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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] [What about the content of this article? (0)] [Affiliation(s)] [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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Berthelot N, Larouche K, Garon-Bissonnette J, Deschênes K, Drouin-Maziade C, Lemieux R. Spillover effects on the relationship with the partner of a mentalization-based intervention for pregnant women. Infant Ment Health J 2024. [PMID: 38598747 DOI: 10.1002/imhj.22113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Revised: 02/09/2024] [Accepted: 03/20/2024] [Indexed: 04/12/2024]
Abstract
The birth of a child has been associated with a decline in couple satisfaction, which has implications for the child's social-emotional development. This study investigated the potential spillover effect on pregnant women's perceptions of their relationships with their partners of the Supporting the Transition to and Engagement in Parenthood (STEP) program, a brief trauma-informed mentalization-based prenatal group intervention. Participants (94% White) were recruited in prenatal clinics and through online advertisements in Quebec, Canada. Both quantitative and qualitative data were collected from participants assigned to the STEP program (n = 42) and those receiving treatment-as-usual (TAU; n = 125). Women participating in STEP reported significant improvements in their relationships with their partners compared to those assigned to TAU. More precisely, they reported higher couple satisfaction, enhanced communication, and increased interest in their partners' emotional experience. The qualitative analysis further substantiated these results, with participants reporting having involved their partners in their pregnancy, shared their insights about themselves with their partners and gained fresh perspectives on their relationships. Participants in STEP also expressed sharing program materials with their partners and considered that such interventions should be extended to expecting fathers. This study underscores the potential of mentalization-based interventions to indirectly contribute to couple relationships, which may have positive implications for parenting and the infant.
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Affiliation(s)
- Nicolas Berthelot
- Department of Nursing Sciences, Université du Québec à Trois-Rivières, Trois-Rivieres, Quebec, Canada
- Centre d'études interdisciplinaires sur le développement de l'enfant et la famille, Trois-Rivieres, Quebec, Canada
- CERVO Brain Research Center, Quebec City, Quebec, Canada
- Interdisciplinary Research Center on Intimate Partner Relationship Problems and Sexual Abuse, Montreal, Quebec, Canada
- Groupe de recherche et d'intervention auprès de l'enfant vulnérable et négligé, Trois-Rivieres, Quebec, Canada
| | - Karl Larouche
- Department of Nursing Sciences, Université du Québec à Trois-Rivières, Trois-Rivieres, Quebec, Canada
- Centre d'études interdisciplinaires sur le développement de l'enfant et la famille, Trois-Rivieres, Quebec, Canada
- CERVO Brain Research Center, Quebec City, Quebec, Canada
- Interdisciplinary Research Center on Intimate Partner Relationship Problems and Sexual Abuse, Montreal, Quebec, Canada
- Groupe de recherche et d'intervention auprès de l'enfant vulnérable et négligé, Trois-Rivieres, Quebec, Canada
| | - Julia Garon-Bissonnette
- Department of Nursing Sciences, Université du Québec à Trois-Rivières, Trois-Rivieres, Quebec, Canada
- Centre d'études interdisciplinaires sur le développement de l'enfant et la famille, Trois-Rivieres, Quebec, Canada
- Interdisciplinary Research Center on Intimate Partner Relationship Problems and Sexual Abuse, Montreal, Quebec, Canada
- Groupe de recherche et d'intervention auprès de l'enfant vulnérable et négligé, Trois-Rivieres, Quebec, Canada
- Department of Psychology and Human Development, Vanderbilt University, Nashville, Tennessee, USA
| | - Kim Deschênes
- Centre d'études interdisciplinaires sur le développement de l'enfant et la famille, Trois-Rivieres, Quebec, Canada
- CERVO Brain Research Center, Quebec City, Quebec, Canada
- Interdisciplinary Research Center on Intimate Partner Relationship Problems and Sexual Abuse, Montreal, Quebec, Canada
- Groupe de recherche et d'intervention auprès de l'enfant vulnérable et négligé, Trois-Rivieres, Quebec, Canada
- Department of Psychology, Université du Québec à Trois-Rivières, Trois-Rivieres, Quebec, Canada
| | - Christine Drouin-Maziade
- Department of Nursing Sciences, Université du Québec à Trois-Rivières, Trois-Rivieres, Quebec, Canada
- Centre d'études interdisciplinaires sur le développement de l'enfant et la famille, Trois-Rivieres, Quebec, Canada
- Interdisciplinary Research Center on Intimate Partner Relationship Problems and Sexual Abuse, Montreal, Quebec, Canada
- Groupe de recherche et d'intervention auprès de l'enfant vulnérable et négligé, Trois-Rivieres, Quebec, Canada
| | - Roxanne Lemieux
- Department of Nursing Sciences, Université du Québec à Trois-Rivières, Trois-Rivieres, Quebec, Canada
- Centre d'études interdisciplinaires sur le développement de l'enfant et la famille, Trois-Rivieres, Quebec, Canada
- Groupe de recherche et d'intervention auprès de l'enfant vulnérable et négligé, Trois-Rivieres, Quebec, Canada
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Yirmiya K, Constantinou M, Simes E, Bateman A, Wason J, Yakeley J, McMurran M, Crawford M, Frater A, Moran P, Barrett B, Cameron A, Hoare Z, Allison E, Pilling S, Butler S, Fonagy P. The mediating role of reflective functioning and general psychopathology in the relationship between childhood conduct disorder and adult aggression among offenders. Psychol Med 2024:1-12. [PMID: 38563288 DOI: 10.1017/s003329172400062x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/04/2024]
Abstract
BACKGROUND The nature of the pathway from conduct disorder (CD) in adolescence to antisocial behavior in adulthood has been debated and the role of certain mediators remains unclear. One perspective is that CD forms part of a general psychopathology dimension, playing a central role in the developmental trajectory. Impairment in reflective functioning (RF), i.e., the capacity to understand one's own and others' mental states, may relate to CD, psychopathology, and aggression. Here, we characterized the structure of psychopathology in adult male-offenders and its role, along with RF, in mediating the relationship between CD in their adolescence and current aggression. METHODS A secondary analysis of pre-treatment data from 313 probation-supervised offenders was conducted, and measures of CD symptoms, general and specific psychopathology factors, RF, and aggression were evaluated through clinical interviews and questionnaires. RESULTS Confirmatory factor analyses indicated that a bifactor model best fitted the sample's psychopathology structure, including a general psychopathology factor (p factor) and five specific factors: internalizing, disinhibition, detachment, antagonism, and psychoticism. The structure of RF was fitted to the data using a one-factor model. According to our mediation model, CD significantly predicted the p factor, which was positively linked to RF impairments, resulting in increased aggression. CONCLUSIONS These findings highlight the critical role of a transdiagnostic approach provided by RF and general psychopathology in explaining the link between CD and aggression. Furthermore, they underscore the potential utility of treatments focusing on RF, such as mentalization-based treatment, in mitigating aggression in offenders with diverse psychopathologies.
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Affiliation(s)
- Karen Yirmiya
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
- Anna Freud National Centre for Children and Families, London, UK
| | - Matthew Constantinou
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
- Anna Freud National Centre for Children and Families, London, UK
| | - Elizabeth Simes
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
- Anna Freud National Centre for Children and Families, London, UK
| | - Anthony Bateman
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
- Anna Freud National Centre for Children and Families, London, UK
| | - James Wason
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Jessica Yakeley
- Portman Clinic, Tavistock and Portman NHS Foundation Trust, London, UK
| | - Mary McMurran
- Institute of Mental Health, University of Nottingham, Nottingham, UK
| | - Mike Crawford
- Division of Psychiatry, Imperial College, London, UK
| | - Alison Frater
- School of Law, Royal Holloway, University of London, London, UK
| | - Paul Moran
- Centre for Academic Mental Health, Population Health Sciences Department, Bristol Medical School, University of Bristol, Bristol, UK
| | - Barbara Barrett
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Angus Cameron
- National Probation Service London Division, London, UK
| | - Zoe Hoare
- NWORTH Clinical Trials Unit, School of Health Sciences, Bangor University, Bangor, UK
| | - Elizabeth Allison
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
- Anna Freud National Centre for Children and Families, London, UK
| | - Stephen Pilling
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - Stephen Butler
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
- Anna Freud National Centre for Children and Families, London, UK
| | - Peter Fonagy
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
- Anna Freud National Centre for Children and Families, London, UK
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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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] [What about the content of this article? (0)] [Affiliation(s)] [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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Zandpour M, Lind M, Sharp C, Hasani J, Bagheri Sheykhangafshe F, Borelli JL. Attachment-Based Mentalization Profiles of Iranian Children: A Mixed-Method Approach. Children (Basel) 2024; 11:258. [PMID: 38397370 PMCID: PMC10888099 DOI: 10.3390/children11020258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Revised: 12/23/2023] [Accepted: 01/19/2024] [Indexed: 02/25/2024]
Abstract
Mentalization, operationalized as reflective functioning (RF), is the ability to understand one's own and another's mental world implicitly or explicitly. RF is a newly discovered research field in Iran and is largely under-studied in Eastern cultures in general, underscoring the high need for cross-cultural studies in this field of research. A qualitative method was used to examine the ability to understand, process, and respond to high-arousal attachment situations in typical and clinical populations of Iranian children recruited from a Tehran primary school. A well-known semi-structured interview commonly used to assess RF in children was used to collect data. Required information on internalizing and externalizing symptoms, demographic information, and all formal diagnoses of children were collected by parents. The results indicated the identification of four different profiles of RF in children, one of which was adaptive, while the other three were maladaptive. Also, the results showed that typically developing children and those having a high social and economic status (SES) were characterized as having a more adaptive profile of RF, while children from the clinical population and those with a low SES reported a more maladaptive profile (passive mentalizing, helpless mentalizing, narcissistic mentalizing) of RF. The present study is an important step in increasing our understanding of the development of mentalization in children and has significant educational and clinical implications.
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Affiliation(s)
- Masoumeh Zandpour
- Department of Psychology, Faculty of Humanities, Tarbiat Modares University, Tehran 14117-13116, Iran
| | - Majse Lind
- Department of Communication and Psychology, Aalborg University, 9000 Aalborg, Denmark
| | - Carla Sharp
- Department of Psychology, University of Houston, Houston, TX 77024, USA
| | - Jafar Hasani
- Department of Clinical Psychology, Faculty of Psychology and Educational Sciences, Kharazmi University, Tehran 15719-14911, Iran
| | | | - Jessica L Borelli
- Department of Psychological Science, University of California, Irvine, CA 92697, USA
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Strifler Y, Diamond GM. Emotional arousal and reflective functioning among parents participating in attachment-based family therapy for LGBTQ+ young adults and their nonaccepting parents. Psychother Res 2024:1-13. [PMID: 38319829 DOI: 10.1080/10503307.2024.2309285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Accepted: 01/09/2024] [Indexed: 02/08/2024] Open
Abstract
OBJECTIVE Parents' rejection of their LGBTQ + young adults can have a negative impact on their young adult's psychological welfare, and on the young adult-parent relationship. Parents' ability to reflect on their child's pain and unmet needs is thought to evoke empathy and compassion, and reduce rejection. Empirical and clinical evidence suggest that parents' level of reflective functioning (RF) is impacted by their level of emotional arousal (EA). This study examined the association between parents' EA and RF within the context of attachment-based family therapy for nonaccepting parents and their LGBTQ+ young adults. METHODS 43 therapy sessions drawn from six different cases were coded for parental RF and EA, based on 30-second segments. This generated a total of 343 observations for analyses. RESULTS Hierarchal linear modeling revealed that parents' level of RF was a function of their concomitant EA, with moderate levels of arousal predicting the highest RF levels. CONCLUSION Moderate EA may facilitate optimal parental reflective functioning. With nonaccepting parents, who typically present for treatment with high levels of maladaptive fear and shame, therapists would do well to assess their level of arousal and, when indicated, employ downregulating interventions before inviting them to reflect on their young adult's experience and needs.
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Affiliation(s)
- Yotam Strifler
- Department of Psychology, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Gary M Diamond
- Department of Psychology, Ben-Gurion University of the Negev, Beer-Sheva, Israel
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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Borelli JL, Hong K, Kazmierski KFM, Smiley PA, Sohn L, Guo Y. Parents' depressive symptoms and reflective functioning predict parents' proficiency in relational savoring and children's physiological regulation. Dev Psychopathol 2024; 36:121-134. [PMID: 36239047 DOI: 10.1017/s095457942200102x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
This study examined parental depression and parental reflective functioning (PRF) as predictors of parental proficiency in relational savoring (RS), the association between RS proficiency and a marker of children's physiological self-regulation, respiratory sinus arrhythmia (RSA), during a stressor, and indirect effects of parental depression and PRF on children's RSA via parents' RS. At Time 1 (T1), parents of 8- to 12-year-old children (N = 139) reported on their depressive symptoms and completed a parenting interview, coded for PRF. After 1.5 years (Time 2; T2), parents savored a positive relational memory that involved their children, which was coded for savoring proficiency. Children's RSA was measured during a stressful task (a series of impossible puzzles). Depressive symptoms (inversely) and PRF (positively) were associated with RS proficiency. Higher parental RS proficiency was associated with children's higher mean levels of RSA during the stressor. Indirect effects models supported that T2 RS proficiency mediated the negative association between parental T1 depressive symptoms and children's T2 RSA, and between T1 PRF and children's T2 RSA. We discuss these findings in terms of implications for parents' emotion regulation, children's emotion regulation, children's mental health, and intervention.
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Affiliation(s)
- Jessica L Borelli
- University of California, Irvine, CA, USA
- Pomona College, Claremont, CA, USA
| | | | | | | | - Lucas Sohn
- University of California, Irvine, CA, USA
| | - Yuqing Guo
- University of California, Irvine, CA, USA
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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] [What about the content of this article? (0)] [Affiliation(s)] [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] [What about the content of this article? (0)] [Affiliation(s)] [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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Liotti M, Fiorini Bincoletto A, Bizzi F, Tironi M, Charpentier Mora S, Cavanna D, Giovanardi G, Jurist E, Speranza AM, Lingiardi V, Tanzilli A. The catcher in the mind: validation of the brief-mentalized affectivity scale for adolescents in the Italian population. Res Psychother 2023; 26:709. [PMID: 38189462 PMCID: PMC10849075 DOI: 10.4081/ripppo.2023.709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/30/2023] [Accepted: 11/03/2023] [Indexed: 01/09/2024]
Abstract
The concept of mentalized affectivity (MA) encompasses the dimensions of identifying, processing, and expressing emotions and describes the process of making sense of and reevaluating one's affects in light of autobiographical memory. This construct was developed within the theoretical framework of mentalization and, due to its interpersonal nature, added further complexity to the emotion regulation construct. This research aimed to examine the factor structure and psychometric properties of the Brief-Mentalized Affectivity Scale for adolescents (B-MAS-A) on an Italian sample of young people (aged 13-19 years). Data were collected using non-probabilistic sampling and an online survey. Participants were asked to complete a large battery of instruments, including the B-MAS-A, the Toronto Alexithymia Scale, the Reflective Functioning Questionnaire, the Epistemic Trust, Mistrust, and Credulity Questionnaire, the Strengths and Difficulties Questionnaire, and the General Self-Efficacy Scale. In study 1, factor analyses carried out on a total sample of 566 adolescents identified 3 distinct dimensions of the same components of MA found in the adult population: i) identifying; ii) processing; iii) expressing emotions. The subscales showed excellent internal consistency. Study 2 (involving a subsample of 288 participants) demonstrated good levels of construct and criterion validity. These results confirm that the B-MAS-A represents a valid and robust instrument for assessing the complex and multifaceted characteristics of MA in adolescents. The B-MAS-A can make a significant contribution to clinical practice and research and encourage systematic studies on MA in psychotherapy, taking into account the developmental stage of adolescence.
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Affiliation(s)
- Marianna Liotti
- Department of Dynamic and Clinical Psychology, and Health Studies, Sapienza University of Rome.
| | | | - Fabiola Bizzi
- Department of Educational Sciences, University of Genoa.
| | - Marta Tironi
- Department of Educational Sciences, University of Genoa.
| | | | | | - Guido Giovanardi
- Department of Dynamic and Clinical Psychology, and Health Studies, Sapienza University of Rome.
| | - Elliot Jurist
- Department of Psychology, City College of the City University of New York.
| | - Anna Maria Speranza
- Department of Dynamic and Clinical Psychology, and Health Studies, Sapienza University of Rome.
| | - Vittorio Lingiardi
- Department of Dynamic and Clinical Psychology, and Health Studies, Sapienza University of Rome.
| | - Annalisa Tanzilli
- Department of Dynamic and Clinical Psychology, and Health Studies, Sapienza University of Rome.
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Benzi IMA, Carone N, Parolin L, Martin-Gagnon G, Ensink K, Fontana A. Different epistemic stances for different traumatic experiences: implications for mentalization. Res Psychother 2023; 26:708. [PMID: 38156583 PMCID: PMC10772857 DOI: 10.4081/ripppo.2023.708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Accepted: 11/04/2023] [Indexed: 12/30/2023]
Abstract
Traumatic experiences may impair reflective functioning (RF), making it difficult for individuals to understand their own and others' mental states. Epistemic trust (ET), which enables evaluating social information as reliable and relevant, may vary in association with RF. In this study, we explored the implications of different ET stances (i.e., trust, mistrust, and credulity) in the relation between different childhood traumatic experiences (i.e., emotional abuse, physical abuse, sexual abuse, emotional neglect, and physical neglect) and different types of RF impairments (uncertainty and certainty about mental states). A non-clinical community sample of 496 cisgender emerging adults (mage = 24.91, standard deviation = 2.66, 71.85% assigned female at birth, 63.63% heterosexual) reported on their childhood traumatic experiences, ET, and RF. We used structural equation models to examine direct and indirect associations. The results showed significant indirect effects between emotional abuse and uncertainty about mental states through credibility. We also observed significant indirect effects between emotional abuse and certainty about mental states through mistrust and credibility. The findings suggest that a lack of discrimination when evaluating knowledge from others (i.e., credulity) might promote increased uncertainty in RF when emerging adults have experienced emotional abuse in their childhood. Conversely, a tendency to view all information sources as unreliable or ill-intentioned (i.e., mistrust) may foster greater certainty in RF as a protective mechanism against an unreliable and potentially harmful world when combined with childhood emotional abuse. The implications for clinical practice and intervention are discussed.
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Affiliation(s)
| | - Nicola Carone
- Department of Brain and Behavioral Sciences, University of Pavia.
| | - Laura Parolin
- Department of Psychology, University of Milano-Bicocca, Milan.
| | | | - Karin Ensink
- Department of Psychology, Laval University, Quebec.
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14
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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: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [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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15
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Locati F, Benzi IMA, Milesi A, Campbell C, Midgley N, Fonagy P, Parolin L. Associations of mentalization and epistemic trust with internalizing and externalizing problems in adolescence: A gender-sensitive structural equation modeling approach. J Adolesc 2023; 95:1564-1577. [PMID: 37500187 DOI: 10.1002/jad.12226] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2023] [Revised: 04/27/2023] [Accepted: 07/17/2023] [Indexed: 07/29/2023]
Abstract
INTRODUCTION Mentalization, operationalized as reflective functioning (RF), allows individuals to interpret actions as caused by intentional mental states. Previous research highlighted the gender-specific associations between adolescents' internalizing and externalizing difficulties and mentalizing impairments. In addition, research suggested that mentalizing facilitates the creation of epistemic trust (ET) to evaluate social information as accurate, reliable, and relevant. However, few investigations explored the concurrent associations between RF, ET, and adolescent psychopathology. METHODS A sample of 447 Italian cisgender adolescents (57% assigned females at birth; age range 12-19 years old; Mage = 15.54, SD = 1.98) self-reported RF (RFQY-5), ET towards mother, father, and peers (IPPA) and mental health problems (YSR-112). Gender-specific structural equation modeling explored the associations between RF, ET, and internalizing/externalizing problems. RESULTS Results suggested an excellent fit for the theoretical model and revealed gender-related associations. In females, findings suggest that ET mediates the association between RF and psychopathology, with indirect associations from RF through ET to lower internalizing and externalizing problems. However, in males, RF and ET display independent associations with psychopathology. CONCLUSION Overall, findings suggest that ET might be a transdiagnostic factor playing different roles associated with adolescent psychopathology. Indeed, links between RF and ET might help to explore gender differences in mental health problems in this developmental phase.
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Affiliation(s)
| | | | - Alberto Milesi
- Department of Psychology, University of Milano-Bicocca, Milan, Italy
| | - Chloe Campbell
- Research Department of Clinical, Educational, and Health Psychology, UCL London, and the Anna Freud Centre, London, UK
| | - Nicholas Midgley
- Research Department of Clinical, Educational, and Health Psychology, UCL London, and the Anna Freud Centre, London, UK
| | - Peter Fonagy
- Research Department of Clinical, Educational, and Health Psychology, UCL London, and the Anna Freud Centre, London, UK
| | - Laura Parolin
- Department of Psychology, University of Milano-Bicocca, Milan, Italy
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Zhou T, Wang Q, Wang Y, Cheng L. Coping with Epidemic-Related Job Stressors in Healthcare Workers During the Late Stage of the COVID-19 Pandemic: Effects of Reflective Functioning and Cognitive Emotion Regulation. Psychol Res Behav Manag 2023; 16:4377-4388. [PMID: 37908681 PMCID: PMC10615099 DOI: 10.2147/prbm.s429109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Accepted: 10/10/2023] [Indexed: 11/02/2023] Open
Abstract
Background Healthcare workers encountered novel job stressors during the late stage of the COVID-19 pandemic. These stressors possessed potential deleterious effects on mental health outcomes, yet the underlying mediating and moderating mechanisms remained relatively unexplored. Objective The current study aimed to examine the role of cognitive emotion regulation as a mediator in the association between pandemic-related job stressors and the psychological symptoms of healthcare professionals in the late stage of the COVID-19 pandemic, and the role of reflective functioning as a resilience factor moderating both the associations of pandemic-related job stressors and cognitive emotion regulation, as well as psychological symptoms. Methods This cross-sectional survey conducted in October 2020 included 2393 healthcare professionals working in departments with a high risk of exposure to COVID-19 from 22 hospitals in Beijing, China. Participants were asked to complete questionnaires measuring pandemic-related job stressors, anxiety, depression, reflective functioning, and cognitive emotion regulation strategies. Path analyses were performed to examine the hypothesized model. Results Epidemic-related job stressors had significant direct effects on depression (β=0.31, p<0.001) and anxiety symptoms (β=0.29, p<0.001) and the indirect effects through mediation of maladaptive cognitive regulation were also significant (for depression, indirect effect=0.06, SE=0.01, CI=[0.04, 0.07]; for anxiety, indirect effect=0.06, SE=0.01, CI=[0.04, 0.08]). The dimension of certainty about mental states in the reflective functioning questionnaire (RFQc) moderated the direct effect of pandemic-related job stressors on depression (β=-0.05, p<0.001) and moderated the effect of job stressors on maladaptive cognitive regulation (β=0.06, p<0.001). Conclusion The results shed light on the roles of cognitive emotion regulation and reflective functioning in coping with pandemic-related job stressors in frontline healthcare workers in periods of dealing with major infectious diseases. The findings have implications for developing interventions for healthcare workers in need.
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Affiliation(s)
- Ting Zhou
- Department of Medical Psychology, School of Health Humanities, Peking University, Beijing, 100191, People’s Republic of China
| | - Qian Wang
- National Clinical Research Centre for Mental Disorders, Beijing Anding Hospital of Capital Medical University, Beijing, 100088, People’s Republic of China
| | - Youyang Wang
- National Clinical Research Centre for Mental Disorders, Beijing Anding Hospital of Capital Medical University, Beijing, 100088, People’s Republic of China
| | - Lizhi Cheng
- National Clinical Research Centre for Mental Disorders, Beijing Anding Hospital of Capital Medical University, Beijing, 100088, People’s Republic of China
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Bassi G, Mancinelli E, Salcuni S, Gori A, Musetti A. Failure in reflective functioning as a key factor in the association between problematic social networking sites use, attachment and childhood maltreatment: A network analysis approach on gender differences. Dev Psychopathol 2023:1-9. [PMID: 37791536 DOI: 10.1017/s0954579423001268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/05/2023]
Abstract
Following a network analysis approach, the present study aims to explore the pattern of mutual relationships between failure in reflective functioning (RF) - defined as hypomentalization - problematic social networking sites use (PSNSU), attachment anxiety and avoidance, and childhood maltreatment among emerging adults, with a focus on gender differences. The study sample comprises N = 1,614 emerging adults (Mage = 23.84; SD = 3.21; 50% identified themselves as women) who completed online self-assessment measures. Results showed significantly greater PSNSU, hypomentalization, childhood emotional abuse, and both attachment avoidance and anxiety among women. Indeed, within the network analysis, performed separately for men and women, network-specific associative patterns were observed; yet also similarities have emerged. Within the women's network, differently from males, attachment avoidance connects, through attachment anxiety, to emotional abuse, mood modification related to PSNSU, and hypomentalization. Nonetheless, hypomentalization was central in both networks, functioning as a hub between attachment anxiety, the PSNSU cluster, and the childhood maltreatment cluster. These results shed light on the use of social network sites as a potential maladaptive emotion regulation strategy, particularly among women. In this regard, the role of RF should be considered as a key treatment target to reduce PSNSU and support the use of adaptive emotion regulation strategies.
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Affiliation(s)
- Giulia Bassi
- Department of Developmental Psychology and Socialization, University of Padova, Padova, Italy
| | - Elisa Mancinelli
- Department of Developmental Psychology and Socialization, University of Padova, Padova, Italy
- Digital Health Lab, Centre for Digital Health and Wellbeing, Fondazione Bruno Kessler, Trento, Italy
| | - Silvia Salcuni
- Department of Developmental Psychology and Socialization, University of Padova, Padova, Italy
| | - Alessio Gori
- Department of Health Science, University of Florence, Florence, Italy
| | - Alessandro Musetti
- Department of Humanities, Social Sciences and Cultural Industries, University of Parma, Parma, Italy
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18
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Menashe-Grinberg A, Atzaba-Poria N. The predictors of change in reflective parenting therapy: Uncovering the influence of parental reflective functioning and child temperament in predicting the improvement in parent-child relationship and child outcome following DUET group intervention. Dev Psychopathol 2023; 35:1901-1912. [PMID: 36537004 DOI: 10.1017/s0954579422000566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Parental reflective functioning (PRF) is the ability of parents to understand their child's behavior in light of underlying mental processes; it is a core element in the parent-child relationship. RF is also considered crucial for self-regulation for both parents and their children. We investigated the relationship between improvement in PRF after DUET group intervention (a RF-based intervention) and improvement in the parent-child interaction, child RF, and child adjustment, and we examined whether these improvements were distinct for children with different temperamental traits (e.g., effortful control). Eighty-four parents completed the DUET program and were assessed before and after the intervention. PRF was measured using observation (mind-mindedness) and a questionnaire. Statistical analysis included hierarchical regression and moderation of regression analysis. Results showed that improvement in the parent-child interaction, child RF, and child behavioral problems were related to improvement in PRF. Furthermore, we found that child temperament acted as a moderator in the link between PRF and child RF, supporting a vantage sensitivity model, meaning that it was the more sensitive children who benefitted the most as a result of the positive change in their parents' RF. Clinical and future directions of this study are discussed.
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Affiliation(s)
| | - Naama Atzaba-Poria
- Department of Psychology, Ben-Gurion University of the Negev, Beer Sheva, Israel
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Dinzinger A, Ismair S, Brisch KH, Sperl W, Deneault AA, Nolte T, Hitzl W, Priewasser B. Mentalizing in first-time fathers: reflective functioning as a mediator between attachment representation and sensitivity. Attach Hum Dev 2023; 25:544-565. [PMID: 37815537 DOI: 10.1080/14616734.2023.2258354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Accepted: 09/09/2023] [Indexed: 10/11/2023]
Abstract
Sensitivity in parent-child interaction is essential for child development. Since fathers are increasingly involved in childrearing, identifying factors leading to paternal sensitivity is crucial. We examined the relation between attachment representation and reflective functioning (RF) as factors influencing paternal sensitivity in a longitudinal study including N = 40 first-time fathers (Mage = 33) and their 6-month-old children. We used the Adult Attachment Interview during pregnancy to assess paternal attachment representation and general RF, the Parental Development Interview to assess fathers' parental RF, and the Emotional Availability Scale to measure sensitivity at child's age of 6 month. Data show that secure paternal attachment representation, high general and parental RF are associated with higher levels of paternal sensitivity. Further, parental RF mediates the association between attachment representation and paternal sensitivity. These findings contribute to the identification of a causal interplay in that they suggest an explanatory effect of RF on the association between fathers' attachment representation, and sensitivity.
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Affiliation(s)
- Antonia Dinzinger
- Institute for Early Life Care, Paracelsus Medical University, Salzburg, Austria
- Department of Pediatrics, University Hospital Salzburg, Paracelsus Medical University, Salzburg, Austria
| | - Selina Ismair
- Institute for Early Life Care, Paracelsus Medical University, Salzburg, Austria
- Department of Pediatrics, University Hospital Salzburg, Paracelsus Medical University, Salzburg, Austria
| | - Karl Heinz Brisch
- Institute for Early Life Care, Paracelsus Medical University, Salzburg, Austria
- Dr. von Hauner Children's Hospital Ludwig Maximilians University, Munich, Germany
| | - Wolfang Sperl
- Department of Pediatrics, University Hospital Salzburg, Paracelsus Medical University, Salzburg, Austria
| | | | - Tobias Nolte
- Research Department for Clinical, Educational and Health Psychology, University College London, UK
| | - Wolfgang Hitzl
- Research and Innovation Management, Biostatistics, Paracelsus Medical University, Salzburg, Austria
| | - Beate Priewasser
- Institute for Early Life Care, Paracelsus Medical University, Salzburg, Austria
- Department of Pediatrics, University Hospital Salzburg, Paracelsus Medical University, Salzburg, Austria
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Salaminios G, Sprüngli-Toffel E, Michel C, Morosan L, Eliez S, Armando M, Fonseca-Pedrero E, Derome M, Schultze-Lutter F, Debbané M. The role of mentalizing in the relationship between schizotypal personality traits and state signs of psychosis risk captured by cognitive and perceptive basic symptoms. Front Psychiatry 2023; 14:1267656. [PMID: 37810595 PMCID: PMC10557948 DOI: 10.3389/fpsyt.2023.1267656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 09/04/2023] [Indexed: 10/10/2023] Open
Abstract
Objective Schizotypal traits and disturbances in mentalizing (the capacity to understand the mental states driving one's own and others' behaviors) have been implicated in increased vulnerability for psychosis. Therefore, we explored the associations linking schizotypal traits, mentalizing difficulties and their interactions to clinical high-risk for psychosis (CHR-P), as captured by the Basic Symptoms (BS) approach, during adolescence and young adulthood. Methods Eighty-seven adolescents and young adults from the general population (46% male, 44% female; age: 14-23 years) were assessed with the Schizophrenia Proneness Interview (SPI-CY/A) for 11 perceptive and cognitive BS, with the Schizotypal Personality Questionnaire (SPQ) for schizotypal traits, and with the Reflective Functioning Questionnaire (RFQ) for self-reported mentalizing abilities. The RFQ evaluates the level of certainty (RFQc scale) and uncertainty (RFQu scale) with which individuals use mental state information to explain their own and others' behaviors. Results Logistic regression models showed significant positive effects of the SPQ disorganization scale on perceptive BS and of the SPQ interpersonal scale on cognitive BS. Post-hoc analyses revealed that schizotypal features pertaining to odd speech and social anxiety, respectively, were associated with perceptive and cognitive BS. Furthermore, higher scores on the RFQu scale and lower scores on the RFQc scale independently explained the presence of cognitive BS. Finally, significant interaction effects between RFQc and SPQ odd speech on perceptive BS, and between RFQc and SPQ social anxiety on cognitive BS were found. Conclusion Our findings suggest that schizotypal traits and mentalizing significantly relate both independently and through their interactions to the presence of cognitive and perceptive BS included in CHR-P criteria. Furthermore, mentalizing dysfunction may contribute in the relation between schizotypal traits and early state signs of CHR-P. Mentalizing may support both detection and early treatment of CHR-P among adolescents and young adults who present with trait risk for psychosis.
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Affiliation(s)
- George Salaminios
- Research Department of Clinical, Educational and Health Psychology, University College London, London, United Kingdom
- Research Department, British Association for Counselling and Psychotherapy, Lutterworth, United Kingdom
| | - Elodie Sprüngli-Toffel
- Developmental Clinical Psychology Research Unit, Faculty of Psychology and Educational Sciences, University of Geneva, Geneva, Switzerland
- Developmental Imaging and Psychopathology Lab, Department of Psychiatry, University of Geneva School of Medicine, Geneva, Switzerland
- Department of Psychiatry, Lausanne University Hospital (CHUV), Lausanne, Switzerland
- Department of Psychiatry, University of Geneva, Geneva, Switzerland
| | - Chantal Michel
- Developmental Clinical Psychology Research Unit, Faculty of Psychology and Educational Sciences, University of Geneva, Geneva, Switzerland
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Larisa Morosan
- Developmental Clinical Psychology Research Unit, Faculty of Psychology and Educational Sciences, University of Geneva, Geneva, Switzerland
- Developmental Imaging and Psychopathology Lab, Department of Psychiatry, University of Geneva School of Medicine, Geneva, Switzerland
| | - Stephan Eliez
- Developmental Clinical Psychology Research Unit, Faculty of Psychology and Educational Sciences, University of Geneva, Geneva, Switzerland
| | - Marco Armando
- Department of Psychiatry, Lausanne University Hospital (CHUV), Lausanne, Switzerland
| | | | - Melodie Derome
- Translational Research Center, University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Frauke Schultze-Lutter
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
- Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich-Heine-University, Düsseldorf, Germany
- Department of Psychology, Faculty of Psychology, Airlangga University, Surabaya, Indonesia
| | - Martin Debbané
- Research Department of Clinical, Educational and Health Psychology, University College London, London, United Kingdom
- Developmental Clinical Psychology Research Unit, Faculty of Psychology and Educational Sciences, University of Geneva, Geneva, Switzerland
- Developmental Imaging and Psychopathology Lab, Department of Psychiatry, University of Geneva School of Medicine, Geneva, Switzerland
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21
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Osborne J, Mattiske J, Winter A, Sved Williams A. Reflective functioning and mother-infant relationships among mothers with Borderline Personality Disorder post-therapy. Infant Ment Health J 2023; 44:679-690. [PMID: 37322386 DOI: 10.1002/imhj.22071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Revised: 05/28/2023] [Accepted: 05/29/2023] [Indexed: 06/17/2023]
Abstract
The stressful nature of parenting infants exacerbates the characteristics of Borderline Personality Disorder (BPD). Consequently, mothers with BPD tend to be emotionally dysregulated, respond impulsively to their infants, and have poorer mother-infant relationships. Few parenting interventions target the specific skill deficits observed in mothers with BPD. This study explored the differences in parental reflective functioning (PRF) and mother-infant relationship quality at baseline and following a 24-week, group parenting intervention for mothers with BPD. PRF and mother-infant relationship quality were assessed from quantitative (N = 23) and qualitative (N = 32) perspectives. Quantitative data (Parental Reflective Functioning Questionnaire) showed a significant improvement in one of the three subscales, Interest and Curiosity, between baseline and post-intervention, and a significant moderate positive association between the subscale Certainty of Mental States and maternal-infant interaction quality post-intervention. Improvements in mother-infant relationship quality were not evident from the observational measure, Nursing Child Assessment Satellite Teaching scale. In contrast, semi-structured interview qualitative data found maternal improvements in parental reflection, coping strategies implemented post-intervention, and quality of mother-infant relationships. Overwhelmingly positive intervention feedback suggested perceived maternal benefits of group format and skills taught. Future studies with larger sample sizes would allow further clarification of such parenting interventions for mothers with BPD.
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Affiliation(s)
- Jo Osborne
- College of Education, Psychology and Social Work, Flinders University, Adelaide, South Australia, Australia
| | - Julie Mattiske
- College of Education, Psychology and Social Work, Flinders University, Adelaide, South Australia, Australia
| | - Amelia Winter
- Helen Mayo House, Women's and Children's Health Network, Adelaide, South Australia, Australia
- Department of Psychiatry, University of Adelaide, Adelaide, South Australia, Australia
| | - Anne Sved Williams
- Helen Mayo House, Women's and Children's Health Network, Adelaide, South Australia, Australia
- Department of Psychiatry, University of Adelaide, Adelaide, South Australia, Australia
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22
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De Palma M, Rooney R, Izett E, Mancini V, Kane R. The relationship between parental mental health, reflective functioning coparenting and social emotional development in 0-3 year old children. Front Psychol 2023; 14:1054723. [PMID: 37325734 PMCID: PMC10267873 DOI: 10.3389/fpsyg.2023.1054723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Accepted: 03/03/2023] [Indexed: 06/17/2023] Open
Abstract
Introduction The transition to parenthood is a high-risk period for many parents and is an important period for child development. Research has identified that parental mental health, reflective functioning (capacity to consider mental states of oneself and others) and coparenting (capacity to work together well as a parenting team) may be particularly significant predictors of later child outcomes, however these factors have seldom been considered together. The present study therefore aimed to investigate the relationship between these factors and the extent to which they predict child social emotional development. Methods Three hundred and fifty parents of infants aged 0 to 3 years 11 months were recruited to complete an online Qualtrics questionnaire. Results Results indicate that both positive coparenting and parental reflective functioning (Pre-mentalizing and Certainty subscales) were found to significantly predict child development. General reflective functioning (Uncertainty subscale) predicted parental depression and anxiety, however unexpectedly, parental mental health was not a significant predictor of child development, but did predict coparenting. General reflective functioning (Certainty subscale) was also found to predict coparenting, which in turn was found to predict parental reflective functioning. We found an indirect effect of general reflective functioning (Certainty) on child SE development via parental reflective functioning (Pre-mentalizing). We also found an indirect effect of negative coparenting on child development via parental reflective functioning (Pre-mentalizing). Discussion The current results support a growing body of research highlighting the important role reflective functioning plays in child development and wellbeing as well as parental mental health and the interparental relationship.
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Affiliation(s)
- Mia De Palma
- Discipline of Psychology, School of Population Health, Curtin University, Perth, WA, Australia
| | - Rosanna Rooney
- Discipline of Psychology, School of Population Health, Curtin University, Perth, WA, Australia
| | - Elizabeth Izett
- Discipline of Psychology, School of Population Health, Curtin University, Perth, WA, Australia
| | - Vincent Mancini
- Discipline of Psychology, School of Population Health, Curtin University, Perth, WA, Australia
- Telethon Kids Institute, Perth, WA, Australia
- Division of Paediatrics, UWA Medical School, University of Western Australia, Perth, WA, Australia
| | - Robert Kane
- Discipline of Psychology, School of Population Health, Curtin University, Perth, WA, Australia
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Lowell AF, DeCoste C, Dalton R, Dias H, Borelli JL, Martino S, McMahon TJ, Suchman NE. Mothering from the Inside Out: Results of a community-based randomized efficacy trial testing a mentalization-based parenting intervention for mothers with addictions. Infant Ment Health J 2023; 44:142-165. [PMID: 36862381 PMCID: PMC10050102 DOI: 10.1002/imhj.22043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 12/22/2022] [Accepted: 01/12/2023] [Indexed: 03/03/2023]
Abstract
Mothering from the Inside Out (MIO) is a mentalization-based parenting intervention developed to address challenges common among mothers experiencing substance use disorders (SUDs) and previously deemed effective when delivered by research clinicians. This randomized clinical trial was designed to test the efficacy of MIO when delivered by community-based addiction counselors in Connecticut, USA. Ninety-four mothers [M(SD)age = 31.01(4.01) years; 75.53% White] caring for a child 11-60 months of age were randomly assigned to participate in 12 sessions of either MIO or psychoeducation. Caregiving, psychiatric, and substance use outcomes were assessed repeatedly from baseline through 12-week follow-up. Mothers who participated in MIO showed decreased certainty about their child's mental states, and decreased depression; their children demonstrated increased clarity of cues. Participation in MIO was not associated with the same degree of improvement that was observed in prior trials where MIO was delivered by research clinicians. However, when delivered by community-based clinicians, MIO may be protective against a deterioration in caregiving over time often seen in mothers with addictions. The drop in efficacy of MIO in this trial raises questions about intervention-intervenor fit. Research should examine factors influencing MIO effectiveness to close the science-to-service gap common in the dissemination of empirically validated interventions.
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Affiliation(s)
- Amanda F. Lowell
- Yale Child Study Center, Yale School of Medicine, New Haven, Connecticut, USA
- Yale Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut, USA
| | - Cindy DeCoste
- Yale Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut, USA
| | - Rachel Dalton
- Yale Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut, USA
- The APT Foundation, Inc., New Haven, Connecticut, USA
| | - Hailey Dias
- Yale Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut, USA
- The APT Foundation, Inc., New Haven, Connecticut, USA
| | - Jessica L. Borelli
- Department of Psychological Science, School of Social Ecology, University of California, Irvine, Irvine, California, USA
| | - Steve Martino
- Yale Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut, USA
- VA Connecticut Healthcare System, West Haven, Connecticut, USA
| | - Thomas J. McMahon
- Yale Child Study Center, Yale School of Medicine, New Haven, Connecticut, USA
- Yale Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut, USA
| | - Nancy E. Suchman
- Yale Child Study Center, Yale School of Medicine, New Haven, Connecticut, USA
- Yale Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut, USA
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24
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Borelli JL, DeCoste C, McMahon TJ. Enhancing parental reflective functioning: A special tribute to the life and work of Nancy E. Suchman, PhD. Infant Ment Health J 2023; 44:137-141. [PMID: 36857483 DOI: 10.1002/imhj.22049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Accepted: 02/14/2023] [Indexed: 03/03/2023]
Abstract
Nancy E. Suchman's contributions to the fields of infant mental health, maternal reflective functioning, and attachment-based intervention will have long-lasting impacts. In particular, through the development and dissemination of her intervention program, Mothering from the Inside Out (MIO), she innovated a way of working with mothers with substance use disorders that represented a paradigm shift within the field of addiction. In this introduction to the special issue, written to honor her life and work, we review Nancy's background and briefly describe her academic accomplishments. The special issue contains nine qualitative and quantitative research reports written by Nancy's colleagues and their collaborators. All nine papers pertain to the theme of understanding, measuring, and promoting parents' capacity for reflective functioning. Four provide findings that advance our understanding of parental reflective functioning. The other five highlight insights from continuing evaluations of MIO, including new adaptations of the model. To introduce the special issue, we provide an overview of the scope of the work done within these projects. Finally, the special issue concludes with two commentaries contributed by Linda Mayes and Arietta Slade, leading scholars within the field who were also Nancy's close colleagues. Both provide insight into Nancy's impact on the field.
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Affiliation(s)
- Jessica L Borelli
- Department of Psychological Science, School of Social Ecology, University of California, Irvine, California, USA
| | - Cindy DeCoste
- Yale School of Nursing, West Haven, Connecticut, USA
| | - Thomas J McMahon
- Department of Psychiatry and Child Study Center, Yale School of Medicine, New Haven, Connecticut, USA
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25
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Stover CS, Farren A, Campbell R, Day MJ, Sernyak Z. Self-reported reflective functioning and father-child interactions in a sample of fathers who have used intimate partner violence. Infant Ment Health J 2023; 44:255-267. [PMID: 36860128 PMCID: PMC10901457 DOI: 10.1002/imhj.22044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Accepted: 01/14/2023] [Indexed: 03/03/2023]
Abstract
Reflective functioning (RF) has been found to be associated with mother-child interactions, but less is known about the association of fathers' self and child-focused RF and father-child relationships. Fathers who have histories of intimate partner violence (IPV) are known to have poor RF, which may impact their father-child interactions. The current study was designed to examine how types of RF are associated with father-child relationships. Pretreatment assessments and recorded, coded father-child play interactions were used to examine associations among fathers' history of adverse childhood experiences (ACES), RF and coded father-child play interactions in a sample of 47 fathers with a history of IPV use in the last 6 months with their coparent. Fathers' ACES and their child's mental states (CM) were associated with father-child dyadic play interactions. Fathers with greater ACES and higher scores on CM had the most dyadic tension and constriction during play interactions. Those with high ACES but low CM had scores similar to those with low ACES and low CM. These results indicate that fathers who have used IPV and have a history of significant adversity may benefit from interventions to increase their child-focused RF and further improve their interactions with their children.
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Affiliation(s)
- Carla S Stover
- Yale University School of Medicine, Child Study Center, New Haven, Connecticut, USA
| | - Angela Farren
- Yale University School of Medicine, Child Study Center, New Haven, Connecticut, USA
| | - Ryan Campbell
- Department of Psychology, Quinnipiac University, Hamden, Connecticut, USA
| | - Michele J Day
- Department of Psychology, University of New Haven, West Haven, Connecticut, USA
| | - Zoe Sernyak
- Yale University School of Medicine, Child Study Center, New Haven, Connecticut, USA
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Carlone C, Milan S, Decoste C, Borelli JL, McMahon TJ, Suchman NE. Self-report measure of parental reflective functioning: A study of reliability and validity across three samples of varying clinical risk. Infant Ment Health J 2023; 44:240-254. [PMID: 36857469 DOI: 10.1002/imhj.22046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Revised: 12/29/2022] [Accepted: 01/12/2023] [Indexed: 03/03/2023]
Abstract
The Parental Reflective Functioning Questionnaire (PRFQ) provides an efficient way to measure a parent's capacity to recognize their child's mental states and to understand the relationship between underlying mental states and behavior. To date, limited work evaluates its psychometric properties beyond initial validation studies. Here we examined the reliability and validity of the PRFQ in three samples of varying clinical risk (e.g., community sample, previous mental health diagnosis, substance use disorder diagnosis). Across samples, the majority (e.g., 75%-78%) of mothers identified as White; all mothers were from the USA. We compared the PRFQ to task-based measures of mentalization, the Parent Development Interview (PDI), and measures of the parent-child relationship. The PRFQ was a reliable measure across samples, and it was associated in theoretically consistent ways with task-based measures of mentalization. Parental RF across the PDI and PRFQ were not highly correlated in a sample of mothers with substance use disorders. Existing RF measures may be tapping into a different component of the broader construct of parental reflective functioning (PRF). The PRFQ was further validated by demonstrating relationships with parent-report measures of the parent-child relationship. Taken together, these findings provide additional support for the reliability and validity of the PRFQ.
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Affiliation(s)
- Christina Carlone
- Department of Psychological Sciences, College of Liberal Arts and Sciences, University of Connecticut, Storrs, Connecticut, USA
| | - Stephanie Milan
- Department of Psychological Sciences, College of Liberal Arts and Sciences, University of Connecticut, Storrs, Connecticut, USA
| | - Cindy Decoste
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Jessica L Borelli
- Department of Psychological Science, University of California, Irvine, California, USA
| | - Thomas J McMahon
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA.,Yale Child Study Center, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Nancy E Suchman
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA.,Yale Child Study Center, Yale University School of Medicine, New Haven, Connecticut, USA
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27
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Borelli JL, Kazmierski KFM, Gaskin GE, Kerr ML, Smiley PA, Rasmussen HF. Savoring interventions for mothers of young children: Mechanisms linking relational savoring and personal savoring to reflective functioning. Infant Ment Health J 2023; 44:200-217. [PMID: 36811971 DOI: 10.1002/imhj.22038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2023] [Accepted: 11/19/2022] [Indexed: 02/24/2023]
Abstract
Parenting interventions can improve parenting outcomes, with widespread implications for children's developmental trajectories. Relational savoring (RS) is a brief attachment-based intervention with high potential for dissemination. Here we examine data from a recent intervention trial in order to isolate the mechanisms by which savoring predicts reflective functioning (RF) at treatment follow-up through an examination of the content of savoring sessions (specificity, positivity, connectedness, safe haven/secure base, self-focus, child-focus). Mothers (N = 147, Mage = 30.84 years, SDage = 5.13; Race: 67.3% White/Caucasian, 12.9% other or declined to state; 10.9% biracial/multiracial, 5.4% Asian, 1.4% Native American/Alaska Native, 2.0% Black/African American; Ethnicity: 41.5% Latina) of toddlers (Mage = 20.96 months, SDage = 2.50; 53.5% female) were randomized to four sessions of RS or personal savoring (PS). Both RS and PS predicted higher RF, but through different means. RS was indirectly associated with higher RF through greater connectedness and specificity of savoring content, while PS was indirectly associated with higher RF through greater self-focus in savoring content. We discuss the implications of these findings for treatment development and for our understanding of the emotional experience of mothers of toddlers.
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Affiliation(s)
- Jessica L Borelli
- Department of Psychological Science, University of California, Irvine, California, USA
| | - Kelly F M Kazmierski
- Department of Psychological Science, University of California, Irvine, California, USA
| | - Gerin E Gaskin
- Department of Psychological Science, University of California, Irvine, California, USA
| | - Margaret L Kerr
- Department of Human Development and Family Studies, University of Wisconsin, Madison, Wisconsin, USA
| | - Patricia A Smiley
- Department of Psychology, Pomona College, Claremont, California, USA
| | - Hannah F Rasmussen
- Department of Psychology, University of Southern California, Los Angeles, California, USA
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28
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Fagerbakk SA, Sørhøy SH, Nilsen T, Laugen NJ. Does clinical training improve mentalization skills in future therapists? A comparison of first and last year students of clinical psychology and of engineering. Front Psychol 2023; 14:1066154. [PMID: 36755673 PMCID: PMC9900102 DOI: 10.3389/fpsyg.2023.1066154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Accepted: 01/09/2023] [Indexed: 01/24/2023] Open
Abstract
Objective Mentalization has been suggested as a therapist skill that might be important for therapeutic success. The aim of this study was to explore whether the mentalization capacity of students of clinical psychology differs from other students, and whether last-year students differ from first-year students. Method A total of 297 students participated in this study, recruited from first and last years of psychology and engineering study programs. All participants filled out the MentS, a self-report measure of mentalization capacity. Results No significant differences were found in self-reported mentalization capacity between first and last year students of clinical psychology. The results did however show that first year students of psychology had significantly higher self-reported mentalization skills compared to students of engineering, and higher MentS-scores were associated with gender (female) and higher age. Conclusion The finding that students of clinical psychology rate themselves as having a higher capacity to mentalize compared to students of engineering might suggest that individuals with a higher capacity to mentalize are more likely to engage in clinical psychology and become therapists. However, the lack of significant difference in self-reported mentalization capacity in last year students of clinical psychology compared to first year students might indicate that the Norwegian education in clinical psychology does not succeed in enhancing mentalization in future therapists. Clinical psychology study programs might benefit from targeted mentalization training.
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29
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Testoni I, Palazzo L, Ronconi L, Macelloni T, Calvo V. Strengths and Weaknesses of Children Witnessing Relatives with Amyotrophic Lateral Sclerosis. Children (Basel) 2023; 10. [PMID: 36670690 DOI: 10.3390/children10010140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 12/20/2022] [Accepted: 01/09/2023] [Indexed: 01/12/2023]
Abstract
Research on minors who have a close family member with amyotrophic lateral sclerosis (ALS) is scarce. This study aims to analyze the relationships between reflective function and wellbeing among such children, considering their reflective function, representations of death, and behavioral problems with the following instruments: Reflective Functioning Questionnaire, Testoni Death Representation Scale for Children, Positive and Negative Affect Schedule for Children, and Strengths and Difficulties Questionnaire. Participants were 248 minors divided into the target group (38 children-16 females, 22 males-7-18 years old (M = 11.61, SD = 2.97)) and the control group (210 students-120 females, 90 males 9-14 years old (M = 11.17, SD = 1.33)). Results showed that the target group exhibited more negative affect and hyperactivity. However, they also showed less uncertainty in their mental states. The opportunity to support these minors is discussed.
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30
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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31
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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. Int J Environ Res 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] [What about the content of this article? (0)] [Affiliation(s)] [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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Strifler Y, Zisenwine T, Diamond GM. Parents' reflective functioning and their agreement on treatment goals in attachment-based family therapy for sexual and gender minority young adults and their nonaccepting parents. J Marital Fam Ther 2022; 48:982-997. [PMID: 35018657 DOI: 10.1111/jmft.12581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Revised: 10/22/2021] [Accepted: 12/21/2021] [Indexed: 06/14/2023]
Abstract
This study examined the trajectories of parents' reflective functioning over the course of individual preparatory sessions with the therapist in attachment-based family therapy (ABFT) for Israeli sexual minority young adults and their nonaccepting parents, and whether such reflective functioning was associated with parents' agreement on the goals for subsequent conjoint corrective attachment sessions. Three parents with good agreement on treatment goals were compared to three parents with poor agreement on treatment goals. Parents' in-session reflectivity regarding their child's experience of nonacceptance, and regarding the quality of their relationship with their child, was observationally measured at the session level. Reflective functioning increased over time among those parents who reported good agreement with the treatment goals. There were no changes in parents' reflective functioning in the poor agreement group. Findings suggest the potential importance of facilitating parents' reflective functioning in ABFT, before conducting conjoint corrective attachment sessions. Research and clinical implications are discussed.
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Affiliation(s)
- Yotam Strifler
- Department of Psychology, Ben-Gurion University, Beer-Sheva, Israel
| | - Tamar Zisenwine
- Department of Psychology, Ben-Gurion University, Beer-Sheva, Israel
| | - Gary M Diamond
- Department of Psychology, Ben-Gurion University, Beer-Sheva, Israel
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33
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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Ekeblad A, Holmqvist R, Andersson G, Falkenström F. Change in reflective functioning in interpersonal psychotherapy and cognitive behavioral therapy for major depressive disorder. Psychother Res 2022; 33:342-349. [PMID: 35952325 DOI: 10.1080/10503307.2022.2109443] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/15/2022] Open
Abstract
BACKGROUND Patients with Major Depressive Disorder (MDD) have been found to have restricted capacity for mentalization, and it is possible that this constitutes a vulnerability factor for developing depression. Due to its focus on linking depressive symptomatology to emotions and interpersonal relations, it was hypothesized that Interpersonal Psychotherapy (IPT) would improve mentalization more than Cognitive Behavioral Therapy (CBT). METHODS In a randomized controlled trial of 90 patients undergoing IPT and CBT for MDD, Reflective Functioning (RF) was rated from Adult Attachment and from Depression-Specific Reflective Functioning (DSRF) Interviews before and after therapy. Treatment outcome was assessed using the Beck Depression Inventory-II. RESULTS The interaction between time and treatment approach was statistically significant, with RF improving significantly more in IPT than in CBT. Change in RF was not correlated with change in depression. The difference in DSRF ratings before and after therapy was not statistically significant for any of the treatments. CONCLUSIONS IPT may improve mentalization more than CBT. However, although RF increased significantly in IPT, the mean level was still low after therapy. A limitation of the study is the large amount of post-treatment missing data. More research is needed to understand the potential role of mentalization in symptom reduction.
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Affiliation(s)
- Annika Ekeblad
- Department of Behavioral Sciences and Learning, Linköping University, Linköping, Sweden.,Psychiatric Clinic, Västernorrland County Council, Sundsvall, Sweden
| | - Rolf Holmqvist
- Department of Behavioral Sciences and Learning, Linköping University, Linköping, Sweden
| | - Gerhard Andersson
- Department of Behavioral Sciences and Learning, Linköping University, Linköping, Sweden.,Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden
| | - Fredrik Falkenström
- Department of Behavioral Sciences and Learning, Linköping University, Linköping, Sweden
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Condon EM, Tobon AL, Holland ML, Slade A, Mayes L, Sadler LS. Examining Mothers' Childhood Maltreatment History, Parental Reflective Functioning, and the Long-Term Effects of the Minding the Baby® Home Visiting Intervention. Child Maltreat 2022; 27:378-388. [PMID: 33678048 DOI: 10.1177/1077559521999097] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Research is needed to better understand how childhood maltreatment history affects parental reflective capacities, and whether early childhood interventions help mitigate these effects. We examined associations between childhood maltreatment and current parenting (parental reflective functioning, parenting behaviors) among mothers who participated in a follow-up study (N = 97) of the Minding the Baby® (MTB) randomized control trial. MTB is a home visiting program that aims to help mothers understand their child's mental states (feelings, intentions, needs) by promoting parental reflective functioning. Mothers retrospectively reported childhood maltreatment using the Childhood Trauma Questionnaire. Endorsing a higher number of childhood maltreatment subtypes was associated with less supportive/engaged parenting and higher pre-mentalizing modes, or difficulty with appropriately reflecting on the child's mental states. These relationships were not moderated by participation in the MTB intervention. However, exploratory analyses of individual maltreatment subtypes revealed that participation in MTB may mitigate the harmful effects of childhood emotional abuse on pre-mentalizing modes, specifically. Further research is needed to understand the mechanisms through which early childhood interventions may prevent intergenerational cycles of maltreatment.
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Affiliation(s)
| | - Amalia Londono Tobon
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School, 12321Brown University, Providence, RI, USA
| | | | | | - Linda Mayes
- 12228Yale Child Study Center, New Haven, CT, USA
| | - Lois S Sadler
- 16230Yale School of Nursing, Orange, CT, USA
- 12228Yale Child Study Center, New Haven, CT, USA
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Myers L, Steele H, Steele M, Murphy A. Exploring maternal reflective functioning as a predictor of mother-child dyadic behaviour over time in a clinical context. Res Psychother 2022; 25:594. [PMID: 35532024 PMCID: PMC9153760 DOI: 10.4081/ripppo.2022.594] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Accepted: 04/02/2022] [Indexed: 06/14/2023]
Abstract
The current study examined 20 participants from group attachment based intervention (GABI), who completed the adult attachment interviews (AAI; George, et al., 1985) as part of a RCT to test the efficacy of GABI compared with treatment as usual, in order to explore the possible benefits higher RF for treatment outcome in terms of interactive mother and child behaviour. Mothers' AAIs were analyzed using the reflective functioning (RF) rating scale (Fonagy, et al., 1998), yielding overall RF scores, prompted/demand RF scores, and spontaneous RF scores, and parent-child dyadic interactive behaviour was coded utilizing the coding interactive behaviour (CIB: Feldman, 1998) manual. Children's age ranged from 2-25 months, mean=14 months. 86.7% of the sample identified English as their primary language, with 13.3% identified speaking both Spanish and English. RF in AAIs obtained at intake from some GABI mothers was expected to be linked to the quality of the parent-child interaction (observed with the CIB), at intake (T1), at end-of treatment T2), and at sixmonth follow-up (T3). Results confirmed this impression insofar as lower overall RF was linked to T1 levels of higher intrusiveness from mothers. At end of treatment (T2), mothers' higher spontaneous RF scores were significantly linked to maternal praising (of the child), child positive affect, child alertness. At 6-month follow up (T3), mother's spontaneous RF scores correlated significantly and positively with maternal elaborating with child positive affect. Discussion focuses on the importance of assessing RF in parents entering therapy with their children as it may provide insight into what parent or child behaviours may be targeted. And the RF scores will highlight which mothers need special attention to stimulate their interest and attention to attachment-related processes in themselves, and in their children.
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Andreas S, Plümer P, Reichholf K, Dehoust M, Schulz H, Müllauer P, Rudden MG, Senft B, Gaugeler R, Hayden M. Psychometric evaluation of the German version of the Brief Reflective Functioning Interview. Psychol Psychother 2022; 95:18-33. [PMID: 34415663 PMCID: PMC9292361 DOI: 10.1111/papt.12360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Revised: 07/21/2021] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To measure mentalization in a feasible manner, various instruments have been designed in recent years. The Brief Reflective Functioning Interview (BRFI) is a short interview that is based on the Adult Attachment Interview (AAI). The aim of both studies was to examine the psychometric properties of the German version of the BRFI and to compare them to those of the AAI. METHODS In Study 1, we examined 60 students using the BRFI and the AAI. In Study 2, the validity of the BRFI was examined using a mixed sample of students and patients (N = 149). Trained coders evaluated the Reflective Functioning Scale (RFS) for the BRFI and the AAI. RESULTS We found a significant positive correlation between the RFS total scores of the BRFI and those of the AAI. In addition, both interviews showed excellent internal consistency. We could also show that persons with mental disorders exhibit lower levels of RF score than mentally stable individuals. Women had higher RF scores in the BRFI than men in both samples. Persons whose mentalization capacity was rated below average in either the BRFI or the AAI also reported significantly lower mentalization ability in the self-assessment (p < .01). CONCLUSIONS Our results revealed that the RFS scores measured by the BRFI are highly comparable to those measured by the AAI. Our findings support the results of previous studies, suggesting that the BRFI is a reliable, valid and easy-to-administer alternative to the AAI. PRACTITIONER POINTS The German version of the Brief Reflective Functioning Interview (BRFI) proved to be a reliable and valid instrument for the assessment of reflective functioning that is shorter in terms of time to complete and the evaluation process than the measurement via the Adult Attachment Interview (AAI). Reflective functioning is negatively associated with psychopathology.
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Affiliation(s)
- Sylke Andreas
- Institut für PsychologieUniversität KlagenfurtAustria
| | - Paul Plümer
- Institut für PsychologieUniversität KlagenfurtAustria
| | | | - Maria Dehoust
- Psychosomatische Klinik GinsterhofRosengartenGermany
| | - Holger Schulz
- Department of Medical PsychologyUniversity Medical Center Hamburg‐EppendorfGermany
| | - Pia Müllauer
- Institut für PsychologieUniversität KlagenfurtAustria
| | - Marie G. Rudden
- Berkshire Psychoanalytic InstituteWest StockbridgeMassachusettsUSA
| | - Birgit Senft
- Reha‐Klinik für Seelische Gesundheit und PräventionKlagenfurtAustria
| | | | - Markus Hayden
- Institut für PsychologieUniversität KlagenfurtAustria,Klinik Bad ReichenhallBad ReichenhallGermany
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Zimmer-Gembeck MJ, Rudolph J, Edwards EJ, Swan K, Campbell SM, Hawes T, Webb HJ. The Circle of Security Parenting Program (COS-P): A Randomized Controlled Trial of a Low Intensity, Individualized Attachment-Based Program With at-Risk Caregivers. Behav Ther 2022; 53:208-223. [PMID: 35227399 DOI: 10.1016/j.beth.2021.07.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Revised: 07/20/2021] [Accepted: 07/23/2021] [Indexed: 12/12/2022]
Abstract
The Circle of Security-Parenting Intervention (COS-P; Cooper et al., 2009) is a psychoeducational program for caregivers of young children that has been widely disseminated. The program is founded in attachment theory and relies on computer-delivered content and parent reflection and discussion to teach concepts of safety and security to promote better caregiver-child relationships and child wellbeing. The present study is a randomized controlled trial of COS-P, individually delivered to 85 Australian caregivers (51 COS-P, 34 waitlist control) who reported parenting distress and child disruptive behaviors. Caregivers completed a baseline assessment and repeated the assessment after completion of COS-P or 8 weeks on the waitlist. Caregivers completed surveys to report child symptoms, and parenting stress, anxious and avoidant attachment, reflective functioning, parenting practices, and depressive symptoms. No differences in COS-P vs. waitlist participants were found at baseline. Analyses of complete data (35 COS-P, 25-26 waitlist) revealed a greater decline in caregivers' attachment anxiety and negative parenting relative to waitlist, but only attachment anxiety in intent-to-treat analyses. Other improvements were found, but these extended to both the COS-P and waitlist conditions and did not differ between conditions. Overall, effects of COS-P were small and rarely significant, suggesting the need to consider alternative programs that have evidence of effectiveness when providing services to at-risk families.
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Affiliation(s)
| | | | | | - Kellie Swan
- Griffith University, School of Applied Psychology and Menzies Health Institute of Queensland
| | - Shawna M Campbell
- Griffith University, School of Applied Psychology and Menzies Health Institute of Queensland
| | - Tanya Hawes
- Griffith University, School of Applied Psychology
| | - Haley J Webb
- Griffith University, School of Applied Psychology
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Alismail F, Stacks AM, Wong K, Brown S, Beeghly M, Thomason M. Maternal caregiving representations of the infant in the first year of life: Associations with prenatal and concurrent reflective functioning. Infant Ment Health J 2022; 43:311-327. [PMID: 34879170 PMCID: PMC9435997 DOI: 10.1002/imhj.21951] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Accepted: 11/02/2021] [Indexed: 12/13/2022]
Abstract
Few studies have examined whether maternal caregiving representations are associated with maternal reflective functioning (MRF), especially when MRF is evaluated longitudinally beginning in pregnancy. This study addresses this gap by evaluating whether prenatal and postnatal MRF are associated with mothers' caregiving representations assessed at 7 months postpartum, and by exploring theoretically unexpected MRF scores in each of the representational categories. Forty-seven mothers were recruited during their last trimester of pregnancy from an obstetrics clinic at a university hospital located in a large mid-western city in the United States. During pregnancy, mothers completed the Pregnancy Interview, and at 7 months postpartum they completed the Parent Development Interview (PDI) and the Working Model of the Child Interview. Results indicate that higher prenatal and postnatal MRF increased the odds of being classified as balanced versus disengaged. At 7 months, MRF also increased the odds of being balanced vs. distorted. Ten mothers who were classified as balanced or distorted had unexpected prenatal MRF scores, and six mothers had unexpected MRF scores when representations were assessed concurrently. Mothers classified as balanced with low MRF scores tended to have a low level of education, whereas mothers classified as distorted with high MRF scores had responses that were hostile, helpless, and role-reversed.
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Affiliation(s)
- Fatimah Alismail
- Merrill-Palmer Skillman Institute, Wayne State University, Detroit, Michigan, USA
| | - Ann M. Stacks
- Merrill-Palmer Skillman Institute, Wayne State University, Detroit, Michigan, USA
| | - Kristyn Wong
- Department of Psychology Michigan State University, East Lansing, Michigan, USA
| | - Suzanne Brown
- School of Social Work, Wayne State University, Detroit, Michigan, USA
| | - Marjorie Beeghly
- Department of Psychology, Wayne State University, Detroit, Michigan, USA
| | - Moriah Thomason
- Department of Child and Adolescent Psychiatry, New York University Langone Health, New York, USA
- Department of Population Health, New York University Langone Health, New York, USA
- Neuroscience Institute, NYU Langone Health, New York, USA
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40
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Barberis N, Cannavò M, Calaresi D, Verrastro V. Reflective functioning and Alexithymia as mediators between attachment and psychopathology symptoms: cross-sectional evidence in a community sample. PSYCHOL HEALTH MED 2022; 28:1251-1262. [PMID: 35193443 DOI: 10.1080/13548506.2022.2045331] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
This study sought to examine the role of Reflective Functioning and Alexithymia as mediators in the association between Attachment and Psychopathology. Questionnaires were administered to 1099 adults aged between 18 and 30 years. Results showed relations between Attachment Anxiety, Reflective Functioning, Alexithymia and Psychopathology. Moreover, Alexithymia was a mediator between Attachment, Reflective Functioning and Psychopathology.Current results provided evidence of the role of both Reflective Functioning and Alexithymia in the relationship between Attachment and Psychopathology. Implications are discussed.
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Affiliation(s)
- Nadia Barberis
- Dipartimento Di Scienze Della Salute, Università Degli Studi Magna Graecia Di Catanzaro, Catanzaro, Italy
| | - Marco Cannavò
- Dipartimento Di Scienze Della Salute, Università Degli Studi Magna Graecia Di Catanzaro, Catanzaro, Italy
| | - Danilo Calaresi
- Dipartimento Di Medicina Clinica E Sperimentale, Università Degli Studi Di Messina, Messina, Italy
| | - Valeria Verrastro
- Dipartimento Di Scienze Della Salute, Università Degli Studi Magna Graecia Di Catanzaro, Catanzaro, Italy
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Londono Tobon A, Condon E, Sadler LS, Holland ML, Mayes LC, Slade A. School age effects of Minding the Baby-An attachment-based home-visiting intervention-On parenting and child behaviors. Dev Psychopathol 2022; 34:55-67. [PMID: 32907642 DOI: 10.1017/s0954579420000905] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Multiple interventions have been developed to improve the caregiver-child relationship as a buffer to the effects of early life adversity and toxic stress. However, relatively few studies have evaluated the long-term effects of these early childhood interventions, particularly on parenting and childhood behaviors. Here we describe the early school-age follow-up results of a randomized controlled trial of Minding the Baby ® (MTB), a reflective, attachment-based, trauma-informed, preventive home-visiting intervention for first-time mothers and their infants. Results indicate that mothers who participated in MTB are less likely to show impaired mentalizing compared to control mothers two to eight years after the intervention ended. Additionally, MTB mothers have lower levels of hostile and coercive parenting, and their children have lower total and externalizing problem behavior scores when compared to controls at follow-up. We discuss our findings in terms of their contribution to understanding the long-term parenting and childhood socio-emotional developmental effects of early preventive interventions for stressed populations.
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Affiliation(s)
| | | | - Lois S Sadler
- Yale Child Study Center, Yale University School of Medicine, New Haven, CT, USA
- Yale School of Nursing, New Haven, CT, USA
| | | | - Linda C Mayes
- Yale Child Study Center, Yale University School of Medicine, New Haven, CT, USA
| | - Arietta Slade
- Yale Child Study Center, Yale University School of Medicine, New Haven, CT, USA
- Yale School of Nursing, New Haven, CT, USA
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Kahya Y, Munguldar K. Difficulties in Emotion Regulation Mediated the Relationship Between Reflective Functioning and Borderline Personality Symptoms Among Non-Clinical Adolescents. Psychol Rep 2022; 126:1201-1220. [PMID: 35048764 DOI: 10.1177/00332941211061072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The literature has established the associations between reflective functioning (RF), affect regulation, and the development of borderline personality disorder (BPD) symptoms. We aimed to examine the mediator role of difficulties in emotion regulation on the relationship between RF and BPD symptoms in a non-clinical adolescent sample. The sample was composed of 546 Turkish adolescents with a mean age of 16.18 (SD = 1.67). Of the sample, 62.5% were adolescent girls and 37.5% of boys. In the present cross-sectional research, volunteer adolescents along with parental permission filled out Socio-Demographics Form, Reflective Functioning Questionnaire, Difficulties in Emotion Regulation Scale, and Borderline Personality Inventory on paper during counseling sessions at schools. Process macro was used to conduct mediation analyses. Compromised RF was related to an increase in adolescent borderline personality symptoms, both directly and indirectly via difficulties in emotion regulation. In this non-clinical adolescent sample, a lower degree of certainty, as well as a higher degree of uncertainty about the mental states, were related to a propensity to emotion dysregulation, specifically experiencing emotions less clearly, approaching emotions impulsively, and facing emotions without a modulation strategy. These associations were in turn related to an increase in borderline personality symptoms. The present research results suggest RF and emotion regulation problems as one field of early intervention for adolescents with BPD symptoms.
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Affiliation(s)
- Yasemin Kahya
- Faculty of Social Sciences and Humanities, Department of Psychology, RinggoldID:390121Social Sciences University of Ankara, Ankara, Turkey
| | - Koret Munguldar
- Department of Clinical Psychology, The Center for Attachment Research, RinggoldID:5926The New School for Social Research, New York, NY, USA
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Enav Y, Hardan AY, Gross JJ. Cognitive reappraisal training for parents of children with autism spectrum disorder. Front Psychiatry 2022; 13:995669. [PMID: 36386964 PMCID: PMC9650555 DOI: 10.3389/fpsyt.2022.995669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2022] [Accepted: 09/20/2022] [Indexed: 11/30/2022] Open
Abstract
Parents of children with autism spectrum disorder (ASD) experience higher stress levels than those of typically developing children. The goal of the current study was to examine whether a mentalization-based intervention would enhance parental cognitive reappraisal, an adaptive form of emotion regulation associated with lower levels of stress. Findings from 27 parents who completed a short training indicated an improvement in cognitive reappraisal. In exploratory analyses, two different types of reappraisal were examined. The intervention-related improvement was found mainly with one type of reappraisal, namely reflective reappraisal that consist of cognitive reappraisal with mentalization characteristics. In light of the evidence indicating that high cognitive reappraisal and high reflective functioning are associated with quality caregiving, findings from the current study suggesting that a brief mentalization-based intervention supports ASD parents' cognitive reappraisal with mentalization characteristics are promising and warrant further investigation.
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Affiliation(s)
- Yael Enav
- Department of Counseling and Human Development, University of Haifa, Haifa, Israel
| | - Antonio Y Hardan
- Department of Psychology, Stanford University, Stanford, CA, United States
| | - James J Gross
- Department of Psychology, Stanford University, Stanford, CA, United States
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44
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Zeeck A, Taubner S, Gablonski TC, Lau I, 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, Zettl M, Meier AF, Hartmann A. In-Session-Reflective-Functioning in Anorexia Nervosa: An Analysis of Psychotherapeutic Sessions of the ANTOP Study. Front Psychiatry 2022; 13:814441. [PMID: 35677868 PMCID: PMC9169151 DOI: 10.3389/fpsyt.2022.814441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2021] [Accepted: 04/19/2022] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE Previous research suggests that patients with anorexia nervosa (AN) show an impaired capacity to mentalize (reflective functioning, RF). RF is discussed as a possible predictor of outcome in psychotherapeutic processes. The study aimed to explore RF in sessions of patients with AN and its association with outcome and type of treatment. METHODS A post-hoc data analysis of selected cases from a randomized trial on outpatient psychotherapy for AN was conducted. Transcripts from 84 sessions of 28 patients (early phase, middle phase, and end of treatment) were assessed using the In-Session-Reflective-Functioning-Scale [14 cognitive-behavior therapy, enhanced (CBT-E); 14 focal psychodynamic therapy (FPT); 16 with good, 12 with poor outcome after 1 year]. Relations between the level of RF, type of treatment, and outcome were investigated using mixed linear models. Additionally, associations with depressive symptoms, weight gain, and therapeutic alliance were explored. RESULTS Mean in-session RF was low. It was higher in FPT when compared to CBT-E treatments. The findings point to an association between RF increase and a positive outcome. An increase in BMI in the first half of treatment was associated with higher subsequent in-session RF. There was no association between RF and depressive symptoms or the therapeutic alliance. DISCUSSION Patients with AN show a low capacity to mentalize in sessions, which seems to be at least partly dependent on the degree of starvation. The results suggest a possible relationship between an increase in in-session RF and outcome, which has to be replicated by further studies.
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Affiliation(s)
- Almut Zeeck
- Center for Mental Health, Department of Psychosomatic Medicine und Psychotherapy, Faculty of Medicine, University of Freiburg, Freiburg im Breisgau, Germany
| | - Svenja Taubner
- Center for Psychosocial Medicine, Institute for Psychosocial Prevention, University Hospital, Heidelberg, Germany
| | - Thorsten C Gablonski
- Department for Psychology, Psychotherapy and Psychoanalysis, Institute for Psychology, University of Klagenfurth, Klagenfurth, Austria
| | - Inga Lau
- Center for Mental Health, Department of Psychosomatic Medicine und Psychotherapy, Faculty of Medicine, University of Freiburg, Freiburg im Breisgau, Germany
| | - Stephan Zipfel
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tuebingen, Tuebingen, Germany
| | - Wolfgang Herzog
- Center for Psychosocial Medicine, Department of General Internal Medicine and Psychosomatics, Heidelberg University Hospital, Heidelberg, Germany
| | - Beate Wild
- Center for Psychosocial Medicine, Department of General Internal Medicine and Psychosomatics, Heidelberg University Hospital, Heidelberg, Germany
| | - Hans-Christoph Friederich
- Center for Psychosocial Medicine, Department of General Internal Medicine and Psychosomatics, 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 Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Markus Burgmer
- Department of Psychosomatic Medicine and Psychotherapy, LWL-Hospital Muenster, Muenster, Germany.,Department of Psychosomatic Medicine and Psychotherapy, University Hospital Muenster, Muenster, Germany
| | - Andreas Dinkel
- Department of Psychosomatic Medicine and Psychotherapy, 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
| | - Max Zettl
- Center for Psychosocial Medicine, Institute for Psychosocial Prevention, University Hospital, Heidelberg, Germany
| | - Alexander F Meier
- Center for Mental Health, Department of Psychosomatic Medicine und Psychotherapy, Faculty of Medicine, University of Freiburg, Freiburg im Breisgau, Germany
| | - Armin Hartmann
- Center for Mental Health, Department of Psychosomatic Medicine und Psychotherapy, Faculty of Medicine, University of Freiburg, Freiburg im Breisgau, Germany
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Fischer-Kern M, Tmej A, Naderer A, Zimmermann J, Nolte T. Failure to resolve loss and compromised mentalizing in female inpatients with major depressive disorder. Attach Hum Dev 2021; 24:503-524. [PMID: 34952561 DOI: 10.1080/14616734.2021.2015794] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Attachment and mentalizing are central concepts in research on the etiology, course, and treatment of depression. The goal of this cross-sectional study was to clarify the unique value of these constructs in characterizing the presence, severity, and chronicity of depression. We examined 50 female inpatients suffering from Major Depressive Disorder (MDD) in comparison to 47 matched healthy controls regarding their attachment states of mind, mentalizing capacities, and clinical variables indicating depression severity and chronicity (e.g. illness duration, number of hospitalizations). In the group of depressed patients, unresolved attachment with regard to loss was significantly overrepresented. Dimensionally, patients were more disorganized and more insecure, whereas there was no difference on the dismissing-preoccupied dimension between the two groups. Mentalizing was significantly lower in patients than in healthy controls. Logistic regression analysis revealed attachment insecurity, mentalizing deficits, and unresolved loss to be incrementally relevant to predict MDD. Correlations with clinical parameters in the group of depressed patients showed positive associations between mentalizing deficits, attachment insecurity, and variables indicating illness chronicity. Our findings highlight the relevance of the inability to resolve or reappraise loss experiences in depressive states.
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Affiliation(s)
- Melitta Fischer-Kern
- Department of Psychoanalysis and Psychotherapy, Medical University Vienna, Vienna, Austria
| | - Anna Tmej
- Department of Psychoanalysis and Psychotherapy, Medical University Vienna, Vienna, Austria
| | - Andrea Naderer
- Department of Psychoanalysis and Psychotherapy, Medical University Vienna, Vienna, Austria
| | | | - Tobias Nolte
- University College London, Welcome Centre for Human Neuroimaging, Institute of Neurology, London, UK.,Anna Freud National Centre for Children and Families, UK
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Abstract
BACKGROUND It is widely accepted that borderline personality disorder (BPD) is associated with significant impairments in mentalization and theory of mind (ToM) which are considered as closely related concepts by many authors particularly in psychoanalytical circles. However, for understanding interpersonal difficulties in personality disorders, it is important to distinguish neuro-social cognitive impairment from the abnormal meta-social-cognitive style of patients. METHODS The current systematic review aimed to conduct separate meta-analyses of 'mentalization' [reflective functioning (RF] and different aspects of ToM in BPD. A literature search was conducted to locate relevant articles published between January 1990 to July 2021. Random-effect meta-analyses were conducted in 34 studies involving 1448 individuals with BPD and 2006 healthy controls. RESULTS A very large impairment in RF was evident in BPD [d = 1.68, confidence interval (CI) = 1.17-2.19]. In contrast, ToM impairment was modest (d = 0.36, CI = 0.24-0.48). BPD patients underperformed healthy controls in ToM-reasoning (d = 0.44, CI = 0.32-0.56) but not ToM-decoding. Increased HyperToM (d = 0.60, CI = 0.41-0.79) and faux pas recognition (d = 0.62, CI = 0.35-0.90) errors in BPD compared to healthy controls were most robust ToM findings in this meta-analysis. CONCLUSIONS BPD is characterized by very severe deficits in RF and modest and selective abnormalities in ToM. Interpersonal problems and difficulties in processing social information in BPD can be best explained by patients' maldaptive meta-social cognitive style and top-down effects of these abnormalities rather than having a primary neuro-social cognitive deficit.
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Affiliation(s)
- Emre Bora
- Department of Psychiatry, Dokuz Eylul University Medical School, Izmir35340, Turkey
- Department of Neurosciences, Insitiute of Health, Dokuz Eylul University, Izmir, Turkey
- Department of Psychiatry, Melbourne Neuropsychiatry Centre, University of Melbourne and Melbourne Health, Carlton South, Victoria3053, Australia
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47
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Chevalier V, Simard V, Achim J, Burmester P, Beaulieu-Tremblay T. Reflective Functioning in Children and Adolescents With and Without an Anxiety Disorder. Front Psychol 2021; 12:698654. [PMID: 34616333 PMCID: PMC8488373 DOI: 10.3389/fpsyg.2021.698654] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Accepted: 08/16/2021] [Indexed: 11/13/2022] Open
Abstract
Reflective functioning (RF), meaning the capacity to interpret mental states (intentions, emotions, thoughts, desires, and beliefs) underlying one’s own and others’ behaviors, may help understand the dysfunctional self-regulation associated with anxiety disorders. However, research on anxiety and RF in clinical samples is scarce. This study aimed to assess whether mothers’ and youths’ RF was associated with youths’ (a) anxiety disorders and symptoms and (b) internalizing symptoms. Another goal was to explore whether RF predicted anxiety and internalizing symptoms beyond the more commonly established effect of attachment. Canadian children and adolescents aged between 8 and 16years, and their mothers were recruited in an outpatient psychiatric clinic (clinical group with a diagnosed anxiety disorder, n=30, mean age=11.5±2.8years) and in the general population (non-clinical group, n=23, mean age=11.5±2.1years). The Child Attachment Interview was used to assess youths’ attachment along with three dimensions of RF (global, regarding self, regarding others). Mothers’ attachment and RF were assessed with the Adult Attachment Interview. Children’s and adolescents’ anxiety and internalizing symptoms were measured with the Behavior Assessment Scale for Children, second version. The clinical and non-clinical groups did not differ in mothers’ or youths’ RF. However, in the overall sample, youths’ RF regarding themselves and maternal attachment preoccupation were associated with internalizing symptoms. Sequential regression analyses revealed that higher RF regarding self predicted a higher level of self-reported internalizing symptoms, beyond the effect of maternal attachment (β=0.43, p<0.05). This study’s finding suggests that clinically anxious children and adolescents have adequate RF. We propose that the sustained hypervigilance and apprehension associated with anxiety make anxious youths sensitive to their own and others’ mental states. Our findings suggest that psychotherapeutic treatments for anxiety should make use of patients’ RF abilities to help them make sense of their symptoms and thus reduce them.
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Affiliation(s)
- Valérie Chevalier
- Department of Psychology, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Valérie Simard
- Department of Psychology, Université de Sherbrooke, Sherbrooke, QC, Canada.,Research Center of the Sainte-Justine University Hospital, Montreal, QC, Canada
| | - Julie Achim
- Department of Psychology, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Pamela Burmester
- Department of Psychology, Université de Sherbrooke, Sherbrooke, QC, Canada
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48
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Bianco F, Levante A, Petrocchi S, Lecciso F, Castelli I. Maternal Psychological Distress and Children's Internalizing/Externalizing Problems during the COVID-19 Pandemic: The Moderating Role Played by Hypermentalization. Int J Environ Res Public Health 2021; 18:ijerph181910450. [PMID: 34639750 PMCID: PMC8507724 DOI: 10.3390/ijerph181910450] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Revised: 09/19/2021] [Accepted: 09/27/2021] [Indexed: 11/30/2022]
Abstract
In order to explore the psychological impact of the COVID-19 outbreak on the caregiver–child relationship, we investigated the interplay among COVID-19 exposure and children’s internalizing/externalizing problems during the Italian lockdown, hypothesizing a mediation effect played by maternal distress. Additionally, we included maternal reflective functioning (i.e., hypermentalization) as a moderator factor among this interplay. A total of 305 Italian mothers of children aged 6–13 years (M = 10.3; SD = 2.4) filled in an online survey. Findings revealed an indirect effect of maternal COVID-19 exposure on children’s anxious/depressed (k2 = 0.46) and attention problems (k2 = 0.32) via maternal distress. Hypermentalization moderated the impact of maternal COVID-19 exposure on children’s anxious/depressed problems (β = −1.08, p = 0.04). Hypermentalization moderated both the relation between maternal distress and children’s aggressive behaviors (β = 12.226; p < 0.001) and between maternal distress and children’s attention problems (β = 5.617, p < 0.001). We found pivotal significant effects of maternal hypermentalization on children’s anxious/depressed and attention problems, indicating that the higher the mother’s hypermentalization was, the higher the children’s problems were. Our results broaden what we knew on the role of maternal reflective and emotional functioning on children’s emotional/behavioral adjustment during stressful situations.
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Affiliation(s)
- Federica Bianco
- Department of Human and Social Sciences, University of Bergamo, Bergamo 24129, Italy
- Correspondence: (F.B.); (I.C.)
| | - Annalisa Levante
- Department of History, Society, and Human Studies, University of Salento, 73100 Lecce, Italy; (A.L.); (F.L.)
- Lab of Applied Psychology, Department of History, Society, and Human Studies, University of Salento, 73100 Lecce, Italy
| | - Serena Petrocchi
- Faculty of Biomedical Sciences, Università della Svizzera italiana, Via Buffi 13, Lugano 6900, Switzerland;
| | - Flavia Lecciso
- Department of History, Society, and Human Studies, University of Salento, 73100 Lecce, Italy; (A.L.); (F.L.)
- Lab of Applied Psychology, Department of History, Society, and Human Studies, University of Salento, 73100 Lecce, Italy
| | - Ilaria Castelli
- Department of Human and Social Sciences, University of Bergamo, Bergamo 24129, Italy
- Correspondence: (F.B.); (I.C.)
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49
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Tan SLS, Stafford L, Bryant C, Jensen H, Komiti A, Newman L. Subjective experiences of participating in an attachment-based early intervention parenting program. Clin Child Psychol Psychiatry 2021; 26:968-980. [PMID: 33878940 DOI: 10.1177/13591045211008220] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This qualitative study evaluated an attachment-based group parenting program that utilises mentalisation-based approach. The Building Early Attachment and Resilience (BEAR) program was designed to promote parent-child attachment across the perinatal period and has pre- and post-natal arms. The post-natal component targets mothers and infants at risk for early disturbances of attachment to, and emotional interaction. This evaluation study aimed to explore mothers' subjective experiences of the post-natal BEAR program in encouraging mothers' reflection on their role as a parent. Thirteen mothers were interviewed. Transcripts were analysed using thematic analysis, with five themes emerging. Overall, mothers reported that the intervention promoted reflection about the parenting role, contributed to perceptions of improved mother-infant interactions and increased understanding of their infant's internal experiences. The results suggest the BEAR program is acceptable and facilitates the development of secure parent-infant attachment.
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Affiliation(s)
- Sophie Li-Shan Tan
- Melbourne School of Psychological Sciences, The University of Melbourne, VIC, Australia
| | - Lesley Stafford
- Centre for Women's Mental Health, The Royal Women's Hospital, Melbourne, VIC, Australia.,Department of Psychiatry, The University of Melbourne, VIC, Australia
| | - Christina Bryant
- Melbourne School of Psychological Sciences, The University of Melbourne, VIC, Australia
| | - Hannah Jensen
- Centre for Women's Mental Health, The Royal Women's Hospital, Melbourne, VIC, Australia
| | - Angela Komiti
- Centre for Women's Mental Health, The Royal Women's Hospital, Melbourne, VIC, Australia.,Department of Psychiatry, The University of Melbourne, VIC, Australia
| | - Louise Newman
- Centre for Women's Mental Health, The Royal Women's Hospital, Melbourne, VIC, Australia.,Department of Psychiatry, The University of Melbourne, VIC, Australia
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50
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Kealy D, Rice SM, Seidler ZE, Oliffe JL, Ogrodniczuk JS. Reflective functioning and men's mental health: Associations with resilience and personal growth initiative. Stress Health 2021; 37:706-714. [PMID: 33486859 DOI: 10.1002/smi.3030] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Revised: 01/14/2021] [Accepted: 01/15/2021] [Indexed: 11/06/2022]
Abstract
Mentalizing, or reflective functioning, refers to the capacity to reflect on one's own and others' mental states in terms of desires, intentions, and feelings. Reflective functioning in men's mental health is poorly understood, particularly in reference to men's resilience and motivation for personal growth. Using a cross-sectional design, the present study investigated impaired reflective functioning in relation to resilience and personal growth initiative among men with mental health concerns. An online sample of 1065 men self-reporting mental health concerns completed measures of reflective functioning, psychological distress, resilience, and personal growth initiative. Logistic regression examined reflective functioning in relation to likely serious mental illness, including interaction with age. Subsequent regression analyses controlled for distress severity in examining associations with resilience and personal growth initiative, and in examining the potential mediating role of reflective functioning. Impaired reflective functioning was significantly associated with serious psychological distress irrespective of age and, after controlling for distress severity, with resilience and personal growth initiative. Moreover, impaired reflective functioning was a significant mediator of the relationship between resilience and personal growth initiative. Findings provide preliminary support for reflective functioning as salient to men's resilience and agency for personal change, indicating a potentially important target in men's mental health work.
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Affiliation(s)
- David Kealy
- Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada
| | - Simon M Rice
- Orygen, Parkville, Victoria, Australia.,Centre for Youth Mental Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Zac E Seidler
- Orygen, Parkville, Victoria, Australia.,Centre for Youth Mental Health, University of Melbourne, Melbourne, Victoria, Australia
| | - John L Oliffe
- School of Nursing, University of British Columbia, Vancouver, British Columbia, Canada.,Department of Nursing, University of Melbourne, Melbourne, Victoria, Australia
| | - John S Ogrodniczuk
- Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada
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