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Wais M, Bégin M, Sharp C, Ensink K. Trauma-related symptoms in adolescents: the differential roles of sexual abuse and mentalizing. Front Psychol 2024; 15:1364001. [PMID: 39021654 PMCID: PMC11252049 DOI: 10.3389/fpsyg.2024.1364001] [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: 12/31/2023] [Accepted: 06/11/2024] [Indexed: 07/20/2024] Open
Abstract
Introduction Major gaps remain in our knowledge regarding childhood sexual abuse (CSA) related symptoms in adolescent psychiatric inpatients, as well as potential resilience factors like mentalizing. CSA is a risk factor for the early emergence of borderline personality features, posttraumatic stress, and sexual concerns. Mentalizing, which involves the capacity to understand our reactions and that of others in psychological terms, is a resilience factor for self and interpersonal functioning. The aim of this study was to address knowledge gaps by examining the contributions of CSA and mentalizing in a latent factor composed of borderline personality features, posttraumatic stress, and sexual concerns in a sample of adolescent psychiatric inpatients. We hypothesized that CSA and mentalizing would independently explain the variance in this latent factor. Method Participants were 273 adolescents aged 12-17 recruited from an adolescent inpatient psychiatric clinic. They completed the Reflective Function Questionnaire for Youth (RFQ-Y), the Trauma Symptom Checklist for Children (TSCC), and the Borderline Personality Features Scale for Children (BPFS-C). CSA was assessed using the Child Attachment Interview (CAI), the Computerized Diagnostic Interview Schedule for Children (C-DISC), as well as the Childhood Trauma Questionnaire (CTQ). Results 27.5% of adolescent psychiatric inpatients reported CSA. CSA and mentalizing were independently associated with a latent factor consisting of posttraumatic stress, borderline personality features, and sexual concerns. CSA explained 5.0% and RF explained 16.7% of the variance of the latent factor. When we consider both the unique and the shared contribution of CSA and mentalizing, the model explained 23.0% of the variance of this factor. Discussion CSA and mentalizing independently explained variance in a latent factor constituted of borderline personality features, posttraumatic stress, and sexual concerns. The direct effect of mentalizing was stronger and mentalizing explained comparatively more variance of trauma-related symptoms in adolescent psychiatric inpatients. The findings are consistent with the theory that mentalizing is an internal resilience factor in adolescent psychiatric inpatients. By implication, clinical interventions focused on promoting the development of mentalizing, such as Mentalization Based Treatment, may palliate mental health difficulties manifested by adolescent psychiatric inpatients including those associated with CSA.
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Affiliation(s)
- Marissa Wais
- École de Psychologie, Université Laval, Québec, QC, Canada
| | - Michaël Bégin
- Département de Psychologie, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Carla Sharp
- Department of Psychology, University of Houston, Houston, TX, United States
| | - Karin Ensink
- École de Psychologie, Université Laval, Québec, QC, Canada
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Kolev MV. Playfulness and adolescence: mentalization and neuropsychoanalysis perspective. Front Psychol 2024; 15:1371747. [PMID: 38933595 PMCID: PMC11201137 DOI: 10.3389/fpsyg.2024.1371747] [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: 01/16/2024] [Accepted: 02/27/2024] [Indexed: 06/28/2024] Open
Abstract
The article attempts at conceptualizing the basic principles of how adolescents develop, getting out of childhood and proceeding to enter young adulthood. The age period of adolescence is marked with intense emotional states, lines of thinking, beliefs and transitions that caregivers often face challenges making sense of or mirroring. Combining mentalization-based approaches with neuropsychoanalytic findings about how basic emotional systems governing playful behavior work can shed additional light into the communication channels and specificities therapists might consider when engaging in such endeavor.
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Zheng W, Wen L, Huang Y, Huang L, Yan C, Chen J, Qu M. The mediating role of childhood maltreatment in the association between residence migration and adolescent depression. J Affect Disord 2024; 346:42-48. [PMID: 37940054 DOI: 10.1016/j.jad.2023.10.150] [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: 07/15/2023] [Revised: 10/23/2023] [Accepted: 10/27/2023] [Indexed: 11/10/2023]
Abstract
BACKGROUND It is well established that residence migration can negatively affect the mental health of adolescents. However, the related factors that mediate the association between residence migration and depression are still uncertain. METHODS The participants were 16,037 adolescents in junior middle schools. A self-administered questionnaire was used for the survey. In addition to collecting general demographic characteristics of the participants, including age, gender, local residence status, only child status, parental marriage status and parent-child relationship, the questionnaire also contained the 9-item Patient Health Questionnaire, the short form of the Childhood Trauma Questionnaire and the Connor-Davidson Resilience Scale. Data analysis was conducted using SPSS software. RESULTS A total of 14,059 valid questionnaires were collected, resulting in 12,122 local adolescents, defined as being born and raised locally, and 1937 migrant adolescents, defined as being transferred from other regions. Meanwhile, 53.3 % of local adolescents and 58.2 % of migrant adolescents reported depressive symptoms. This result indicated that residence migration might contribute to depression symptoms(OR = 1.136, 95%CI: 1.013-1.273, p < 0.05). Childhood maltreatment and parental divorce are risk factors for depression in migrant adolescents. For all adolescents, resilience and a good parent-child relationship may reduce the risk of depression. Childhood maltreatment completely mediates residence migration-related depression(95 % bootstrap CI = 0.146, 0.323). CONCLUSION This study revealed that residence migration could contribute to adolescent depression, and childhood maltreatment may largely mediate this process, providing new insight into the relationship between adolescent depressive symptoms and residence migration. Reducing childhood maltreatment may effectively improve the depressive symptoms of migrant adolescents.
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Affiliation(s)
- Wancheng Zheng
- Xuanwu Hospital Capital Medical University, Beijing, China
| | - Lulu Wen
- Xuanwu Hospital Capital Medical University, Beijing, China
| | - Yunjian Huang
- Xuanwu Hospital Capital Medical University, Beijing, China
| | - Liyuan Huang
- Xuanwu Hospital Capital Medical University, Beijing, China
| | - Chuming Yan
- Xuanwu Hospital Capital Medical University, Beijing, China
| | | | - Miao Qu
- Xuanwu Hospital Capital Medical University, Beijing, China.
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Ensink K, Deschênes M, Bégin M, Cimon L, Gosselin T, Wais M, Normandin L, Fonagy P. Dimensional model of adolescent personality pathology, reflective functioning, and emotional maltreatment. Front Psychiatry 2024; 14:1302137. [PMID: 38268556 PMCID: PMC10806145 DOI: 10.3389/fpsyt.2023.1302137] [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: 09/26/2023] [Accepted: 12/18/2023] [Indexed: 01/26/2024] Open
Abstract
Introduction Childhood emotional abuse (CEA) is a recognized risk factor for adolescent mentalizing challenges. However, there's limited understanding about how CEA might influence personality development and elevate the risk of adolescent personality pathology. A deeper grasp of these pathways is crucial, given that adolescence is a pivotal developmental phase for identity integration, personality consolidation, and the emergence of personality disorders. As the emphasis shifts to dimensional perspectives on adolescent personality pathology, the spotlight is increasingly on adolescents' evolving personality organization (PO). Within this framework, personality disorder manifestations stem from inherent vulnerabilities in PO. A comprehensive understanding of how CEA leads to these inherent vulnerabilities in PO can inform enhanced interventions for at-risk adolescents. Nonetheless, our comprehension lacks insight into potential pathways to PO, especially those involving external factors like maltreatment and individual traits like mentalizing. This study sought to bridge these gaps by employing latent factor analysis and structural equation modeling to explore connections between emotional maltreatment, adolescent mentalizing, and PO. Methods A community-based cohort of 193 adolescents (aged 12-17) took part in self-report assessments: the Childhood Experience of Care and Abuse Questionnaire (CECA.Q), the Reflective Functioning Questionnaire for Youth (RFQ-Y), and the Inventory for Personality Organization for Adolescents (IPO-A). Results The structural equation model revealed a significant direct influence of CEA on both RFQ-Confusion and PO, and a noteworthy direct effect of RFQ-Confusion on PO. Remarkably, the model accounted for 76.9% of the PO variance. CEA exhibited a significant indirect impact on PO through RFQ-Confusion, which was accountable for 52.3% of the CEA effect on PO, signifying a partial mediation by mentalizing. Discussion These insights carry substantial clinical implications, especially for devising integrated, trauma-informed strategies for adolescents with personality pathologies. This is particularly relevant for enhancing mentalizing and bolstering personality consolidation among adolescent CEA survivors.
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Affiliation(s)
- Karin Ensink
- École de Psychologie, Université Laval, Québec, QC, Canada
| | | | - Michaël Bégin
- Département de Psychologie, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Laurie Cimon
- Département de Médecine Sociale et Préventive, Université Laval, Québec, QC, Canada
| | | | - Marissa Wais
- École de Psychologie, Université Laval, Québec, QC, Canada
| | - Lina Normandin
- École de Psychologie, Université Laval, Québec, QC, Canada
| | - Peter Fonagy
- Research Department of Clinical, Educational and Health Psychology, University College London, London, United Kingdom
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Huang M, Hou J. Childhood maltreatment and suicide risk: The mediating role of self-compassion, mentalization, depression. J Affect Disord 2023; 341:52-61. [PMID: 37633526 DOI: 10.1016/j.jad.2023.08.112] [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: 04/02/2023] [Revised: 08/21/2023] [Accepted: 08/23/2023] [Indexed: 08/28/2023]
Abstract
BACKGROUND Childhood maltreatment (CM) is a well-established risk factor for depression and increased suicide risk. This study aimed to investigate the distinctive mechanisms of individual types of CM on young adult suicide risk, by exploring the potential mediating role of mentalization, self-compassion, and depression. METHODS A total of 4873 adults completed a survey screening for experiences of CM, self-compassion, mentalization, depression, and suicide risk. RESULTS The path analysis revealed significant direct effects of mentalization, self-compassion, and depression on suicide risk. Moreover, mentalization, self-compassion, and depression mediated the relationship between emotional abuse/neglect and suicide risk, whereas physical neglect contributed to suicide risk only through mentalization and depression. Furthermore, sexual abuse had a significant direct effect on suicide risk, whereas physical abuse did not show any direct or indirect effects. LIMITATIONS The cross-sectional design of the study limits its ability to establish causality, and the risk of recall bias in reporting physical or sexual abuse cannot be ignored. CONCLUSIONS This study represents the first identification of disturbances in self-compassion, mentalization, and depression that mediate the relationship between various types of CM and suicide risk in young adults. Our findings suggest substantive differences in the impact of emotional CM compared to other forms of CM. Enhancing self-compassion and mentalization abilities could be valuable intervention strategies for individuals with a history of emotional CM. Addressing factors that hinder the recall of relevant subjective experiences of physical and sexual abuse is also critical.
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Affiliation(s)
- Manxia Huang
- Department of Psychology, Institute of Education, China University of Geosciences, Wuhan, China.
| | - Jinbo Hou
- Student Mental Health Education Center, China University of Geosciences, Wuhan, China
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Martin-Gagnon G, Fonagy P, Bégin M, Normandin L, Ensink K. Measuring mentalizing in youth: further validation of the reflective functioning questionnaire for youth (RFQY-13). Front Psychol 2023; 14:1260281. [PMID: 37908815 PMCID: PMC10613668 DOI: 10.3389/fpsyg.2023.1260281] [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: 07/17/2023] [Accepted: 10/03/2023] [Indexed: 11/02/2023] Open
Abstract
Objective This study investigated the psychometric properties, including the factor structure, validity, and reliability of the 13-item Reflective Function Questionnaire for Youth (RFQY-13), using a new scoring system. Method A community sample of 414 adolescents and a clinical sample of 83 adolescents (aged 12-21) completed the RFQY, the Borderline Personality Features Scale for Children (BPFS-C), the Beck Youth Inventories (BYI), the Child Behavior Checklist-Youth Self Report (CBCL-YSR) and the Movie for the Assessment of Social Cognition (MASC). Results Using the new scoring system, our results demonstrated configural and metric invariance, as well as adequate reliability and validity across both samples for the two-factor structure of the RFQY. The Uncertainty subscale also showed strong associations with psychopathology. Discussion The findings show that the RFQY-13, when used with the new coding system, has good psychometric properties and is a reliable measure of mentalizing for adolescents and young adults. We discuss clinical implications, limitations and future directions.
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Affiliation(s)
| | - Peter Fonagy
- Psychoanalysis Unit, Research Department of Clinical, Educational and Health Psychology, University College London, London, United Kingdom
| | - Michaël Bégin
- Département de Psychologie, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Lina Normandin
- École de Psychologie, Université Laval, Québec, QC, Canada
| | - Karin Ensink
- École de Psychologie, Université Laval, Québec, QC, Canada
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