The mindful trajectory: Developmental changes in mentalizing throughout adolescence and young adulthood

Assessment of personality disorders in adolescents - a clinical validity and utility study of the structured interview of personality organization (STIPO)

BACKGROUND

The diagnosis of personality disorders (PD) in adolescence still poses a challenge. Early diagnosis and targeted intervention are called for, since patients with PD present with severe consequences in terms of psychosocial functioning and personal suffering including higher suicide risk. New guidelines advise semi-structured interviews for the dimensional assessment of personality functioning.

METHODS

We included 136 patients aged 13 to 17.9 years with a categorical PD diagnosis and 35 healthy control (HC) adolescents to assess the applicability of the Structured Interview for Personality Organization (STIPO) for adolescents and evaluate its validity by correlating the six outcome domains (identity, object relations, defenses, aggression, moral values, reality testing) and the overall severity level to several validated instruments. Furthermore, we assessed personality traits, internalizing and externalizing behavior and depressive symptoms.

RESULTS

All STIPO domains differed significantly between patients and HC (p <  0.001). Outcome measures correlated significantly with validated self-rating questionnaires. STIPO severity levels correlated significantly with psychopathology. Personality traits "dissocial behavior" and "emotional dysregulation" correlated positively with all STIPO domains and the overall level of personality organization (PO).

CONCLUSIONS

Results indicate that the STIPO is a reliable and valid instrument for the assessment of PD in adolescents. It comprises the core elements of personality functioning, as requested in Criterion A in the AMPD of the DSM-5 and ICD-11 and could be useful for treatment planning, evaluation of the course of treatment as well as for prognostic considerations.

Adolescent Vulnerability to Internet Media Exposure: The Role of Self-Mastery in Mitigating Post-Traumatic Symptoms

The internet has revolutionized communication, becoming central to daily life. Consequently, news consumption shifted dramatically with increased media access, exposing individuals to global traumatic events, such as armed conflicts. Adolescents are particularly vulnerable to the negative effects of this exposure due to their media expertise and developmental stage. Young adults are more mature and independent but remain vulnerable to the harmful effects of internet exposure. This study examined the relationship between internet media exposure to armed conflict and post-traumatic symptoms and psychiatric symptomology among adolescents and young adults. Additionally, self-mastery was explored as a resilience factor in both groups. A sample of 329 participants, including 159 adolescents (ages 12-18) and 168 young adults (ages 20-26), completed questionnaires assessing direct and internet media exposure to armed conflict events, self-mastery, post-traumatic symptoms and psychiatric symptomology. Structural equation modeling (SEM) revealed that internet media exposure was positively associated with post-traumatic symptoms and psychiatric symptomatology only among adolescents, whereas direct exposure was significantly related to post-traumatic symptoms only among young adults. Self-mastery moderated these effects in both groups, buffering the psychological impact of the most relevant exposure. The findings underscore the need for interventions that foster self-mastery to mitigate the adverse effects of traumatic media exposure, particularly among adolescents. Developmental implications are discussed.

A longitudinal neuroimaging study of adolescent girls' mentalizing and perspective-taking tendencies

Research in developmental psychology suggests that self-concept formation and mentalizing capacities, along with their neural foundations, show significant developmental change during adolescence. Perspective-taking tendencies are also believed to increase in adolescence, supporting the refinement of prosocial behavior and the demands of increasingly complex social relationships. To explore the development of, and relationship between, these processes in adolescence, early adolescent girls (N = 172) completed a measure of perspective-taking tendencies and a self-evaluation fMRI task at two waves, approximately 18 months apart (mean ages = 11.62 and 13.20, respectively). In line with our hypothesis, perspective-taking tendencies were positively associated with age. Greater perspective-taking tendencies were also associated with a more prosocial, and less antisocial, self-concept. In addition, dmPFC activity increased with age, but this did not survive correction for multiple comparisons across all mentalizing regions. Post hoc analyses also showed that an increase in perspective-taking tendencies across waves was significantly associated with activity in parts of the precuneus at wave 2. Finally, while we did not observe cross-variable coupling, our Bivariate Latent Change Score model showed that lower perspective-taking tendencies at wave 1 were associated with greater latent change in this variable (and the same was true for mean activity in mentalizing brain regions).

Impact of mentalization, identity diffusion and psychopathology on nonsuicidal self-injury among adolescents

INTRODUCTION

Nonsuicidal self-injury (NSSI) has become a major public health issue in adolescents. This cross-sectional case-controlled study aims to assess the impact of identity diffusion, psychopathology, and mentalization on NSSI in adolescence.

METHODS

The study sample consisted of 153 adolescents (76.5% girls; Mage = 15.6 years). The sample included 56 clinical cases of NSSI, 45 psychiatric cases without NSSI, and 52 healthy controls, all recruited in Ankara, Türkiye, from June 1, 2022, to August 31, 2022. Mentalization was assessed by "The Movie for the Assessment of Social Cognition" (MASC) which categorizes mentalizing as "correct mentalizing" "hypermentalizing" "undermentalizing" and "no-mentalizing". All participants filled in the Self-Injurious Behavior Screening Questionnaire, Assessment of Identity Development in Adolescence (AIDA), and Youth Self Report (YSR), and Inventory of Statements About Self-injury (ISAS).

RESULTS

The NSSI group showed lower mentalizing capacity than the healthy control group (p = .011), and more no-mentalizing errors than the other two groups (p = .014). Identity diffusion scores were higher in the NSSI group than in the other two groups (p < .001). Multivariate logistic regression analysis showed that the presence of maternal psychiatric disorder (p = .019, OR = 5.21), identity diffusion (p = .007, OR = 1.02), no mentalizing (p = .049, OR = 1.28), and total psychopathology symptoms (p = .009, OR = 1.12) had a significant impact on NSSI.

CONCLUSIONS

Current findings suggest that transdiagnostic approaches, including mentalization and identity diffusion, may contribute to a more comprehensive understanding of NSSI and to the development of clinical interventions.

Childhood Trauma, Mentalization and Obsessive Compulsive Symptoms in a Non-Clinical Sample: A Mediation Analysis Study

Objective

Obsessive and compulsive symptoms (OCS) are cross-cutting psychopathological manifestations frequently detected in a variety of clinical and non-clinical samples. It has been suggested that impaired mentalization abilities and traumatic experiences during childhood may be relevant etiopathogenetic factors in the development of OCS. The purpose of the current study was to cross-sectionally assess these variables in a non-clinical sample, testing the mediational role of mentalization abilities in the association between childhood trauma (CT) and OCS.

Method

667 participants (488 females; mean age= 29.76 ± 11.87 years; age range: 18-80) answered a survey including the Childhood Trauma Questionnaire, the Mentalization Questionnaire and the Obsession-Compulsion subscale of the Brief Symptom Inventory.

Results

The mediation model was significant for the total effect (p< .001), showing that CT was positively associated with OCS (95% CI: .006; .019) and that this association was mediated by reduced levels of mentalization capacity (95% CI: .003; .009). Such results were significant controlling for potential sociodemographic and clinical confounding variables.

Conclusions

The findings contribute to elucidate the complex relationships between CT, mentalization capacity, and OCS, supporting the possibility that mentalization impairments, arising from CT, may affect top-down control mechanisms thus contributing to the development of OCS.

A short version of the reflective functioning questionnaire: Validation in a greek sample

This study aims to validate the Greek version of the 54-item Reflective Functioning Questionnaire (RFQ), a measure designed to assess an individual's capacity for understanding themselves and others based on internal mental states. This capacity, also known as Reflective Functioning (RF) or mentalizing, is believed to play a significant role in both typical and atypical development. The validation process examined the factor structure of the RFQ and its relationship with a variety of psychosocial and clinical constructs that have theoretical and empirical links to RF. Additionally, this research investigated the factor structure's invariance across gender and age groups to determine the robustness of the instrument. A unique contribution of this work lies in examining the application of the RFQ to attachment classifications through the use of cluster analysis. The sample consisted of 875 Greek adults from the general community with a mean age of 28.5 and a median age of 22. Participants completed the Greek RFQ along with a series of self-report questionnaires assessing psychosocial constructs, including attachment, epistemic trust, emotion regulation, and psychological mindedness, as well as clinical variables such as anxiety, depression, and borderline personality traits. Our findings suggest that a shorter, 31-item version of the questionnaire provides a robust three-factor structure across a non-clinical Greek adult population. The three identified subscales are (a) excessive certainty, (b) interest/curiosity, and (c) uncertainty/confusion, all demonstrating satisfactory reliability and construct validity. The uncertainty subscale was found to be associated with insecure attachment styles, epistemic mistrust and credulity, emotional suppression, and low psychological mindedness. In contrast, the certainty and curiosity subscales were linked to secure attachment, epistemic trust, emotion reappraisal, and psychological mindedness. Uncertainty was further shown to differ significantly across probable clinical and non-clinical groups, as distinguished by cut-off scores for anxiety, depression, and borderline personality disorder (BPD). However, the certainty and interest/curiosity subscales only varied between the two BPD groups. Our results provide the first evidence supporting the use of a 31-item version of the RFQ with three validated subscales to reliably assess reflective functioning in the Greek population, demonstrating stronger psychometric properties compared to other RFQ versions reported in previous studies. Findings suggest that impaired mentalizing capacity, as measured by the RFQ, is linked to insecure attachment, epistemic mistrust and credulity, poor emotion regulation, and low psychological mindedness, and potentially plays a role in adult mental health symptoms.

Longitudinal joint trajectories of gambling disorder and hypomentalization: A latent class growth analysis among young adults

INTRODUCTION

Only a few studies have investigated the relationship between risk for gambling disorder (GD) and mentalization difficulties. However, these results on positive correlations were all from cross-sectional studies; therefore, it would be important to investigate the longitudinal relationship between the constructs.

AIMS

It was aimed to identify subgroups of gamblers with different joint growth trajectories of risk for GD and hypomentalization (i.e., uncertainty of understanding own and others' mental states) and to compare the identified latent classes along impulsivity, sensation seeking and depression.

METHODS

Data from waves 1-3 of the Budapest Longitudinal Study were used. The final sample included 219 young adult gamblers who completed the study questionnaire and reported past-year gambling in all three waves (Females: N = 93 [42.29%]; Mean age: 28.36 years [SD = 4.29]). Standardized questionnaires were administered to measure the main constructs.

RESULTS

A four-class model was retained based on latent class growth analysis. Class 1 had consistently moderately high risk for GD and hypomentalization, and Class 4 presented consistently low risk for GD and hypomentalization. Classes 2-3 were characterized by low risk for GD and increasing hypomentalization. Class 1 had significantly higher sensation seeking and depression compared with the other subgroups in multiple cases. Class 4 showed significantly lower impulsivity and sensation seeking than the other classes.

CONCLUSIONS

Elevated hypomentalization was presented among individuals with risk for GD. However, there is little empirical evidence to support that the two constructs have convergently changing trajectories. A cautious interpretation of the results is recommended due to low symptom presence.