Associations of mentalization and epistemic trust with internalizing and externalizing problems in adolescence: A gender-sensitive structural equation modeling approach.

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.

Unpacking trust: The Italian validation of the Epistemic Trust, Mistrust, and Credulity Questionnaire (ETMCQ).

The construct of epistemic trust has received much consideration in recent psychological literature, even though mainly from a theoretical perspective. The overall aim of this study was to validate the first self-report measure of epistemic trust-the Epistemic Trust, Mistrust, and Credulity Questionnaire (ETMCQ)-in an Italian sample. Our primary goal was to test the factorial validity of the instrument, also exploring the influence of age, gender, and level of education on epistemic trust (Study 1, n = 843). Secondarily, we investigated the associations between epistemic trust, mistrust, credulity, and other aspects of psychological functioning, as well as with the presence of adverse childhood experiences in a smaller number of participants (Study 2, n = 445). Besides the ETMCQ, the survey included an ad hoc questionnaire investigating socio-demographic characteristics and self-report measures of reflective functioning, mentalized affectivity, traumatic experiences, attachment, and psychological symptoms. Statistical analysis showed a three-factor hierarchical structure similar to the model proposed in the original validation, with some differences that suggest an influence of cultural factors in determining individuals' epistemic stance. Our results corroborate previous theoretical contributions regarding the association between epistemic trust and psychological wellbeing, and between epistemic disruptions and higher levels of psychological suffering. Both Mistrust and Credulity were significantly related to the presence of childhood traumatic experiences, attachment avoidance and anxiety, lower levels of mentalization, lower abilities in emotional regulation, and higher levels of psychopathological symptoms. The ETMCQ represents an easily administered and time-effective tool. Its use could pave the way for interesting clinical and theoretical findings.

Adolescence in lockdown: The protective role of mentalizing and epistemic trust.

OBJECTIVE: Mentalizing is the ability to interpret one's own and others' behavior as driven by intentional mental states. Epistemic trust (openness to interpersonally transmitted information) has been associated with mentalizing. Balanced mentalizing abilities allow people to cope with external and internal stressors. Studies show that social isolation imposed by the COVID-19 pandemic was highly stressful for most people, especially for adolescents. Here we examine whether mentalizing and epistemic trust were protective factors in relation to emotional distress during the lockdown. METHOD: A total of 131 nonclinical adolescents, aged between 12 and 18 years, were evaluated during the lockdown using the Reflective Functioning Questionnaire for Youth, Inventory of Parent and Peer Attachment, Perceived Stress Scale, and Difficulties in Emotion Regulation Scale. RESULTS: Results from network analysis showed that epistemic trust and mentalizing were negatively associated with perceived stress and emotion dysregulation. Epistemic trust in fathers was associated with level of perceived stress, and epistemic trust in mothers with emotion dysregulation. CONCLUSION: These findings suggest that epistemic trust and the capacity to mentalize were low in adolescents during lockdown, and this was associated with high levels of stress. However, robust levels of epistemic trust and mentalizing may have acted as protective factors that buffered individuals from the risk of emotional dysregulation during the lockdown.

The interplay of mentalization and epistemic trust: a protective mechanism against emotional dysregulation in adolescent internalizing symptoms.

Mentalization is the ability to interpret actions as caused by intentional mental states. Moreover, mentalization facilitates the development of epistemic trust (ET), namely, the ability to evaluate social information as accurate, reliable, and relevant. Recent theoretical literature identifies mentalization as a protective factor, contrasting psychopathology and emotional dysregulation. However, few investigations have explored the concurrent associations between mentalization, ET and emotion dysregulation in the context of internalizing problems in adolescence. In the present study, 482 adolescents from the general population aged between 12 and 19 were assessed with the epistemic trust mistrust credulity questionnaire, the reflective functioning questionnaire- youth, the difficulties in emotion regulation scale, and the youth self-report. We tested the relationship between the variables through serial mediation models. Results showed that mentalization reduces internalizing problems via emotional dysregulation; ET is positively associated with mentalization but not symptomatology. Finally, both epistemic mistrust and epistemic credulity are significantly associated with internalizing symptomatology; those effects are mediated differently by difficulties in emotional regulation. In conclusion, the present study confirms mentalization's role as a protective factor in developmental psychopathology. Nevertheless, exploring the role of the different epistemic stances guarantees a better understanding of psychopathological pathways in adolescence.

Anxiety in Attachment and Sexual Relationships in Adolescence: A Moderated Mediation Model.

Adolescence is characterized by several transformations, such as identity construction, progressive estrangement from parents, relational interest in peers, and body changes that also involve sexuality issues. In this process, attachment patterns play a fundamental role in relationships, and when these are dysfunctional, they can result in internalizing and externalizing problems. Often, females show their relational difficulties through internalizing expressions and males through externalizing expressions. Additionally, given the sexual progress involved in this life moment, psychological symptomatology may influence adolescents' perception of sex and performance. Our purpose is to study the mediating role of internalizing and externalizing symptomatology in the relationship between attachment patterns and sexual and psychological dimensions. In addition, we investigated the moderating effect of the sex assigned at birth on this mediation model. n = 493 adolescents (38.3% males; Mage = 16.51; SD = 1.17) participated in the study. The results show a significant mediation effect of internalizing symptomatology on the relationship between attachment and sexual anxiety. Additionally, this effect is moderated significantly by assigned-at-birth sex. These results confirm that in adolescence, attachment patterns can influence adolescents' perception of sex. The connection between these two psychological dimensions is influenced by symptomatologic expression. Further investigations are needed.

Binge eating attitudes in community adolescent sample and relationships with interview-assessed attachment representations in girls: a multi-center study from North Italy.

PURPOSE: To compare community girls at risk and not at risk for binge eating (BE) in attachment representations through a narrative interview and to test the predictive role of attachment pattern(s) on the risk of binge eating among community girls. METHODS: From 772 community adolescents of both sexes (33% boys) screened through the Binge Eating Scale (BES), 112 girls between 14 and 18 years, 56 placed in a group at risk for binge eating (BEG), and 56 matched peers, not at risk (NBEG), were assessed in attachment representations through the Friends and Family Interview (FFI). RESULTS: (1) Compared to NBEG, girls in the BEG showed more insecure-preoccupied classifications and scores, together with lower narrative coherence, mother's representation as a secure base/safe haven, reflective functioning, adaptive response, and more anger toward mother. (2) Both insecure-dismissing and preoccupied patterns predicted 15% more binge-eating symptoms in the whole sample of community girls. CONCLUSIONS: Insecure attachment representations are confirmed risk factors for more binge eating, affecting emotional regulation and leading to "emotional eating", thus a dimensional assessment of attachment could be helpful for prevention and intervention. Implications and limits are discussed. LEVEL OF EVIDENCE: III. Evidence obtained from cohort or case-control analytic studies.

Italia Ti Ascolto [Italy, I am listening]: an app-based group psychological intervention during the COVID-19 pandemic.

The onset of the coronavirus disease 2019 (COVID-19) pandemic impacted individuals' psychological wellbeing resulting in heightened perceived stress, anxiety, and depression. However, a significant issue in accessing psychological care during a lockdown is the lack of access to in-person interventions. In this regard, research has shown the efficacy and utility of psychological app-based interventions. 'Italia Ti Ascolto' (ITA) has been developed as a population tailored internet-based intervention to offer an online professional solution for psychological support needs. The ITA app is available on iOS and Android systems. Users completed a baseline assessment on emotion regulation strategies (cognitive reappraisal and expressive suppression), psychological stress, anxiety, depression, and perceived social support. Participants could select among several one-hour long clinical groups held by expert psychotherapists. After every session, people were asked to complete a quick users' satisfaction survey. Our contribution presents ITA's intervention protocol and discusses preliminary data on psychological variables collected at baseline. Data showed significant associations between emotion regulation strategies, symptoms of depression and anxiety, and level of stress. Moreover, the role of perceived social support is considered. Future developments and implications for clinical practice and treatment are discussed.