Abstract
BackgroundMentalizing, the ability to understand the self and others as well as behaviour in terms of intentional mental states, is impaired in Borderline Personality Disorder (BPD). Evidence for mentalizing deficits in other mental disorders, such as depression, is less robust and these links have never been explored while accounting for the effects of BPD on mentalizing. Additionally, it is unknown whether BPD symptoms might moderate any relationship between depressive symptoms and mentalizing.MethodsUsing multivariate regression modelling on cross-sectional data obtained from a sample of 274 participants recruited from clinical settings, we investigated the association between mentalizing impairment and depression and examined whether this was moderated by the presence and number of concurrent BPD symptoms, while adjusting for socio-demographic confounders.ResultsImpaired mentalizing was associated with depressive symptoms, after adjustment for socio-demographic confounders and BPD symptoms (p = 0.002, β = − 0.18). BPD symptoms significantly moderated the association between impaired mentalizing and depressive symptoms (p = 0.003), with more severe borderline symptoms associated with a stronger effect of poor mentalization on increased depressive symptoms.ConclusionMentalizing impairments occur in depression even after adjusting for the effect of BPD symptoms. Our findings help further characterise mentalizing impairments in depression, as well as the moderating effect of BPD symptoms on this association.. Further longitudinal work is required to investigate the direction of association.
Highlights
Mentalizing refers to the ability to understand behaviours and actions in oneself and others in terms of internal mental states
The number of Borderline Personality Disorder (BPD) symptoms was strongly associated with the severity of depressive symptoms (β = 0.76 (0.68 to 0.84), p < 0.001)
Multivariate associations Following adjustment for age, gender, household income, ethnicity, years in education, current employment and the number of BPD symptoms, impairment in mentalizing remained significantly associated with the severity of depressive symptoms but the association was substantially attenuated (β = − 0.18 (− 0.07 to − 0.29), p = 0.002). (Table 2 – found at end of file)
Summary
Mentalizing refers to the ability to understand behaviours and actions in oneself and others in terms of internal mental states. Individuals with BPD are prone to pre-mentalistic states, such as psychic equivalence (regarding negative thoughts as indicating or being equivalent to a negative reality) when they experience strong negative affect [9, 10]. These deficits in mentalizing are thought to arise from disordered attachment and negative experiences of social communication [11]. Mentalizing, the ability to understand the self and others as well as behaviour in terms of intentional mental states, is impaired in Borderline Personality Disorder (BPD). It is unknown whether BPD symptoms might moderate any relationship between depressive symptoms and mentalizing
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