceted Empathy Test was used to assess cognitive empathy, emotional empathy for positive emotions, and emotional empathy for negative emotions. Personality functioning, pathological personality traits, and DSM-5 Section II PDs were assessed via interviews and self-reports. Confirmatory factor analyses were applied to associate the three empathy facets with the three personality pathology approaches, each modeled with general personality pathology (common factor) and specific personality pathology (residuals of indicators). RESULTS Impairments in cognitive empathy and emotional empathy for positive emotions were significantly correlated with general personality pathology. All three empathy facets were also correlated to specific personality pathology when controlling for general personality pathology, respectively. Impairments in cognitive empathy were incrementally associated with identity and empathy (personality functioning), psychoticism (pathological personality traits), and paranoid and dependent PD (DSM-5 Section II PDs). Deficits in emotional empathy for positive emotions were incrementally associated with self-direction and intimacy (personality functioning) and detachment (pathological personality traits). Impairments in emotional empathy for negative emotions were incrementally associated with antagonism (pathological personality traits) and antisocial PD (DSM-5 Section II PDs). CONCLUSION The results suggest that impairments in cognitive empathy and emotional empathy for positive emotions, but not for negative emotions, are markers of general personality pathology, while deficits in the three empathy facets are also markers for specific personality pathology.
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Affiliation(s)
- Ludwig Ohse
- Department of Clinical Psychology and Psychotherapy, Psychologische Hochschule Berlin, Berlin, Germany
| | | | - André Kerber
- Division of Clinical Psychological Intervention, Freie Universität Berlin, Berlin, Germany
| | - Leonie Kampe
- Department for Psychological Diagnostic, International Psychoanalytic University Berlin, Berlin, Germany
| | - Jil Mohr
- Department of Clinical Psychology and Psychotherapy, Psychologische Hochschule Berlin, Berlin, Germany
| | - Robert Schierz
- Department of Clinical Psychology and Psychotherapy, Psychologische Hochschule Berlin, Berlin, Germany
| | - Michael Rentrop
- KBO-Inn-Salzach-Klinikum Wasserburg/Inn, Wasserburg am Inn, Germany
- Department of Psychiatry and Psychotherapy, Technical University of Munich, Munich, Germany
| | - Isabel Dziobek
- Department of Clinical Psychology of Social Interaction, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Susanne Hörz-Sagstetter
- Department of Clinical Psychology and Psychotherapy, Psychologische Hochschule Berlin, Berlin, Germany
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Johnsen JAK, Haukefer SB, Korsan SJ, Larsen M, Holde GE. Quality of life, mentalization, and perception of challenging patient encounters in dentistry: A cross-sectional study. BDJ Open 2023; 9:27. [PMID: 37419929 DOI: 10.1038/s41405-023-00156-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Revised: 06/20/2023] [Accepted: 06/20/2023] [Indexed: 07/09/2023] Open
Abstract
OBJECTIVE This study investigated how exposure to challenging patient encounters influenced participants' self-reported quality of life, and how participants' mentalization capabilities affected the perceptions of challenging patients encounters among Norwegian dentists and dental students. MATERIALS AND METHODS Data was collected with an online questionnaire, and a total of 165 dentists (n = 126) and dental students (n = 39) responded. RESULTS Participants who reported higher total exposure of challenging encounters reported lower quality of life (QoL). Mentalization tendencies affected the perception of challenging encounters with specific types of patients; critical and anxious; as well as the estimation of the total exposure to challenging patient encounters. Participants that were overconfident with regards to the mental states of others found these patient types less challenging and they reported less overall exposure to challenging patients than underconfident participants. Also, overconfident participants reported higher QoL than underconfident participants. CONCLUSIONS Mentalization capabilities of dental practitioners interact with the perception of challenging encounters in dental practice, and how practitioners respond to these challenges. Measures should be undertaken to increase the awareness of metacognitive skills in dentistry with the dual goal of improving patient care as well as the quality of life of dental practitioners.
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Affiliation(s)
- Jan-Are K Johnsen
- Department of Clinical Dentistry, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway.
| | - Sunniva B Haukefer
- Department of Clinical Dentistry, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Sofie J Korsan
- Department of Clinical Dentistry, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Maria Larsen
- Department of Clinical Dentistry, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Gro Eirin Holde
- Department of Clinical Dentistry, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
- The Public Dental Health Service Competence Centre of Northern Norway, Tromsø, Norway
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Derks SDM, Willemen AM, Vrijmoeth C, Sterkenburg PS. Lessons learned from the adaptation of the Reflective Functioning Questionnaire (RFQ) for Dutch people with mild to borderline intellectual disabilities. PLoS One 2023; 18:e0287751. [PMID: 37368894 DOI: 10.1371/journal.pone.0287751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Accepted: 06/13/2023] [Indexed: 06/29/2023] Open
Abstract
BACKGROUND People with mild to borderline intellectual disabilities (MBIDs) face challenges in social functioning, possibly as a result of limited mentalising abilities such as reflecting on the behaviour of themselves and others. Reflective functioning in people with MBIDs has not yet been investigated due to a lack of instruments. The Reflective Functioning Questionnaire (RFQ) is a seemingly easy adaptable, short self-report questionnaire. The aim of the present, explorative study was to adapt the RFQ for people with MBIDs and investigate the psychometric properties and correlations with other mentalising related constructs. The formulation of the items was adapted to the target group and items were added to broaden the scope towards reflection on both the self and other. METHOD Participants were 159 adults with MBIDs who completed a Dutch-translated and easy-to-read RFQ with five supplemental items, a questionnaire for autistic traits, a self-report questionnaire assessing perspective taking and two performance-based measures assessing emotion recognition and Theory of Mind. RESULTS Confirmatory factor analysis confirmed the factor structure of the RFQ and revealed a two-factor structure with a Self and Other subscale. Generally satisfactory internal consistency and test-retest reliability were found. Explorative results showed correlations of the RFQ-8 and RFQ subscales with autistic traits and between the RFQ Other and perspective taking. CONCLUSIONS This explorative study is the first testing psychometric properties of the RFQ as a self-report questionnaire for assessing reflective functioning in adults with MBIDs. This step is relevant in gaining more scientific knowledge on assessing mentalising in people with MBIDs.
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Affiliation(s)
- Suzanne D M Derks
- Department of Clinical Child and Family Studies & Amsterdam Public Health, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Agnes M Willemen
- Department of Clinical Child and Family Studies & Amsterdam Public Health, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Cis Vrijmoeth
- Centre for Research and Innovation in Christian Mental Health Care, Hoevelaken, The Netherlands
| | - Paula S Sterkenburg
- Department of Clinical Child and Family Studies & Amsterdam Public Health, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Bartiméus, Doorn, The Netherlands
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Remmers C, Zürn M, Anoschin A, Topolinski S, Zimmermann J. Intuition and meaning in life in persons with varying level of depressive symptoms and impairments in personality functioning. J Clin Psychol 2023; 79:1398-1419. [PMID: 36693351 DOI: 10.1002/jclp.23487] [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: 01/12/2022] [Revised: 12/27/2022] [Accepted: 01/08/2023] [Indexed: 01/26/2023]
Abstract
OBJECTIVES The current research explored the interplay between intuition, meaning in life, and psychopathology. Specifically, we investigated whether experiential and reflective components of meaning in life are associated with depressive symptoms and personality pathology, whether intuition is related to the experience of meaning, and whether psychopathology has disruptive effects on intuition as well as on the link between intuition and the experience of meaning. METHODS We tested our preregistered hypotheses in two independent studies. In Study 1, N = 448 participants completed self-report instruments assessing the experiential and the reflective dimensions of meaning in life, depressive symptoms, and impairments in personality functioning. Intuition was operationalized as the ability to intuitively detect semantic coherence in an experimental task. Additionally, self-reported confidence in intuition was assessed. In Study 2, we aimed to replicate our findings and hypotheses that emerged from Study 1 with a new sample of N = 1189 participants. RESULTS In both studies, participants with more depressive symptoms or higher levels of personality pathology experienced life as less meaningful but reflected significantly more about meaning in life. The intuitive ability to discriminate between coherence and incoherence in the experimental task was neither related to the experience of meaning in life nor to psychopathology, but more confidence in intuition was associated with experiencing life as more meaningful and with less psychopathological symptoms. It was tentatively supported that the association between meaning in life and intuition was moderated by psychopathology. CONCLUSION The findings are discussed in terms of their clinical implications and regarding the cognitive-affective processes potentially underlying people's experience of life being meaningful.
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Affiliation(s)
- Carina Remmers
- Department of Psychology and Psychotherapy, Faculty of Health, Witten/Herdecke University, Witten, Germany
| | - Michael Zürn
- Department of Psychology, University of Cologne, Cologne, Germany
| | - Albert Anoschin
- Department of Psychology and Psychotherapy, Faculty of Health, Witten/Herdecke University, Witten, Germany
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Tanzilli A, Cibelli A, Liotti M, Fiorentino F, Williams R, Lingiardi V. Personality, Defenses, Mentalization, and Epistemic Trust Related to Pandemic Containment Strategies and the COVID-19 Vaccine: A Sequential Mediation Model. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph192114290. [PMID: 36361183 PMCID: PMC9656964 DOI: 10.3390/ijerph192114290] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Revised: 10/10/2022] [Accepted: 10/27/2022] [Indexed: 05/14/2023]
Abstract
BACKGROUND The COVID-19 pandemic has considerably influenced all domains of people's lives worldwide, determining a high increase in overall psychological distress and several clinical conditions. The study attempted to shed light on the relationship between the strategies adopted to manage the pandemic, vaccine hesitancy, and distinct features of personality and mental functioning. METHODS The sample consisted of 367 Italian individuals (68.1% women, 31.9% men; M age = 37, SD = 12.79) who completed an online survey, including an instrument assessing four response styles to the pandemic and lockdown(s), the Personality Inventory for DSM-5-Brief Form, the Defense Mechanisms Rating Scales-Self-Report-30, the Reflective Functioning Questionnaire, and the Epistemic Trust, Mistrust, Credulity Questionnaire. RESULTS Maladaptive response patterns to pandemic restrictions were related to dysfunctional personality traits, immature defense mechanisms, poor mentalization, and epistemic mistrust or credulity. Moreover, more severe levels of personality pathology were predictive of an extraverted-maladaptive response style to health emergency through the full mediation of low overall defensive functioning, poor certainty of others' mental states, and high epistemic credulity. CONCLUSIONS Recognizing and understanding dysfunctional psychological pathways associated with individuals' difficulties in dealing with the pandemic are crucial for developing tailored mental-health interventions and promoting best practices in healthcare services.
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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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Neues Testinstrument zur Bewertung der
Mentalisierungsfähigkeit entwickelt. Psychother Psychosom Med Psychol 2022. [DOI: 10.1055/a-1773-7376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Das Wahrnehmen und Interpretieren mentaler Zustände von sich selbst oder
anderen kann unter dem Begriff des Mentalisierens zusammengefasst werden.
Defizite im Mentalisieren können sich dabei auf die psychische
Gesundheit auswirken und zu maladaptiven Gefühls-, Denk- und
Verhaltensmustern beitragen. Wissenschaftler der Universität Kassel
haben nun ein neues Instrument entwickelt, das die wahrgenommene
Mentalisierungsfähigkeit testet.
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