Terms Of Mental States Research Articles

The mediating role of reflective functioning in the association between childhood trauma and suicide attempt

BackgroundChildhood trauma is intimately related with suicidal behaviour. Patients who have suffered childhood trauma develop impaired Reflective Functioning (RF), which refers to the capacity to understand ourselves and others in terms of intentional mental states. An improvement in RF has been associated with a reduction in suicidal attempts, but the mediating role of RF between childhood trauma and suicidal behaviour has not been addressed so far. ObjectiveWe aim to examine the potential mediating effect of RF among childhood trauma and suicide attempts. MethodWe included 748 patients who had attempted suicide at least once. They were asked to complete the Reflective Functioning Questionnaire (RFQ-8), the Columbia-Suicide Severity Rating scale (CSSRS), and the Childhood Trauma Questionnaire-Short Form (CTQ-SF). We conducted linear regressions by simple mediating model to examine the role of RF in the indirect association between childhood trauma and the number of suicide attempts. ResultsOur results show significant indirect effects through hypo and hypermentalizing between Emotional Abuse (EA) and Sexual Abuse (SA) in childhood and the number of suicide attempts in lifetime. These results indicate that ineffective RF significantly mediates the association between childhood trauma and suicidality. ConclusionThis is the first study supporting the mediational role of RF in the relationship between EA and SA, and the number of suicide attempt in lifetime. These findings have important implications for reducing suicide rates and preventing future re-attempts. Further studies analysing this mediating role and focusing efforts on increasing RF-based interventions are required.

Inflammatory Bowel Disease and Irritable Bowel Syndrome: What Differences in Mentalization Abilities? A Scoping Review

Mentalization is a psychological process that enables individuals to understand the self and others in terms of intentional mental states. The aim of this scoping review was to provide an overview of the findings on mentalization in patients with inflammatory bowel disease (IBD) and irritable bowel syndrome (IBS). A literature search, in line with the Preferred Reporting Items for Systematic Review and Meta-analysis Protocols extension for Scoping Review guidelines, was conducted in the following bibliographic databases: PubMed, PsycINFO, and Scopus. Databases were queried using the following strings (with Boolean operators): (“mentaliz*” OR “metacogniti*” OR “theory of mind” OR “ToM” OR “reflective function*”) AND (“irritable bowel syndrome” OR “IBS” OR “inflammatory bowel disease” OR “IBD”). In line with the eligibility criteria, seven articles were included. Results showed that no significant differences in metacognitive ability were found between patients in the IBD and IBS groups. This review revealed the mentalizing difficulties for patients with IBD and IBS. These results should be interpreted with caution since they are based on a few studies that used different instruments to assess mentalizing processes. Future studies are needed to clarify the role of mentalization in patients with these gastrointestinal conditions.

Mentalizing School. Could develop the ability to mentalize support the functioning of students, parents, and teachers in the school environment? An attempt to answer the question taking into account reports from international research.

Mentalization is a multifaceted cognitive activity that enables individuals to interpret the behaviors of others (and their own) in terms of intentional mental states. A person who engages in mentalization is aware that human behavior stems from one's mental state. The capacity for mentalization begins to develop in childhood, primarily through secure relationships with caregivers, but it can be cultivated throughout life, including through functioning in a mentalizing environment, such as a school. This article aims to address the question of whether developing the ability to mentalize can support the functioning of students, parents, and teachers in the school environment. Findings from previous research and interventions conducted in various parts of the world not only provide an affirmative answer to this question but also identify the characteristics of a mentalizing school that caters to the need for future-oriented education.

Mentalizing in Adolescents and Young Adults with Attention Deficit Hyperactivity Disorder: Associations with Age and Attention Problems

Introduction: Growing, albeit heterogenous evidence questions whether attention deficit/hyperactivity disorder (ADHD) is associated with socio-cognitive impairments, especially beyond childhood. This study focuses on mentalizing – the socio-cognitive ability to attribute and reason in terms of mental states. We aimed to characterize mentalizing performance in terms of correct scores and types of errors in adolescents and young adults with ADHD. Methods: Forty-nine adolescents and adults with ADHD and 49 healthy controls matched for age and gender completed a computerized naturalistic mentalizing task, the Movie for Assessment of Social Cognition (MASC). Repeated measures analyses of variance examined the effects of age group and ADHD diagnosis on MASC performance. Additionally, associations between mentalizing scores, the severity of attention problems, and the presence of comorbidity were explored in the ADHD group. Results: Results showed an increased prevalence of hypomentalizing errors in adolescents with ADHD. Lower mentalizing scores in adolescents with ADHD were correlated with indices of inattentiveness, impulsivity, and vigilance problems. Hypomentalizing errors in adolescents showed to be particularly associated with inattentiveness, after controlling for age and comorbidity. In contrast, adults with ADHD performed similarly to controls and their scores on the mentalizing task were not correlated to attention problems. Conclusion: These findings highlight potential developmental differences in mentalizing abilities in ADHD youths and their association with attentional impairments.

A deeper look at the association between childhood maltreatment and reflective functioning

ABSTRACT Childhood maltreatment is theorized as impeding the development of reflective functioning (RF; ability to perceive and interpret oneself and others in terms of mental states). However, previous research typically failed to support this association or yielded small sized and mixed associations. This study aims to provide a deeper look at the association between childhood maltreatment and RF by characterizing two non-mentalizing categories. One-hundred-and-sixteen pregnant women (mean age = 27.62, SD = 4.52) from the community (48.3% with a university degree, 96.5% in a relationship with the other parent) retrospectively reported on childhood abuse and neglect using the Childhood Trauma Questionnaire. They also participated in the Adult Attachment Interview subsequently coded using the Reflective Functioning Scale. Participants with poor to low RF were allocated to one of two groups (disavowal-distancing or distorted-inconsistent) using indicators provided in the RF Scale. No association was found between childhood maltreatment and overall RF when controlling for education level. A multinomial logistic regression revealed that childhood maltreatment was strongly predictive of a disrupted, over-analytical and inconsistent reflection about mental states but not of a tendency to discourse little about mental states. This tendency was rather only predicted by education level. Findings suggest that childhood maltreatment would lead to specific impairments in RF and that not considering how individuals fail to mentalize about attachment relationships may mask strong associations between RF and its determinants and correlates, including childhood maltreatment.

The Spanish version of the reflective functioning questionnaire: Validity data in the general population and individuals with personality disorders.

Mentalization or reflective functioning (RF) is the capacity to interpret oneself or the others in terms of internal mental states. Its failures have been linked to several mental disorders and interventions improving RF have a therapeutic effect. Mentalizing capacity of the parents influences the children's attachment. The Reflective Functioning Questionnaire (RFQ-8) is a widely used tool for the assessment of RF. No instrument is available to assess general RF in Spanish-speaking samples. The aim of this study is to develop a Spanish version of the RFQ-8 and to evaluate its reliability and validity in the general population and in individuals with personality disorders. 602 non-clinical and 41 personality disordered participants completed a Spanish translation of the RFQ and a battery of self-reported questionnaires assessing several RF related constructs (alexithymia, perspective taking, identity diffusion and mindfulness), psychopathology (general and specific) and interpersonal problems. Temporal stability was tested in a non-clinical sub-sample of 113 participants. Exploratory and confirmatory factor analyses suggested a one-factor structure in the Spanish version of the RFQ-8. RFQ-8 understood as a single scale was tested, with low scorings reflecting genuine mentalizing, and high scorings uncertainty. The questionnaire showed good internal consistence in both samples and moderate temporal stability in non-clinical sample. RFQ correlated significantly with identity diffusion, alexithymia, and general psychopathology in both samples; and with mindfulness, perspective taking, and interpersonal problems in clinical sample. Mean values of the scale were significantly higher in the clinical group. This study provides evidence that the Spanish version of the RFQ-8, understood as a single scale, has an adequate reliability and validity assessing failures in reflective functioning (i.e., hypomentalization) in general population and personality disorders.

Parental reflective functioning in adult outpatients with personality disorders: associations with symptoms of psychopathology and interpersonal problems

Impaired parental reflective functioning (PRF), i.e. difficulties in understanding one’s child in terms of mental states, may constitute a risk for children’s development and wellbeing. Impaired PRF has been linked to parental psychopathology, however no study has investigated PRF in adult patients with personality disorders (PDs). We examined PRF in a sample of adult outpatients with diagnosed PDs compared with healthy controls (HCs), and explored associations between PRF and symptoms of psychopathology and interpersonal problems in parents with PD. A convenience sample of treatment-seeking outpatients with PDs (n = 34) were assessed with questionnaires measuring PRF (The Parental Reflective Functioning Questionnaire (PRFQ)), symptoms of psychopathology (Symptom Checklist Revised (SCL-90-R)) and interpersonal problems (Inventory of Interpersonal Problems (IIP)). PRF scores were compared with reported means of HCs (n = 156) pooled from a previous study. Parents with PD reported higher levels of pre-mentalizing and lower levels of certainty about mental states compared with HCs. Both groups reported high levels of interest and curiosity and did not differ significantly in this regard. Exploratory analyses showed that low levels of certainty about mental states was associated with high levels of depressive and psychotic symptoms and submissive types of interpersonal problems (social-avoidance and non-assertiveness). Our findings provide preliminary evidence that patients with PD have impairments in PRF compared with HCs. The findings stress the importance of assessing the multidimensional nature of PRF in parents with PD.

Knowledge Routines, Threads and Network Dynamics

Abstract The paper focuses on knowledge generation, a topic frequently overlooked in the traditional debates in epistemology and philosophy of science. We focus on investigation as the primary process generating knowledge and its products. Investigation is taken as a generalization of the research process that includes similar knowledge-generating practices in aboriginal communities. To characterize the complexity of investigation processes and their products we go beyond traditional epistemological characterization of knowledge in terms of mental states and turn to the concept of routine. Investigation processes share a common symbolic representation form which we call here a knowledge thread. The dynamics of the knowledge thread may be characterized by two intertwined tiers: cognitive and institutional. Using examples from our previous studies, especially on the recent discovery of microRNAs in molecular biology, we illustrate the dynamics of threads and claim that it is susceptible to the social network analysis which, however, requires insightful applications and sound interpretation of the results. Such an interpretation, as we suggest, may further be elaborated on the grounds of anthropological theories of distributed agency and distributed cognition.

Concept Representation and the Geometric Model of Mind

Abstract Current cognitive architectures are either working at the abstract, symbolic level, or the low, emergent level related to neural modeling. The best way to understand phenomena is to see, or imagine them, hence the need for a geometric model of mental processes. Geometric models should be based on an intermediate level of modeling that describe mental states in terms of features relevant from the first-person perspective but also linked to neural events. Concepts should be represented as geometrical objects that have sufficiently rich structures to show their properties and their relations to other concepts. The best way to create such geometrical representations of concepts is through the approximate description of the physical states of neural networks. The evolution of brain states is then represented as a trajectory linking successful concepts, and topological constraints on the shape of such trajectory define grammar and logic.

Understanding Your Baby: protocol for a controlled parallel group study of a universal home-based educational program for first time parents

BackgroundInfant mental health represents a significant public health issue. The transition to parenthood provides optimal opportunities for supporting parenting competence. Especially parental mentalization, i.e. the caregiver’s ability to notice and interpret the child’s behavior in terms of mental states, is important in infancy where the caregiver-infant communication is based solely on the infant’s behavioral cues. MethodsThis study evaluates the efficacy of the intervention Understanding Your Baby (UYB) compared to Care As Usual (CAU) in 10 Danish municipalities. UYB aims at promoting parental competence in new parents by supporting them in noticing their infants’ behavioral cues and interpreting them in terms of mental states. Participants will be approximately 1,130 singletons and their parents. Inclusion criteria are first-time parents, minimum 18 years old, living in one of the 10 municipalities, and registered in the Danish Civil Registration Register (CPR). Around 230 health visitors deliver the UYB as part of their routine observation of infant social withdrawal in the Danish home visiting program. During an interaction between the health visitor and the infant, the health visitor articulates specific infant behaviors and helps the caregivers interpret these behaviors to mental states. The study is a controlled parallel group study with data obtained at four time points in two phases: First in the control group receiving the publicly available postnatal care (CAU), secondly in the intervention group after UYB implementation into the existing postnatal services. The primary outcome is maternal competence. Secondary measures include paternal competence, parental stress, parental mentalizing, and infant socioemotional development. Analysis will employ survey data and data from the health visitors’ register.DiscussionResults will provide evidence regarding the efficacy of UYB in promoting parenting competences. If proved effective, the study will represent a notable advance to initiating the UYB intervention as part of a better infant mental health strategy in Denmark. Conversely, if UYB is inferior to CAU, this is also important knowledge in regard to promoting parenting competence and infant mental health in a general population.Trial registrationhttps://ClinicalTrials.gov with ID no. NCT03991416. Registered at 19 June 2019—Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT03991416

Individual Differences in Mentalizing Tendencies

The human capacity to represent others and oneself in terms of internal mental states—mentalizing—varies across individuals. In this paper, we assess the extent to which commonly used mentalizing measures successfully capture meaningful individual differences in mentalizing tendencies and explore how these tendencies relate to broader variability in cognitive and social functioning. To this end, we administered a battery of behavioral and self-report measures of mentalizing, fluid intelligence, personality dimensions, sense of self, cognitive tendencies, and psychopathology symptoms in an online study (N=150). In a series of preregistered analyses, we found that fluid intelligence scores were most predictive of mentalizing variability while dimensions such as psychopathy, empathy and sense of power were also significantly associated with this variability (though to a lesser extent than fluid intelligence). Of the psychopathology symptoms assessed, somatization and self-harm were most strongly associated with inter-individual variability in mentalizing and uncertainty about mental states was the mentalizing dimension most tightly correlated to psychopathology symptoms. Our findings point to the need for more research to explore ways in which mentalizing tendencies are tied to other domains, such as general cognitive functioning and psychopathology. Additionally, our findings highlight the potential for merging clinical assessment tools with social cognition research.

Special Report: How to Work With Patients Using Problem-Focused Psychodynamic Psychotherapies

Special Report: How to Work With Patients Using Problem-Focused Psychodynamic Psychotherapies

The generality and particularity of perception

This paper responds to critical comments by Christopher Hill, Ram Neta, and Nico Orlandi on my book The Unity of Perception: Content, Consciousness, Evidence (OUP 2018). It addresses questions about why analyzing mental states in terms of capacities is more explanatory powerful than analyzing them in terms of processes. It further develops my view of functions and their relation to mental capacities. It clarifies the internalist commitments of my externalist view of content, consciousness, and evidence. The topics addressed include further the many‐properties problem, the relation between what is perceived and what is represented, as well as the evidential transparency principle.

Interpersonal Psychotherapy and Mentalizing-Synergies in Clinical Practice.

Interpersonal psychotherapy (IPT) is an evidence-supported, relationally focused treatment for people living with depression and other psychiatric disorders in the context of stressful life events. Mentalizing, also relationally focused, promotes the ability to perceive, understand, and interpret human behavior in terms of intentional mental states of others or oneself, in order to support social leaning. IPT and mentalization-based treatments (MBT) both seek to improve interpersonal effectiveness, albeit with different emphases in the therapeutic process, with IPT promoting interpersonal problem solving and MBT promoting understanding of the obstacles to this outcome. In this article, the authors propose that the central intentions of IPT and mentalizing are essentially linked and complementary; understanding others and oneself in relationships facilitates interpersonal problem resolution and symptomatic recovery and enhances resilience. The clinical synergies of IPT and mentalizing are elaborated and illustrated through a case example of treatment for a socially isolated woman with depression and interpersonal sensitivities.

INDICATORS OF PSYCHOLOGICAL HEALTH OF MILITARY SERVANTS

The article presents the theoretical and empirical levels of mental state of military men. It presented the terms of positive and negative mental states in psychology. The main positive mental state of military men are the state of confidence, the state of readiness for activity, the state of restraint, volitional activity etc. The main negative state of military man are depressive trends, increased anxiety, and decreased self-esteem. The article presents the results of the psychological assessment, using to study the mental state of military men with the help of the self-assessment test of mental state by Hans Eysenck. According to the psychological assessment it is noted that military men tend to be confident in themselves and their forces, but they are not always ready to innovate and have problems with adaptation to these changes, trying to independently control the situation in life. It is established that the military men are dominated by the average level of manifestation of such psychological states as anxiety, frustration, aggressiveness and rigidity, which gives rise to certain peculiarities in the structure of personality and its functioning in society.

A Formal Analysis of the Concept of Behavioral Individuation of Mental States in the Functionalist Framework

The functionalist theory of mind proposes to analyze mental states in terms of internal states of Turing machine, and states of the machine’s tape and head. In the paper, I perform a formal analysis of this approach. I define the concepts of behavioral equivalence of Turing machines, and of behavioral individuation of internal states. I prove a theorem saying that for every Turing machine T there exists a Turing machine T’ which is behaviorally equivalent to T, and all of whose internal states of T’ can be behaviorally individuated. Finally, I discuss some applications of this theorem to computational theories of mind.

Mentalization-based treatment for adolescents with conduct disorder (MBT-CD): protocol of a feasibility and pilot study

BackgroundConduct disorder (CD) is a complex mental disorder characterized by severe rule-breaking and aggressive behavior. While studies have shown that several therapeutic interventions are effective in treating CD symptoms, researchers call for treatments based on etiological knowledge and potential patho-mechanisms. Mentalization-based treatment (MBT) may represent such a treatment approach: Studies have shown that individuals with CD show mentalizing deficits and that mentalizing might represent a protective factor against the development of the disorder. As MBT focuses on the understanding of social behavior in terms of mental states, fostering mentalizing might help CD individuals to (re)gain an adaptive way of coping with negative emotions especially in social interactions and thus reduce aggressive behavior. For this purpose, MBT was adapted for adolescents with CD (MBT-CD). This is a protocol of a feasibility and pilot study to inform the planning of a prospective RCT. The primary aim is to estimate the feasibility of an RCT based on the acceptability of the intervention and the scientific assessments by CD individuals and their families indicated by quantitative and qualitative data, as well as based on necessary organizational resources to conduct an RCT. The secondary aim is to investigate the course of symptom severity and mentalizing skills.MethodsThe bi-center study is carried out in two outpatient settings associated with university hospitals (Heidelberg and Mainz) in Germany. Adolescents aged between 11 and 18 years with a CD or oppositional defiant disorder (ODD) diagnosis are included. Participants receive MBT-CD for 6 to 12 months. The primary outcome of the feasibility study (e.g., recruitment and adherence rates) will be descriptively analyzed. Multilevel modeling will be used to investigate secondary outcome data.DiscussionFostering the capacity to mentalize social interactions triggering non-mentalized, aggressive behavior might help CD individuals to behave more adaptively. The feasibility trial is essential for gathering information on how to properly conduct MBT-CD including appropriate scientific assessments in this patient group, in order to subsequently investigate the effectiveness of MBT-CD in an RCT.Trial registrationClinicalTrials.gov, NCT02988453. November 30, 2016Sources of monetary supportDietmar Hopp Stiftung, Heidehof StiftungRecruitment statusRecruitment complete and intervention complete, follow-up assessments ongoing (Heidelberg). Recruitment and assessments ongoing (Mainz).Primary sponsor, principal investigator, and lead investigator in HeidelbergSvenja Taubner is responsible for the design and conduct of MBT-CD intervention and feasibility and pilot study, preparation of protocol and revisions, and publication of study results.Secondary sponsor and lead investigator in MainzEsther Sobanski is responsible for the recruitment and data collection in the collaborating center MainzRecruitment countryGermanyHealth condition studiedConduct disorder, oppositional defiant disorderInterventionMentalization-based treatment for conduct disorder (MBT-CD): MBT-CD is an adaptation of MBT for Borderline Personality Disorder. This manualized psychodynamic psychotherapy focuses on increasing mentalizing, i.e., the ability to understand behavior in terms of mental states, in patients. MBT-CD includes weekly individual sessions with the patient and monthly family sessions.Key inclusion and exclusion criteriaIncluded are adolescent individuals with a diagnosis of conduct disorder or oppositional defiant disorder aged between 11 and 18 years.Study typeFeasibility and pilot study (single-group)Date of first enrollment19.01.2017Study statusThe trial is currently in the follow-up assessment phase in Heidelberg and in the recruitment and treatment phase in Mainz.Primary outcomesAcceptability of MBT-CD intervention (as indicated by recruitment rates, completion rates, drop-out rates, treatment duration, oral evaluation), acceptability of scientific assessments (as indicated by adherence, missing data, oral evaluation), and necessary organizational resources (scientific personnel, recruitment networks, MBT-CD training and supervision) to estimate feasibility of an RCTSecondary outcomesAdolescents’ symptom severity and mentalizing abilityProtocol version20.08.2020, version 1.0

Mentalizing Bodies: Explicit Mentalizing Without Words in Psychotherapy.

Introduction: Mentalization concerns the human ability to understand the actions of others (and oneself) in terms of intentional mental states. Theoretically, the notion has been described via the poles of automatic, non-verbal implicit mentalization as opposed to conscious and verbal explicit mentalization. In this article, we challenge this standard distinction by examining examples from psychotherapy. We argue that explicit mentalization can also be carried out via embodied non-verbal actions.Method: Four cases of real-life interaction from psychotherapy sessions are analyzed from the qualitative perspective of embodied cognition and multimodal interaction analysis. The analyses are based on video data transformed into transcriptions and anonymized drawings from a larger cognitive ethnography study conducted at a psychiatric hospital in Denmark.Results: The analyses demonstrate the gradual development from predominantly implicit mentalizing to predominantly explicit mentalizing. In the latter part of the examples, the mentalizing activity is initiated by the therapist on an embodied level but in an enlarged and complex manner indicating a higher level of awareness, imagination, and reflection. Thus, the standard assumption of explicit mentalization as contingent on verbal language is challenged, since it is demonstrated how processes of explicit mentalization can take place on an embodied level without the use of words.Conclusion: Based on real-life data, the study demonstrates that online processes of implicit and explicit mentalization are gradual and interwoven with embodied dynamics in real-life interaction. Thus, the analyses establish a window into how mentalization is carried out by psychotherapists through interaction, which testifies to the importance of embodied non-verbal behavior in psychotherapy. Further, informed by the notion of affordance-space, the study points to alternative ways of conceptualizing the intertwined nature of bodies and environment in relation to conveying more complex understandings of other people.

Impaired mentalizing in depression and the effects of borderline personality disorder on this relationship

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.

Pragmatism as Transcendental Philosophy, Part 2: Peirce on God and Personality

Pragmatism as Transcendental Philosophy, Part 2: Peirce on God and Personality