Abstract
Schizotypal trait expression and mentalizing impairments represent key factors associated with increased vulnerability for schizophrenia. In the current study, we analysed the nature of associations linking specific schizotypal personality features to mentalizing difficulties during adolescence. Furthermore, we examined the extent to which mentalizing difficulties mediate the relationship between schizotypal trait features and self-reported thought problems. One hundred and five community adolescents (Mage = 15.72; SD = 1.91) completed a recently developed self-report measure of mentalizing (Reflective Functioning Questionnaire [RFQ]), evaluating the degree of certainty (RFQc-scale) and uncertainty (RFQu-scale) with which individuals utilize mental state information to understand their own and others' behaviour. High scores on the RFQu-scale reflect poor usage of mental state information, while high scores on the RFQc-scale capture adaptive levels of certainty about mental states. Self-report questionnaires were also used to assess schizotypal trait expression, thought problems and symptoms of anxiety/depression. Linear regression models indicated that schizotypal features of social anxiety and odd speech accounted for increased RFQu scores, while odd speech also accounted for reduced RFQc scores. RFQu partially mediated the effects of social anxiety and odd speech on the level of thought problems in the sample. Present findings suggest that schizotypal features that impede interpersonal communication during adolescence are linked to difficulties in mental state understanding. Our study also provides original data suggesting that the effects of social anxiety and odd speech on psychosis-risk may partially depend upon the level of mentalizing uncertainty. Mentalizing difficulties may constitute important clinical assessment and early prevention treatment targets in adolescents who demonstrate schizotypal features.
Highlights
Our study provides original data suggesting that the effects of social anxiety and odd speech on psychosis-risk may partially depend upon the level of mentalizing uncertainty
Contemporary research suggests that clinical psychosis is distally linked with schizotypal trait expression (Chapman, Chapman, Kwapil, Eckblad, & Zinser, 1994; Kwapil, Gross, Silvia, & Barrantes-Vidal, 2013), and more proximally with the breakdown of higher-order cognitive processes pertaining to mentalizing (Kim et al, 2011) – the capacity to understand the intentional mental states driving one's own and others' behaviours (Fonagy & Target, 1996)
In accordance with our hypothesis, the present findings show that interpersonal schizotypal manifestations pertaining to social anxiety are associated to high mentalizing uncertainty
Summary
Contemporary research suggests that clinical psychosis is distally linked with schizotypal trait expression (Chapman, Chapman, Kwapil, Eckblad, & Zinser, 1994; Kwapil, Gross, Silvia, & Barrantes-Vidal, 2013), and more proximally with the breakdown of higher-order cognitive processes pertaining to mentalizing (Kim et al, 2011) – the capacity to understand the intentional mental states driving one's own and others' behaviours (Fonagy & Target, 1996). Meta-analytic investigations indicate that patients with established schizophrenia, first episode sufferers, as well as help-seeking individuals at clinical high-risk for psychosis (CHR), perform poorly in multiple domains of mentalizing, such as ToM, self-monitoring and emotion recognition (Bora & Pantelis, 2013; Brüne, 2005; Sprong, Schothorst, Vos, Hox, & Van Engeland, 2007). Current evidence suggest the presence of a generalized impairment in mentalizing processes across schizophrenia-spectrum disorders
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