The Effects of Cognitive-Affective Switching With Unpredictable Cues in Adults and Adolescents and Their Relation to "Cool" Executive Functioning and Emotion Regulation.

The impact of emotion on executive functioning is gaining interest. It has led to the differentiation of "cool" Executive Functioning (EF) processes, such as cognitive flexibility, and "hot" EF processes, such as affective flexibility. But how does affective flexibility, the ability to switch between cognitive and affective information, vary as a function of age and sex? How does this construct relate to "cool" executive functioning and cognitive-emotion regulation processes? In this study, 266 participants, including 91 adolescents (M = 16.08, SD = 1.42 years old) and 175 adults (M = 25.69, SD = 2.17 years old), completed a cognitive-affective switching task with specific (as opposed to general) unpredictable switches, as well as measures of inhibition, attention, and cognitive-emotion coping strategies. We expected cognitive to affective switching to be more costly than affective to cognitive switching in females versus males, as well as higher switch costs in adolescents. Using linear mixed modelling, we analysed the effect of age, sex, and types of switching on reaction time. Results show that adolescents are slower switchers than adults, and demonstrate that females, although faster switchers than males, are slower when switching from cognitive to affective content than when they are switching from affective to cognitive content. Multiple regression analyses revealed age-specific associations between cognitive-affective switching and inhibition. These results converge with reported developmental and gender specificities in EF and emotion processing, respectively. Additionally, affective flexibility could relate to differences in vigilance and inhibition.

Prevalence Rates and Evolution of Psychiatric Disorders Among Incarcerated Youths in Comparison With Non-incarcerated Youths.

Background: Our main objective was to provide estimates of the prevalence rates of psychiatric disorders and comorbidities among youths in a juvenile detention center in Geneva, Switzerland. We also aimed to investigate potential positive effects of intensive psychotherapeutic and educational services this center provides. Finally, we examined psychiatric care prior to and after custody as well as the evolution of the youths' mental health during detention. Methods: We conducted a longitudinal study including a group of incarcerated (n = 86) and a group of non-incarcerated (n = 169) youths (12-18 years old). Measures included diagnoses of psychiatric disorders, cognitive functions, trauma, psychopathic traits and the Youth Self-Report (aggressive behavior, attentional disorders, criminal behavior, social withdrawal, anxiety, depression and somatic complaints) collected at baseline and at discharge for the incarcerated group. Data were analyzed using mixed-effect models. Results: Psychiatric disorders were prevalent in the incarcerated group (82.6, 95% CI: 71.6-90.7%), but young people also often suffered from several disorders simultaneously. Two-thirds of the incarcerated participants had a diagnosis of two or more psychiatric disorders. Regarding health care, most incarcerated participants (79.1%) had psychiatric care prior to detention. The planned care after detention was associated with psychiatric comorbidities, care being more likely planned for those with comorbidities (p = 0.030). Compared to the non-incarcerated group, the incarcerated group had lower scores on cognitive functioning (p < 0.001) and higher scores on trauma (p < 0.021) and psychopathic traits (p < 0.034). The youths' stay in the detention center was associated with a positive change of mental health, with externalized problems being significantly reduced at the end of their stay (p = 0.017). Conclusion: Our findings showed that youths in conflict with the law are characterized by (1) their internal vulnerabilities: a high prevalence of psychiatric disorders and psychiatric comorbidities, lower cognitive functions, externalized problems and psychopathic traits; (2) environmental factors: victims of violence and sexual abuse; and (3) their psychiatric history. Besides, the evolution of the most prevalent issues was favorable over time, which puts into question the usual perspective about the deleterious effect of detention.

Associations between schizotypal personality features, mentalizing difficulties and thought problems in a sample of community adolescents.

AIM: 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. METHODS: 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. RESULTS: 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. CONCLUSIONS: 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.

The role of interoception in understanding others' affect. Dissociation between superficial and detailed appraisal of facial expressions.

Embodied models of social cognition argue that others' emotional states are processed by re-enacting a representation of the same state in the observer, along with associated somatic and physiological responses. In this framework, previous studies tested whether a strong sensitivity to interoceptive signals (i.e., inputs arising from within one's body) facilitates the understanding of others' affect, leading to mixed results. Such heterogeneity in the literature could reflect methodological differences in paradigms employed, with some probing classification of a precise condition, and others requiring the assessment of supra-ordinal dimensions orthogonal to many states. Here, we engaged fifty young women in a study where they evaluated others' naturalistic facial reactions to painful and disgusting stimuli of comparable unpleasantness. Separately, we measured their interoceptive abilities through a well-known heartbeat counting task. We found that individuals that were more accurate in tracking their heartbeats across time were also more prone to judge facial expressions as more unpleasant (supra-ordinal assessment). However, when specifically asked to discriminate between comparably-unpleasant pain and disgust (state-specific assessment), participants' performance was not influenced by their interoceptive abilities. Although confined to a female sample, this study extends our knowledge on the role of interoception in the understanding of others, which influences only the evaluation of general features such as unpleasantness (common between pain and disgust), without extending to the appraisal of a precise state. This finding supports multi-componential models of social cognition, suggesting that only part of our ability to assess others' affect is mediated by a representation of one's affective/somatic responses.

Validation of the French version of the « Meta-Cognition Questionnaire ¼ for adolescents (MCQ-Af): Evolution of metacognitive beliefs with age and their links with anxiety during adolescence.

INTRODUCTION: The Meta-Cognitions Questionnaire for Adolescents (MCQ-A) measures individual differences of metacognitive beliefs and monitoring thought to be involved in the onset and maintenance of psychological disorders, especially in those involving anxiety. This assessment tool has been employed in research and clinical settings involving French-speaking adolescents, but appropriate validation has yet to be conducted. This article aims to first validate the francophone version of the MCQ-Af using measures sensitive to the expression of anxiety, and secondly, to examine the influence of age and gender on metacognitive beliefs, anxiety and their links. METHOD: 214 adolescents (114 females) between 13 and 17 completed the MCQ-Af (French version) as well as the Revised-Children's Manifest Anxiety Scale (R-CMAS), French version, to assess anxiety manifestations. Structural validity was examined with confirmatory factor analyses. Three models were compared to the higher order five factor model proposed in the original validation study. Internal consistency and test-retest reliability were also performed. Student's t tests as well as simple and stepwise regressions were conducted to assess for age and gender. RESULTS: The five correlated factors retained in the original version of the MCQ were replicated, and confirmatory factor analyses yielded comparable fit indices for a covariate factor model, as well as for a bifactor model. The bifactor model was privileged for theoretical reasons. Analyses were performed on a shortened questionnaire of 27 items as 3 items (2, 12 and 14) had non-significant loadings in prior path analyses. Age and gender differences were found in specific sub-factors of the MCQ-Af; positive and negative metacognitive beliefs seem to increase with age; girls seem to score higher on the negative metacognitive beliefs and thought control dimensions. The study further reports specific links between anxiety manifestation and negative and positive metacognitive beliefs, as well as confidence in one's memory. A modest influence of age and gender on this link was also highlighted. CONCLUSION: The present research provides the first evidence that the MCQ-Af is a valid and reliable instrument to assess individual differences of metacognitive beliefs in French-speaking adolescents. Nevertheless, it highlights that caution should be taken in regards of 3 items in particular (items 2, 12 and 14). Furthermore, age and gender in assessed samples of adolescents might influence the scores of the different dimensions of the questionnaire.

Longitudinal Relationships Between Reflective Functioning, Empathy, and Externalizing Behaviors During Adolescence and Young Adulthood.

Reflective functioning (RF) refers to the understanding of one's own and others' behaviors in terms of mental states, whereas empathy entails the abilities to understand (cognitive empathy) and to share (affective empathy) the emotions of others. Low RF and low empathy have been previously related to externalizing behaviors, such as aggression and rule breaking. However, few longitudinal studies have simultaneously examined the relationships between these variables during adolescence. The aim of the present study is to investigate the longitudinal effects of both RF and empathy on potential changes in externalizing behaviors over time, in a group of 103 adolescents and young adults from the general population assessed repeatedly up to four times. We conducted multilevel analysis in order to examine the effects of RF and empathy on the initial levels and the trajectories of externalizing behaviors over time, while accounting for other variables previously associated with externalizing behaviors, such as age, gender, internalizing problems, and cognitive abilities. The results suggest that the ability to reflect on behaviors in terms of mental states predicted a sharper decrease in externalizing behaviors over time. Moreover, externalizing behaviors at the first assessment were associated with RF impairments and low affective empathy. Age, gender, cognitive abilities, and cognitive empathy were not associated with externalizing behaviors. We discuss how our results, based on a typically developing population, might inform primary or indicated prevention strategies for externalizing behaviors by focusing on socio-cognitive processes such as RF and affective empathy.

Internalized stigmatization in borderline personality disorder and attention deficit hyperactivity disorder in comparison to bipolar disorder.

INTRODUCTION: Internalized stigma constitutes a major concern in mental health illness. It has numerous repercussions on patients, including poor self-esteem, higher illness severity, poor adherence to care and reduced global functioning. The goal of this study was to compare internalized stigma between three diagnoses frequently seen in psychiatric practice: Borderline personality disorder (BPD), Attention deficit-hyperactivity disorder (ADHD) and Bipolar disorder (BD). METHODS: A total of 244 French-speaking patients were recruited in a specialized psychiatric center at University Hospitals of Geneva, Switzerland. 39 patients had a diagnosis of BPD, 136 had ADHD and 69 had BD. Every subjects completed the Internalized Stigma of Mental Illness (ISMI) scale, which is the most widely used scale employed to measure of internalized stigma. One way ANOVA analysis with adjustment on age and gender was done to compare the three groups (BPD, ADHD, BD). RESULTS: Participants with BPD reported higher ISMI score than subjects with ADHD and BD. BD experienced more internalized-stigma than ADHD. Higher ISMI score was also associated with higher severity of the respective disorder, poorer quality of life and unemployment. LIMITATIONS: Limitations of this research include the small sample, especially in BPD group. A disequilibrium between male and female subjects can also impact our results. Observational nature of our study mean that we can only make correlation between variables and not infer causality. Finally, other confounding factors not taken into account in this study may have had influence on stigma. CONCLUSIONS: Our findings are coherent with recent literature on BPD reporting high level of distress and of stigmatization. This has serious consequences on provided care and need to be address by mental health professionals to assure the optimal service to this population.

Roles of age, gender and psychological difficulties in adolescent mentalizing.

INTRODUCTION: Adolescence is a critical period for the development of mentalizing - the imaginative capacity to understand one's own and others' behaviour in terms of underlying mental states. Yet, factors and mechanisms underlying individual differences in adolescent mentalizing remain poorly understood. This exploratory study examined whether and how a) age and gender and b) psychological difficulties correlate with mentalizing performance in adolescents from the general population. METHODS: 89 adolescents from Geneva, Switzerland (54 females, age 12-17 years) completed a computerized task of mentalizing and a self-report measure of psychopathology. RESULTS: Mentalizing performance improved with age. Males showed lower scores on the mentalizing task and made more hypermentalizing errors than females. The main findings revealed a negative association between mentalizing performance and self-reported attention problems. Post-hoc analyses further demonstrated that self-reported attentional difficulties were particularly associated with weaker scores on items requiring mentalizing about intentions, while self-reported withdrawal/depression symptoms were particularly associated with weaker scores on items requiring mentalizing about emotions and thoughts. CONCLUSION: The present study highlights a negative association between attentional difficulties and mentalizing performance in community adolescents. Moreover, it provides preliminary evidence suggesting that age, gender and psychological difficulties can be distinctively associated with patterns of correct and incorrect mentalizing in community adolescents. Implications for future research and clinical practice are discussed.

Resting-State Networks of Adolescents Experiencing Depersonalization-Like Illusions: Cross-sectional and Longitudinal Findings.

The mirror-gazing task (MGT) experimentally induces illusions, ranging from simple color changes in the specular image of oneself, to depersonalization-like anomalous self-experiences (ASE) as in experiencing one's specular image as someone else. The objective was to characterize how connectivity in resting-state networks (RSNs) differed in adolescents reporting such depersonalization-like ASEs during the MGT, in a cross-sectional (Y1) and in a longitudinal manner (a year after). 75 adolescents were recruited; for the cross-sectional analysis, participants were split into 2 groups: those who reported depersonalization-like ASEs on the MGT (ASE), and those who did not (NoASE). For the longitudinal analysis, participants were split into 3 groups whether they experienced MGT depersonalization-like ASEs: only at Y1 (Remitters), both times (Persisters), or never (Controls). Participants also filled out self-reports assessing schizotypal personality (Schizotypal Personality Questionnaire [SPQ]), and underwent resting-state functional MRI procedure (rs-fMRI). A group level Independent Component Analysis (ICA) was conducted and voxel-wise inter-group differences within RSNs were examined. The rs-fMRI analysis revealed lower connectivity of specific visual areas within the primary visual network (PVN), and higher connectivity of regions within the Default Mode Network (DMN) when contrasting the ASE and NoASE groups. The areas that were atypically connected within the PVN further presented differential pattern of connectivity in the longitudinal analysis. Atypical connectivity of visual area within the DMN at Y1 was associated with higher scores on the disorganized dimension of schizotypy at the second evaluation. The present study uncovers a subtle signature in the RSNs of non-clinical adolescents who experienced task-induced ASEs.

Mentalization-based treatment for adults with attention-deficit/hyperactivity disorder: a pilot study.

Recent literature suggests that, in addition to its core cognitive and behavioural symptoms, socioemotional difficulties represent key characteristics of adult attention-deficit/hyperactivity disorder (ADHD). Importantly, these deficits not only contribute negatively to the low social functioning and poorer professional achievements of ADHD patients relative to healthy individuals, they also respond poorly to medication and are not specifically addressed by current evidence-based psychological treatments. Mentalization-based treatment (MBT) is a psychological intervention focused on promoting the imaginative capacity to understand human behaviour as being driven by mental states. MBT has been shown to be effective in patients with chronic emotional dysregulation; it may therefore represent a valuable approach to address sociocognitive deficits and shape adaptive functioning in ADHD. In this study, we tailored the timelimited MBT program developed for borderline personality disorder to the specific clinical needs of individuals with ADHD. We report on the first eight patients with ADHD included in our programme at the Geneva University Hospitals. Preliminary results support the feasibility and relevance of the MBT model for ADHD. We discuss conceptual and clinical implications of the current data.

Afferent cardiac signals modulate attentional engagement to low spatial frequency fearful faces.

Despite the growing consensus that the continuous dynamic cortical representations of internal bodily states shape the subjective experience of emotions, physiological arousal is typically considered only a consequence and rarely a determinant of the emotional experience. Recent experimental approaches study how afferent autonomic signals from the heart modulate the processing of sensory information by focussing on the phasic properties of arterial baroreceptor firing that is active during cardiac systole and quiescent during cardiac diastole. For example, baroreceptor activation has been shown to enhance the processing of threat-signalling stimuli. Here, we investigate the role of cardiac afferent signals in the rapid engagement and disengagement of attention to fear stimuli. In an adapted version of the emotional attentional cueing paradigm, we timed the presentation of cues, either fearful or neutral faces, to coincide with the different phases of the cardiac cycle. Moreover, we presented cues with different spatial frequency ranges to investigate how these interoceptive signals influence the processing of visual information. Results revealed a selective enhancement of attentional engagement to low spatial frequency fearful faces presented during cardiac systole relative to diastole. No cardiac cycle effects were observed to high spatial frequency nor broad spatial frequency cues. These findings expand our mechanistic understanding of how body-brain interactions may impact the visual processing of fearful stimuli and contribute to the increased attentional capture of threat signals.

Attachment and Reflective Functioning in Women With Borderline Personality Disorder.

Insecure attachment and impairments in reflective functioning (RF) are thought to play a critical role in borderline personality disorder (BPD). In particular, the mentalization-based model argues that insecure attachment indirectly accounts for increased BPD features, notably via disruption of RF capacities. Although the mediation relationship between attachment, RF, and BPD is supported by previous evidence, it remains to be directly tested in adults with BPD. In the current study, a sample of 55 female adult BPD patients and 105 female healthy controls completed a battery of self-report measures to investigate the interplay between attachment, RF capacities, and BPD clinical status. Overall, the results showed that BPD patients pre- dominantly reported insecure attachment, characterized by negative internal working models of the self as unlovable and unimportant to others, and decreased RF abilities. Our findings further indicated that actual RF capacities mediated the relationships between adult insecure attachment and BPD clinical status.

Patterns of source monitoring bias in incarcerated youths with and without conduct problems.

INTRODUCTION: Antisocial individuals present behaviours that violate the social norms and the rights of others. In the present study, we examine whether biases in monitoring the self-generated cognitive material might be linked to antisocial manifestations during adolescence. We further examine the association with psychopathic traits and conduct problems (CPs). METHODS: Sixty-five incarcerated adolescents (IAs; M age = 15.85, SD = 1.30) and 88 community adolescents (CAs; M age = 15.78, SD = 1.60) participated in our study. In the IA group, 28 adolescents presented CPs (M age = 16.06, SD = 1.41) and 19 did not meet the diagnostic criteria for CPs (M age = 15.97, SD = 1.20). Source monitoring was assessed through a speech-monitoring task, using items requiring different levels of cognitive effort; recognition and source-monitoring bias scores (internalising and externalising biases) were calculated. RESULTS: Between-group comparisons indicate greater overall biases and different patterns of biases in the source monitoring. IA participants manifest a greater externalising bias, whereas CA participants present a greater internalising bias. In addition, IA with CPs present different patterns of item recognition. CONCLUSIONS: These results indicate that the two groups of adolescents present different types of source-monitoring bias for self-generated speech. In addition, the IAs with CPs present impairments in item recognition. Future studies may examine the developmental implications of self-monitoring biases in the perseverance of antisocial behaviours from adolescence to adulthood.

Mentalization in adults with attention deficit hyperactivity disorder: Comparison with controls and patients with borderline personality disorder.

Emotion dysregulation and interpersonal hardships constitute core features of borderline personality disorder (BPD). Research has established the link between these core dysregulations and fluctuations in the capacity to appreciate the mental states that underlie behavior (mentalizing, operationalized as reflective functioning (RF)). As emotion dysregulation and interpersonal hardships also characterize adults with attention deficit hyperactivity disorder (ADHD), this study sought to examine the potential RF impairments affecting this population. 101 adults with ADHD, 108 with BPD and 236 controls were assessed using the RF questionnaire (RFQ), evaluating how individuals employ information about mental states to better understand their own and others' behaviors. The RFQ comprises two dimensions, certainty (RF_c) and uncertainty (RF_u) about mental states. RF scores helped distinguish ADHD from controls, but also from BPD (F = 48.1(2/441); p < 0.0001 for RF_c and F = 92.5(2/441); p < 0.0001 for RF_u). The ADHD group showed intermediary RF scores compared to the controls (b = -0.70; p < 0.0001 and b = 0.89; p < 0.0001 for RF_c and RF_u) and BPD group (b = 0.44; p = 0.001 and b = -0.56; p = 0.001 for RF_c and RF_u). Lower RF scores correlated with poor anger control and high levels of impulsivity. Higher severity of ADHD (more attentional and hyperactive/impulsive symptoms) was correlated with RF impairments. In conclusion, RF may constitute an important process underlying attentional, hyperactive/impulsive as well as emotional symptoms in ADHD; it should therefore be considered in the assessment of these patients.

From the body's viscera to the body's image: Is there a link between interoception and body image concerns?

Interoception, the sense of the physiological condition of the body originating from within its internal organs, and body image, namely the perception, feelings and attitudes one has about one's body, are two fundamental components of our sense of personal identity and overall well-being. However, the relation between interoception and body image remains poorly understood. We here review recent behavioural and neuroimaging evidence from non-clinical and clinical populations (e.g. eating disorders) to propose that basic interoceptive processes and interoceptive awareness may crucially contribute to the complex formation of body image, as well as to its disturbances. In particular, lower interoceptive accuracy and awareness are associated with body-image concerns. We provide a potential mechanistic explanation of the link between interoception and body image, which aims to integrate interoceptive and exteroceptive representations of the body. The suggested link between interoception and body image can inform new empirically testable hypotheses on the underlying neurocognitive processes that are central to body image concerns and disturbances, and motivate relevant clinical implications.

Brain activity underlying negative self- and other-perception in adolescents: The role of attachment-derived self-representations.

One of teenagers' key developmental tasks is to engage in new and meaningful relationships with peers and adults outside the family context. Attachment-derived expectations about the self and others in terms of internal attachment working models have the potential to shape such social reorientation processes critically and thereby influence adolescents' social-emotional development and social integration. Because the neural underpinnings of this developmental task remain largely unknown, we sought to investigate them by functional magnetic resonance imaging. We asked n = 44 adolescents (ages 12.01-18.84 years) to evaluate positive and negative adjectives regarding either themselves or a close other during an adapted version of the well-established self-other trait-evaluation task. As measures of attachment, we obtained scores reflecting participants' positive versus negative attachment-derived self- and other-models by means of the Relationship Questionnaire. We controlled for possible confounding factors by also obtaining scores reflecting internalizing/externalizing problems, schizotypy, and borderline symptomatology. Our results revealed that participants with a more negative attachment-derived self-model showed increased brain activity during positive and negative adjective evaluation regarding the self, but decreased brain activity during negative adjective evaluation regarding a close other, in bilateral amygdala/parahippocampus, bilateral anterior temporal pole/anterior superior temporal gyrus, and left dorsolateral prefrontal cortex. These findings suggest that a low positivity of the self-concept characteristic for the attachment anxiety dimension may influence neural information processing, but in opposite directions when it comes to self- versus (close) other-representations. We discuss our results in the framework of attachment theory and regarding their implications especially for adolescent social-emotional development and social integration.

Emotion Recognition and Perspective Taking: A Comparison between Typical and Incarcerated Male Adolescents.

BACKGROUND: Previous research suggests that antisocial individuals present impairment in social cognitive processing, more specifically in emotion recognition (ER) and perspective taking (PT). The first aim of the present study was to investigate the recognition of a wide range of emotional expressions and visual PT capacities in a group of incarcerated male adolescents in comparison to a matched group of community adolescents. Secondly, we sought to explore the relationship between these two mechanisms in relation to psychopathic traits. METHODS: Forty-five male adolescents (22 incarcerated adolescents (Mage = 16.52, SD = 0.96) and 23 community adolescents (Mage = 16.43, SD = 1.41)) participated in the study. ER abilities were measured using a dynamic and multimodal task that requires the participants to watch short videos in which trained actors express 14 emotions. PT capacities were examined using a task recognized and proven to be sensitive to adolescent development, where participants had to follow the directions of another person whilst taking into consideration his perspective. RESULTS: We found a main effect of group on emotion recognition scores. In comparison to the community adolescents, the incarcerated adolescents presented lower recognition of three emotions: interest, anxiety and amusement. Analyses also revealed significant impairments in PT capacities in incarcerated adolescents. In addition, incarcerated adolescents' PT scores were uniquely correlated to their scores on recognition of interest. CONCLUSIONS: The results corroborate previously reported impairments in ER and PT capacities, in the incarcerated adolescents. The study also indicates an association between impairments in the recognition of interest and impairments in PT.

Mental strategies as mediators of the link between attachment and PTSD.

The authors analyzed the relationship between attachment dimensions (avoidance and anxiety) and posttraumatic stress disorder (PTSD) symptoms through the mediation of the mental strategies organization, that is, behavioral and intrapsychic strategies used to cope with traumatic events and symptoms, among a sample of war veterans. Sample was composed of Portuguese war veterans (N = 60): 30 veterans suffered from chronic PTSD (nonrecovered) and 30 veterans had remission from PTSD (recovered). Assessment of mental strategies was retrieved from 1 interview assessed by 3 judges, and attachment patterns and PTSD symptoms were assessed through self-report measures. Path coefficients of direct and total effects were estimated. Results showed lower mental strategies organization and higher attachment anxiety among nonrecovered participants. Indirect effect of attachment anxiety on PTSD symptoms through mental strategies was significant when no variable was entered as covariate. Indirect effect of attachment avoidance on PTSD symptoms through mental strategies organization was not significant. The authors discussed that the development of more mature mental strategies play a central role in working with veterans to cope with posttraumatic symptoms. (PsycINFO Database Record

Attachment, Neurobiology, and Mentalizing along the Psychosis Continuum.

In this review article, we outline the evidence linking attachment adversity to psychosis, from the premorbid stages of the disorder to its clinical forms. To better understand the neurobiological mechanisms through which insecure attachment may contribute to psychosis, we identify at least five neurobiological pathways linking attachment to risk for developing psychosis. Besides its well documented influence on the hypothalamic-pituary-adrenal (HPA) axis, insecure attachment may also contribute to neurodevelopmental risk through the dopaminergic and oxytonergic systems, as well as bear influence on neuroinflammation and oxidative stress responses. We further consider the neuroscientific and behavioral studies that underpin mentalization as a suite of processes potentially moderating the risk to transition to psychotic disorders. In particular, mentalization may help the individual compensate for endophenotypical impairments in the integration of sensory and metacognitive information. We propose a model where embodied mentalization would lie at the core of a protective, resilience response mitigating the adverse and potentially pathological influence of the neurodevelopmental cascade of risk for psychosis.

The French Version of the Reflective Functioning Questionnaire: Validity Data for Adolescents and Adults and Its Association with Non-Suicidal Self-Injury.

INTRODUCTION: The capacity to understand one's own actions and those of others in terms of cognitive and affective mental states (i.e., reflective functioning or mentalizing) is thought to play a critical role in both typical and atypical development. To date, however, no self-report tool is available for assessing reflective functioning ability in French-speaking samples. The first aim of this study is to investigate the reliability and validity of the reflective functioning questionnaire (RFQ) in French-speaking adolescents and adults. Secondly, we investigate whether low levels of reflective functioning were associated with non-suicidal self-injury. METHODS: 130 adolescents (66 females, Mage = 15.72, SDage = 1.74) and 253 adults (168 females, Mage = 23.10, SDage = 2.56) completed a French translation of the RFQ and a battery of self-reported questionnaires to assess a set of clinical (alexithymia; borderline traits; internalizing and externalizing symptoms) and psychological (empathy; mindfulness) variables. RESULTS: The current results showed configural invariance of the original two-factor structure of the RFQ across French-speaking adolescents and adults and satisfactory reliability and construct validity of the two subscales. Furthermore, we observed that recent episodes of non-suicidal self-injury were associated with lower levels of reflective functioning in the adult, but not in the adolescent, sample. DISCUSSION: The present research has methodological and clinical implications in that it provides the first evidence that the RFQ can be used to reliably assess reflective functioning in French-speaking population. The study further shows that impaired ability to consider mental states that lie behind behaviors might play a role in non-suicidal self-injury, at least in adults.