Mentalizing ability, mentalizing impairments, and anorexia nervosa: Validation of the Hebrew version of the Movie for the Assessment of Social Cognition (MASC)

Mentalizing Oneself and Others in Anorexia Nervosa: From Subjective Evaluation to Performance

OBJECTIVE

The present study examined impairment in two main dimensions of mentalizing (self-other and emotional-cognitive) in patients with anorexia nervosa (AN) by combining self-reported measures with performance-based tasks.

METHOD

Forty-five patients with AN recruited from an eating disorder unit and 45 healthy controls (HCs) recruited from the general population completed the Mentalization Scale and the Movie for Assessment of Social Cognition.

RESULTS

The results revealed that in self-reported evaluations of their mentalization process, patients with AN hypo-mentalized about themselves and others' mental states. However, they used more hyper-mentalizing than HCs when mentalizing others' emotional and cognitive mental states in performance-based tasks. Finally, the severity of eating symptoms in patients with AN was associated with higher levels of perceived hypo-mentalizing about their own mental states and lower levels of perceived hypo-mentalizing of others' mental states. No associations were found between the severity of eating symptoms and mentalizing performance.

CONCLUSIONS

This study emphasizes the importance of mentalizing impairment in patients with AN, which should be considered via a multidimensional approach that considers both emotional and cognitive dimensions and the ability to assess patients' competences.

Social cognition in women with borderline personality disorder based on an exhaustive analysis of the Movie for Assessment of Social Cognition (MASC) categories

A significant number of borderline personality disorder (BPD) symptoms are manifested in the interpersonal context. This can be explained by the difficulties in attributing the mental states of oneself and others, which constitutes social cognition. Errors in social cognition are interrelated with the affective, cognitive, impulsive, and interpersonal areas of the person with BPD. The aims of this study was to analyze social cognition in women with BPD compared with a control group and to analyze social cognition in BPD based on BPD symptoms and its severity. To assess social cognition, we used a full range of social cognition categories provided by the Movie for the Assessment of Social Cognition (MASC): correct theory of mind (ToM); attribution of mental states (thoughts, emotions, or intentions); errors of mentalization; types of ToM; and attribution of mental states through perceptive or cognitive cues and through hot or cold emotions. The MASC has high ecological validity and has been validated in Spanish. The sample comprised 79 women, including 47 women with BPD and 32 healthy women. Worse social cognition performance was observed in women with BPD. More severe borderline symptoms were related to worse functioning in the correct ToM and to errors of no mentalization. Involvement of the cognitive area in borderline symptoms was associated with worse functioning in correct ToM and worse social cognition in cognitive areas as well as with hypermentalization. This is the first study that uses all the MASC categories and considers BPD heterogeneity and its severity to study social cognition.