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1.
Med Hypotheses ; 128: 33-42, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31203906

RESUMO

The capacity to understand another person's emotions, intentions, beliefs and personality traits, based on observed or communicated behaviors, is termed social cognition. During the last decade, social neuroscience has made great progress in understanding the neural correlates of social cognition. However, because the cerebellum is traditionally viewed as only involved in motor processing, the contribution of this major part of the brain in social processing has been largely ignored and its specific role in social cognition remains unclear. Nevertheless, recent meta-analyses have made its crucial contribution to social cognition evident. This raises the question: What is the exact function of the cerebellum in social cognition? We hypothesize that the cerebellum builds internal action models of our social inter-actions to predict how other people's actions will be executed, what our most likely responses are to these actions, so that we can automatize our interactions and instantly detect disruptions in these action sequences. This mechanism likely allows to better anticipate action sequences during social interactions in an automatic and intuitive way and to fine-tune these anticipations, making it easier to understand behaviors and to detect violations. This hypothesis has major implications in neurological disorders affecting the cerebellum such as autism, with detrimental effects on social functionality, especially on more complex and abstract social cognitive processes. Because the fundamental anatomical organization of the cerebellum is identical in many species (cerebellar microcomplexes), this hypothesis could have major impacts to elucidate social interactions in social animals.


Assuntos
Cerebelo/fisiologia , Cognição/fisiologia , Comportamento Social , Animais , Transtorno do Espectro Autista/fisiopatologia , Comportamento Animal , Encéfalo , Mapeamento Encefálico , Cérebro/fisiologia , Comunicação , Condicionamento Operante , Emoções/fisiologia , Humanos , Relações Interpessoais , Imagem por Ressonância Magnética , Memória , Mentalização/fisiologia , Neurônios-Espelho/fisiologia , Vias Neurais/fisiologia , Neurociências , Ratos , Recompensa
2.
Curr Med Sci ; 39(3): 472-482, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31209821

RESUMO

The high rate of relapse among heroin users remains a significant public concern in China. In the present study, we utilized a Motivation-Skill-Desensitization-Mental Energy (MSDE) intervention and evaluated its effects on abstinence and mental health. Eighty-nine male heroin users in a drug rehabilitation center were enrolled in the study. The participants in the MSDE intervention group (n=46) received MSDE intervention, which included motivational interviewing, coping skills training, eye movement desensitization and reprocessing, and mindfulness-based psychotherapy. The participants in the control group (n=43) received a series of lectures on skills training. A significant increase in Contemplation Ladder score (P<0.001) and decreases in scores on the Obsessive Compulsive Drug Use Scale (P<0.001), Beck Depression Inventory (P<0.001), and Aggression Questionnaire (P=0.033) were found immediately after intervention. Compared to the control group, the MSDE intervention group reported significantly higher abstinence rates (P=0.027) and retention rates (P<0.001) at follow-up. Overall, the MSDE intervention, which uses a combined strategy for relapse prevention, could be a promising approach for preventing relapse among heroin users in China.


Assuntos
Terapia Cognitivo-Comportamental/métodos , Dessensibilização e Reprocessamento através dos Movimentos Oculares/métodos , Dependência de Heroína/terapia , Mentalização/fisiologia , Motivação/fisiologia , Adulto , Agressão/psicologia , China , Seguimentos , Dependência de Heroína/psicologia , Dependência de Heroína/reabilitação , Humanos , Masculino , Saúde Mental , Cooperação do Paciente/psicologia , Cooperação do Paciente/estatística & dados numéricos , Inventário de Personalidade , Centros de Tratamento de Abuso de Substâncias , Inquéritos e Questionários
3.
Soc Cogn Affect Neurosci ; 14(5): 549-558, 2019 05 31.
Artigo em Inglês | MEDLINE | ID: mdl-31037308

RESUMO

Recent research has revealed that the cerebellum plays a critical role in social reasoning and in particular in understanding false beliefs and making trait attributions. One hypothesis is that the cerebellum is responsible for the understanding of sequences of motions and actions, which may be a prerequisite for social understanding. To investigate the role of action sequencing in mentalizing, we tested patients with generalized cerebellar degenerative lesions on tests of social understanding and compared their performance with matched healthy volunteers. The tests involved understanding violations of social norms making trait and causal attributions on the basis of short behavioral sentences and generating the correct chronological order of social actions depicted in cartoons (picture sequencing task). Cerebellar patients showed clear deficits only on the picture sequencing task when generating the correct order of cartoons depicting false belief stories and showed at or close to normal performance for mechanical stories and overlearned social scripts. In addition, they performed marginally worse on trait attributions inferred from verbal behavioral descriptions. We conclude that inferring the mental state of others through understanding the correct sequences of their actions requires the support of the cerebellum.


Assuntos
Cerebelo/fisiologia , Cerebelo/fisiopatologia , Comportamento Social , Idoso , Cognição , Feminino , Voluntários Saudáveis , Humanos , Imagem por Ressonância Magnética , Masculino , Mentalização/fisiologia , Pessoa de Meia-Idade , Testes Neuropsicológicos , Projetos Piloto , Desempenho Psicomotor , Repressão Psicológica , Percepção Social , Degenerações Espinocerebelares/fisiopatologia , Degenerações Espinocerebelares/psicologia , Teoria da Mente
4.
BMC Psychiatry ; 19(1): 134, 2019 05 06.
Artigo em Inglês | MEDLINE | ID: mdl-31060534

RESUMO

BACKGROUND: Mentalizing, the mental capacity to understand oneself and others in terms of mental states, has been found to be reduced in some mental disorders such as Borderline Personality Disorder (BPD). Some studies have suggested that Eating Disorders (EDs) may also be associated with impairments in mentalizing, but studies have not always yielded consistent results. This is the first study to systematically investigate mentalizing impairments in patients with Bulimia Nervosa (BN) compared with controls. In addition, we investigated whether impairments in mentalizing were related to BPD features, rather than BN per se, given the high comorbidity between BPD and BN. METHODS: Patients with BN (n = 53) and healthy controls (HCs; n = 87) completed a battery of measures assessing mentalizing including the Reflective Function Questionnaires (RFQ), the Object Relations Inventory (ORI; Differentiation-Relatedness Scales) and the Reading The Mind in The Eyes Test (RMET). RESULTS: Patients with BN scored significantly lower than HCs on all tests of mentalizing, with moderate to large between-group effect sizes. These differences were partially accounted for by BPD features as assessed with the Zanarini Rating Scale for Borderline Personality Disorder (ZAN-BPD), and partially by bulimic symptoms measured with the Eating Disorder Examination Questionnaire (EDE-Q). CONCLUSIONS: Patients with BN have significantly lower levels of mentalizing as assessed with a broad range of tests compared to HCs. These differences were related to both bulimic symptoms and BPD features. Although further research in larger samples is needed, if replicated, these findings suggest that poor mentalizing may be a significant factor in BN patients and should be addressed in treatment, regardless of the presence of BPD features.


Assuntos
Transtorno da Personalidade Borderline/complicações , Transtorno da Personalidade Borderline/psicologia , Bulimia Nervosa/complicações , Bulimia Nervosa/psicologia , Mentalização/fisiologia , Adolescente , Adulto , Transtorno da Personalidade Borderline/fisiopatologia , Bulimia Nervosa/fisiopatologia , Estudos de Casos e Controles , Comorbidade , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Inquéritos e Questionários , Adulto Jovem
5.
Psychopathology ; 52(1): 10-17, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30904904

RESUMO

BACKGROUND: The aim of this study was to investigate the mediating role of mentalization in the association between adult attachment and interpersonal problems. METHODS: The sample consisted of 89 patients with different types of mental disorders who were at the beginning of treatment in one of two medical centers. Both mediational analysis and path analysis were used to test the model. RESULTS: The proposed model revealed a good model fit. The data indicate that mentalization fully mediates the effect of attachment on interpersonal distress. Symptom severity proved to be a strong confounding variable that influenced all other variables and reduced existing effects. CONCLUSION: We conclude that both mentalization and symptom distress are key components in the association of adult attachment and interpersonal problems. Therefore, we recommend research on integrative psychotherapy concepts rather than unilateral approaches.


Assuntos
Relações Interpessoais , Transtornos Mentais/terapia , Mentalização/fisiologia , Psicoterapia/métodos , Adolescente , Adulto , Idoso , Feminino , Humanos , Masculino , Transtornos Mentais/patologia , Pessoa de Meia-Idade , Inquéritos e Questionários , Adulto Jovem
6.
Neurobiol Aging ; 73: 1-8, 2019 01.
Artigo em Inglês | MEDLINE | ID: mdl-30300745

RESUMO

Behavioral studies suggest that older adults may be less adept than younger adults at remembering information contradicting their first impressions about others' trustworthiness. To identify the neural bases associated with such age-related differences, we measured the brain activity of older and younger participants using functional magnetic resonance imaging while they processed feedback on whether their initial trustworthiness impressions of stimulus persons, whose true trustworthiness had been predetermined, were right or wrong. Of special interest was the activation in mentalizing- (e.g., medial prefrontal cortex) and reward-related brain regions (e.g., striatum), which are known to be involved in impression formation and feedback learning, respectively. The reduction in the striatal responses to impression-contradicting versus impression-confirming feedback was greater in older than in younger participants. The activation of some mentalizing-related regions (medial prefrontal cortex and precuneus) was lower in older than younger participants; however, it was not modulated by impression-feedback congruency. The results suggest that age-related differences in the striatum engagement may underlie older adults' inefficiency in learning impression-incongruent information about others' trustworthiness.


Assuntos
Envelhecimento/fisiologia , Envelhecimento/psicologia , Encéfalo/fisiologia , Face/fisiologia , Aprendizagem/fisiologia , Mentalização/fisiologia , Recompensa , Confiança , Adulto , Idoso , Encéfalo/diagnóstico por imagem , Retroalimentação Psicológica , Feminino , Humanos , Julgamento/fisiologia , Imagem por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Adulto Jovem
7.
Psychother Res ; 29(2): 251-266, 2019 02.
Artigo em Inglês | MEDLINE | ID: mdl-28513339

RESUMO

OBJECTIVE: The aim of this study was to explore the experience of central psychological change processes for female patients with borderline symptomology and substance use disorder in mentalization-based treatment. METHOD: Semi-structured qualitative interviews on experiences from mentalization-based treatment with 13 participants were conducted. The interview material was analysed within a hermeneutical-phenomenological epistemology, with emphasis on researcher reflexivity. RESULTS: The following themes regarding central psychological change processes were found: "by feeling the feeling," "by thinking things through," "by walking in your shoes to see myself" and "by stepping outside of own bad feelings in seeing you." Two of these themes dealt with intra-psychic modes of how to relate to own mind-states. First, they had a shift from avoiding emotions into tolerating emotions. Second, they discovered the ability to think mental states through. Two themes dealt with mental stances for dealing with interpersonal situations, where one mode included a self-reflective stance in difficult encounters, and the other mode entailed an empathic reflective stance by exploring others' intentionality. CONCLUSIONS: The findings are in line with theoretical assumptions that increasing mentalizing capacity is a central change process for these patients. Furthermore, the findings demonstrate the complex interaction between different modes of mentalizing. Clinical or methodological significance of this article: The article explores change processes in manualized psychotherapy for patients with comorbid borderline personality disorder and substance use disorder, a focus which is not researched in the clinical literature. We claim that putting attention to this patient group and investigating their potential in psychotherapy is of clinical significance. Methodologically, this article utilizes thematic analyses within an epistemology following a specific procedure that is step based and transparent, thus it is of interest for qualitative researchers who also utilize thematic analyses.


Assuntos
Transtorno da Personalidade Borderline/fisiopatologia , Transtorno da Personalidade Borderline/terapia , Mentalização/fisiologia , Psicoterapia Psicodinâmica/métodos , Transtornos Relacionados ao Uso de Substâncias/terapia , Adulto , Transtorno da Personalidade Borderline/epidemiologia , Transtorno da Personalidade Borderline/psicologia , Comorbidade , Feminino , Humanos , Projetos Piloto , Pesquisa Qualitativa , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Transtornos Relacionados ao Uso de Substâncias/fisiopatologia , Transtornos Relacionados ao Uso de Substâncias/psicologia
8.
J Pers Disord ; 33(2): 145-163, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-29469664

RESUMO

Mentalization is proposed to underlie the disturbed interpersonal relatedness that is a hallmark of borderline personality disorder (BPD). Despite growing evidence of BPD in adolescents, studies examining mentalization in relation to adolescent BPD have remained limited. Given contradictory findings of this relationship, particularly with adults, further research of mentalization in adolescents with BPD is warranted. The current study further clarifies the nature of mentalizing impairments, related to BPD, by examining different aspects of mentalization between adolescents with BPD (n = 26) and a group of healthy controls (n = 25). Findings support studies that suggest that mentalization may be an important treatment target, influencing BPD symptoms and interpersonal functioning in adolescents with BPD. They also support the importance of examining mentalizing abilities in relation to varying levels of complexity, interpersonal contexts, and levels of arousal. Limitations and further research are discussed.


Assuntos
Transtorno da Personalidade Borderline/diagnóstico , Mentalização/fisiologia , Adolescente , Transtorno da Personalidade Borderline/psicologia , Estudos de Casos e Controles , Criança , Feminino , Humanos , Relações Interpessoais , Masculino
9.
Neuropsychol Rehabil ; 29(9): 1383-1398, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-29254438

RESUMO

Youth with moderate or severe traumatic brain injury (TBI) are at risk for reduced social participation after the injury, and the contribution of social cognition to these changes in functioning has been little studied. This study aimed to examine social participation and to measure the contribution of social and non-social cognitive functions to social participation impairment in youth (ages 12-21) who sustained moderate or severe TBI. Youth with TBI (n = 23) were compared to typically developing (TD) controls on self- and parent-rated social participation questionnaires. Direct testing of social cognition (mentalising, social knowledge, emotion recognition) and higher order cognitive abilities (intellectual abilities, attention and executive functions) was also conducted. Significant differences were found between the TBI participants and TD controls on social participation measures. Mentalising and problem-solving abilities revealed to be significant correlates of social participation as reported by youth with brain-injury and their parents. Overall, these results corroborate previous findings by showing that social participation is significantly reduced after TBI, and further shows that mentalising, which is not always considered during rehabilitation, is an important contributing factor. In addition to executive function measures, social cognition should therefore be systematically included in assessment following youth TBI for intervention and prevention purposes.


Assuntos
Lesões Encefálicas Traumáticas/fisiopatologia , Disfunção Cognitiva/fisiopatologia , Emoções/fisiologia , Reconhecimento Facial/fisiologia , Mentalização/fisiologia , Participação Social , Percepção Social , Habilidades Sociais , Adolescente , Adulto , Lesões Encefálicas Traumáticas/complicações , Criança , Disfunção Cognitiva/etiologia , Feminino , Humanos , Masculino , Índice de Gravidade de Doença , Adulto Jovem
10.
Personal Disord ; 10(1): 70-79, 2019 01.
Artigo em Inglês | MEDLINE | ID: mdl-29999394

RESUMO

This article reports a delayed-treatment randomized controlled trial of a mentalization-based intervention for families or significant others living with or supporting a person with borderline personality disorder (BPD). In all, 56 family members/significant others living with/supporting people with a diagnosis of BPD were randomized either to immediate mentalization-based Families and Carers Training and Support, a supportive and skills-based program consisting of five 1.5- to 2-hr evening meetings, delivered by trained family members, or to delayed intervention. The primary outcome was adverse incidents reported by the family member in relation to the person with BPD. Secondary outcomes included self-reported family well-being, empowerment, burden, and levels of anxiety and depression. Family members randomized to immediate intervention showed a significant reduction in reported adverse incidents between themselves and the identified patient in the second phase of treatment compared with those randomized to delayed intervention. Analysis of the rate of change indicated a significantly steeper decline for the immediate-treatment group compared with the delayed-intervention group (ß = -1.07, 95% confidence interval [-1.40, -0.74], z = -6.3, p < .000). Secondary outcome measures showed family functioning and well-being improved more in the immediate-treatment group; changes were maintained at follow-up. There were no differences in depression, total anxiety, and total burden; both groups showed improvement on all these measures. Findings show that the mentalization-based Families and Carers Training and Support program delivered by families to families supporting a person with BPD reduces reported adverse incidents within the family. Further studies are needed to show whether this reduction improves outcomes for the individual with BPD. (PsycINFO Database Record (c) 2019 APA, all rights reserved).


Assuntos
Transtorno da Personalidade Borderline/enfermagem , Família/psicologia , Educação em Saúde/métodos , Mentalização/fisiologia , Psicoterapia/métodos , Apoio Social , Adolescente , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem
11.
Encephale ; 45(2): 133-138, 2019 Apr.
Artigo em Francês | MEDLINE | ID: mdl-29960681

RESUMO

INTRODUCTION: Borderline Personality Disorder is a frequent disorder that is challenging for therapists to treat due to the prevalence of self-damaging and suicidal behaviours and interruptions of the therapeutic alliance, as well as a poor response to psychotropic treatments. In recent years, several empirically-validated psychotherapeutic treatments have been developed, including Mentalisation-Based Therapy, which is an integrative psychodynamic approach created in Britain. Although numerous studies have showed Mentalisation-Based Therapy to be an efficient treatment of Borderline Personality Disorder, its specific components have yet to be assessed. Furthermore, there have been no empirical studies conducted among groups of French-speaking patients. The purpose of this study is twofold: To provide an initial assessment of the efficacy of the mentalisation-based psycho-educational component, which is the first component of any mentalisation-based therapy, and to provide the first assessment of this approach among a population of French-speaking patients. METHOD: Over a three-month period, 14 Borderline Personality Disorder sufferers followed a psycho-educational Mentalisation-Based Therapy programme consisting of group sessions to introduce patients to mentalisation and weekly individual interviews. Patients filled in various question forms assessing, among others, the intensity of their depression, their degree of hopelessness, their emotional regulation strategies, and their reflective abilities. RESULTS: The psycho-educational component of Mentalisation-Based Therapy is significantly associated with improved cognitive emotional regulation, empathy and reflective abilities, and with a reduced sense of hopelessness. The programme retention rate was of 71.4%. CONCLUSION: Despite the small sample size and the short treatment period, these preliminary results demonstrate the efficiency of the psycho-educational phase of Mentalisation-Based Therapy, and in particular the positive effects of the treatment on depressive symptomatology and self-regulation processes among patients with a Borderline Personality Disorder diagnosis.


Assuntos
Transtorno da Personalidade Borderline/terapia , Mentalização/fisiologia , Psicoterapia/métodos , Teoria da Mente/fisiologia , Adulto , Instituições de Assistência Ambulatorial , Transtorno da Personalidade Borderline/epidemiologia , Transtorno da Personalidade Borderline/psicologia , Cultura , Feminino , Humanos , Idioma , Masculino , Autoimagem , Inquéritos e Questionários , Suíça/epidemiologia , Adulto Jovem
12.
Soc Cogn Affect Neurosci ; 14(12): 1285-1295, 2019 12 30.
Artigo em Inglês | MEDLINE | ID: mdl-31993655

RESUMO

Childhood traumatic brain injury (TBI) affects over 600 000 children per year in the United States. Following TBI, children are vulnerable to deficits in psychosocial adjustment and neurocognition, including social cognition, which persist long-term. They are also susceptible to direct and secondary damage to related brain networks. In this study, we examine whether brain morphometry of the mentalizing network (MN) and theory of mind (ToM; one component of social cognition) mediates the effects of TBI on adjustment. Children with severe TBI (n = 15, Mage = 10.32), complicated mild/moderate TBI (n = 30, Mage = 10.81) and orthopedic injury (OI; n = 42, Mage = 10.65) completed measures of ToM and executive function and underwent MRI; parents rated children's psychosocial adjustment. Children with severe TBI demonstrated reduced right-hemisphere MN volume, and poorer ToM, vs children with OI. Ordinary least-squares path analysis indicated that right-hemisphere MN volume and ToM mediated the association between severe TBI and adjustment. Parallel analyses substituting the central executive network and executive function were not significant, suggesting some model specificity. Children at greatest risk of poor adjustment after TBI could be identified based in part on neuroimaging of social brain networks and assessment of social cognition and thereby more effectively allocate limited intervention resources.


Assuntos
Lesões Encefálicas Traumáticas/fisiopatologia , Lesões Encefálicas Traumáticas/psicologia , Encéfalo/fisiopatologia , Mentalização/fisiologia , Teoria da Mente/fisiologia , Adolescente , Criança , Função Executiva/fisiologia , Feminino , Humanos , Imagem por Ressonância Magnética , Masculino , Comportamento Social
13.
PLoS One ; 13(11): e0207869, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30500853

RESUMO

Maternal mentalization refers to a mother's capacity to understand mental-states of herself and her child and to regard her child as a psychological agent. In mother-infant interactions, this capacity is commonly conceptualized as maternal mind-mindedness, which can be divided into two dimensions: appropriate and nonattuned interpretations of the infants' mental-states. Appropriate mind-mindedness refers to interpretations that seem to be compatible with the infant's behaviors, whereas nonattuned mind-mindedness refers to noncompatible interpretations. The aim of this study was to investigate the cognitive mechanisms that contribute to mind-mindedness. Specifically, we investigated the role of executive functions in appropriate and nonattuned mind-mindedness, and the moderating roles of two infant-related factors, prematurity (as a stressful context) and child temperament (as a context of unpredictability and negative emotionality). To this end, mother-infant free play interactions were coded for mind-mindedness in a sample of 102 mothers and their 6-month-old infants (61 preterm, 41 full-term). When children were 66-months old, mothers completed cognitive tasks that assessed working memory updating, resistance to interference, response inhibition, and shifting. Appropriate mind-mindedness was positively associated with updating, and this link was stronger when infant temperament was rated as more difficult. Furthermore, among mothers of full-term infants, mothers' resistance to interference was negatively associated with nonattuned mind-mindedness. This link was not evident in the stressful context of premature birth. Mothers' response inhibition and shifting were not associated with either of the mind-mindedness dimensions. Implications on understanding variability in maternal mentalization during mother-infant interactions and the roles of executive functions in parenting are discussed.


Assuntos
Função Executiva , Mentalização/fisiologia , Relações Mãe-Filho/psicologia , Mães/psicologia , Adulto , Criança , Feminino , Humanos , Lactente , Recém-Nascido , Masculino
14.
PLoS One ; 13(11): e0206433, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30383803

RESUMO

INTRODUCTION: Impairments in the ability to understand others and the self in terms of internal mental states (reflective functioning [RF] or mentalizing) are thought to play a key role in the development of borderline personality disorder (BPD). The first aim of this study was to validate the Italian version of the Reflective Functioning Questionnaire (RFQ), a brief self-report measure of RF, by examining its factor structure with Principal Component Analyses (PCA), and correlations with constructs that should be theoretically related to RF. In addition, we investigated whether the RFQ could empirically distinguish between healthy controls and carefully diagnosed BPD patients using Research Operating Curve methods, and was related to severity of borderline pathology as measured with the Shedler-Westen Assessment Procedure (SWAP), an observer-rated measure of BPD pathology. METHODS: An Italian translation of the RFQ was administered to a sample of 154 healthy controls and a clinical sample of 59 BPD patients diagnosed with the Structured Clinical Interview for DSM-IV Axis II disorders. Clinical severity of BPD was assessed with the SWAP. Normal controls completed self-report inventories of constructs related to RF (mindfulness, empathy, Theory of Mind, alexithymia, and autistic traits). RESULTS: PCA confirmed the a priori factor structure in the Italian translation of the RFQ, showing two subscales that measure certainty and uncertainty about mental states, with satisfactory reliability and construct validity. These dimensions also distinguished BPD patients from healthy controls (p < 0.05). ROC analyses showed that the uncertainty subscale discriminated BPD patients from healthy individuals (area under the curve = 78%, cut of 4.5 points, sensitivity = 73%, specificity = 68%). Within the patient group, regression analyses showed uncertainty about mental states to have a significant unique contribution in predicting BPD severity (p < 0.05), explaining 12% of the variance. CONCLUSIONS: Results largely supported the reliability and validity of the Italian version of the RFQ. These findings also provide further evidence for the role of impairments in mentalizing and reinforce the rationale for offering mentalization-based interventions to individuals with this disorder.


Assuntos
Transtorno da Personalidade Borderline/diagnóstico , Mentalização/fisiologia , Inquéritos e Questionários , Pensamento/fisiologia , Tradução , Adolescente , Adulto , Transtorno da Personalidade Borderline/patologia , Transtorno da Personalidade Borderline/psicologia , Estudos de Casos e Controles , Manual Diagnóstico e Estatístico de Transtornos Mentais , Feminino , Humanos , Itália , Idioma , Masculino , Pessoa de Meia-Idade , Reprodutibilidade dos Testes , Autorrelato , Índice de Gravidade de Doença , Inquéritos e Questionários/normas , Teoria da Mente/fisiologia , Adulto Jovem
15.
Infant Behav Dev ; 53: 43-48, 2018 11.
Artigo em Inglês | MEDLINE | ID: mdl-30314716

RESUMO

Pregnancy is shaped by unfolding psychological and biological changes in preparation for parenthood. A growing literature has examined the postpartum maternal brain. However, few studies examine the maternal brain during pregnancy, and whether brain function in pregnancy may have implications for postpartum caregiving. Using event-related potentials, we examined the late positive potential (LPP) elicited by infant distress and neutral faces in 35 women during their third trimester of pregnancy. Then, at 3 months postpartum, mothers completed a measure of parental reflective functioning to capture how they regarded their capacity to consider their child's thoughts and feelings. We found that in the third trimester, infant distress faces elicited larger LPPs compared to infant neutral faces. Moreover, the LPP elicited by infant neutral faces predicted levels of postpartum reflective functioning. Specifically, a larger LPP elicited by neutral infant faces predicted greater maternal self-reported difficulty recognizing and understanding their own infant's thoughts and feelings. Our findings suggest that studying the pregnant brain may have predictive value for facets of postpartum caregiving and may inform clinical interventions with new mothers.


Assuntos
Encéfalo/fisiologia , Mentalização/fisiologia , Relações Mãe-Filho/psicologia , Mães/psicologia , Gravidez/psicologia , Adulto , Eletroencefalografia/métodos , Emoções/fisiologia , Feminino , Humanos , Lactente , Período Pós-Parto/psicologia , Terceiro Trimestre da Gravidez , Inquéritos e Questionários
16.
Psychiatry ; 81(3): 240-257, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30183526

RESUMO

BACKGROUND: Affective temperaments have been shown to be related to psychiatric disorders and suicidal behaviors. Less is known about the potential contributory role of affective temperaments on suicide risk factors. In the present study, we investigated whether the effect of affective temperaments on suicide risk was mediated by other variables, such as hopelessness, mentalization deficits, dissociation, psychological pain, and depressive symptoms. METHODS: Several assessment instruments, including the Mini International Neuropsychiatric Interview (MINI); the Temperament Evaluation of Memphis, Pisa, and San Diego Autoquestionnaire (TEMPS-A); the Beck Hopelessness Scale (BHS); the Gotland Male Depression Scale (GMDS); the Dissociative Experiences Scale (DES); the Psychological Pain Assessment Scale (PPAS); and the Mentalization Questionnaire (MZQ), were administered to 189 psychiatrically hospitalized patients (103 women, 86 men) in Rome, Italy. RESULTS: In single-mediator models, hopelessness, depressive symptoms, and mentalization, but not psychological pain or dissociation, were significant mediators in the association between prevalent temperament and suicide risk. In a multiple-mediator model, a significant indirect effect was found only for depression. Results demonstrated that patients with negative temperaments reported higher suicide risk, psychological pain, hopelessness, and depression, and less mentalization than patients with no prevalent temperament or hyperthymic temperaments. CONCLUSIONS: Hopelessness, depression, and mentalization are all factors that mediate the relation between affective temperaments and suicide risk. Identifying factors that mediate the effects of affective temperamental makeup on suicide risk should enhance screening and intervention efforts.


Assuntos
Afeto/fisiologia , Depressão/fisiopatologia , Esperança/fisiologia , Transtornos Mentais/fisiopatologia , Mentalização/fisiologia , Suicídio , Temperamento/fisiologia , Adulto , Feminino , Humanos , Pacientes Internados , Masculino , Pessoa de Meia-Idade , Unidade Hospitalar de Psiquiatria , Fatores de Risco
17.
BMC Psychiatry ; 18(1): 257, 2018 08 16.
Artigo em Inglês | MEDLINE | ID: mdl-30115039

RESUMO

BACKGROUND: Expressed emotion (EE) is a global index of familial emotional climate, which is comprised of emotional over-involvement (EOI) and critical comments (CC)/hostility. Although EE is an established predictor of negative outcomes for both people with long-term mental health difficulties and their family carers, its psychological underpinnings remain relatively poorly understood. This paper examined associations between attachment, mentalisation ability and aspects of EE. METHODS: Carers of people with long-term mental health difficulties (n = 106) completed measures of adult attachment (the Experiences in Close Relationships-Short Form questionnaire), mentalisation (the Reading the Mind in the Eyes Test and the Emotional Self-Efficacy Scale) and EE (the Family Questionnaire). Data were analysed using hierarchical multiple regression. RESULTS: Attachment avoidance and facets of mentalisation were directly and uniquely positively associated with CC/hostility, with attachment avoidance and other-directed emotional self-efficacy (one facet of mentalisation) each significantly predicting CC/hostility scores after controlling for the effects of EOI and demographic variables. However, no associations were observed between EOI, attachment anxiety and mentalisation. Furthermore, no indirect effects from attachment to EE via mentalisation was found. CONCLUSIONS: Although it would be premature to propose firm clinical implications based on these findings, data indicate that it may be beneficial for clinicians to consider attachment and mentalisation in their conceptualisation of carers' criticism and hostility. However, further research is needed to clarify the magnitude of these associations and their direction of effect before firm conclusions can be drawn.


Assuntos
Cuidadores/psicologia , Emoções Manifestas , Transtornos Mentais/psicologia , Saúde Mental , Mentalização , Apego ao Objeto , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Emoções Manifestas/fisiologia , Feminino , Humanos , Masculino , Transtornos Mentais/terapia , Mentalização/fisiologia , Pessoa de Meia-Idade , Autorrelato , Inquéritos e Questionários , Fatores de Tempo , Adulto Jovem
18.
Psychiatry Res ; 268: 198-205, 2018 10.
Artigo em Inglês | MEDLINE | ID: mdl-30048885

RESUMO

There are conflicting results concerning risk of violence in schizophrenia. Empathy and mentalization deficits are associated both with schizophrenia and violence, however, there are only a few studies with equivocal results concerning their relationship. 88 violent and nonviolent paranoid schizophrenic and violent and nonviolent control males in psychiatric, forensic psychiatric and correctional institutions completed the Ekman 60 Faces test, Faux Pas Recognition Test, Eysenck IVE test, Interpersonal Reactivity Index, and the Spielberger Anger Expression Scale. Data were analysed with ANOVA and logistic regression models. Significant group differences with a characteristic pattern were detected in mentalization, facial affect recognition, fear and anger recognition, interpersonal distress, and frequency of direction of anger expression. Predictors of violent behaviour were different in the schizophrenic and non-schizophrenic groups. Lack of major differences in empathy and mentalization between violent and nonviolent schizophrenia patients suggests that such deficits are core features of schizophrenia but do not determine emerging violence in this illness. Our results emphasise the importance of distinguishing between violence related to core positive symptoms of schizophrenia and that emerging from independent comorbid antisocial personality traits in order to identify targets for screening, detection, prevention and management of violence risk in different subpopulations of schizophrenia patients.


Assuntos
Empatia/fisiologia , Mentalização/fisiologia , Psicologia do Esquizofrênico , Violência/psicologia , Adulto , Agressão/psicologia , Ira , Transtorno da Personalidade Antissocial/psicologia , Humanos , Masculino
19.
J Clin Psychol ; 74(12): 2276-2286, 2018 12.
Artigo em Inglês | MEDLINE | ID: mdl-29998458

RESUMO

OBJECTIVES: Associations between interpersonal problems and mentalization have rarely been investigated. In this study, we explored patterns of interpersonal problems, mentalization, symptom severity, and attachment during inpatient treatment and at follow-up. Additionally, we investigated whether mentalization predicts a decrease in interpersonal distress. METHOD: We analyzed time-series data from patients with mental disorders. Data were collected at the beginning and at the end of inpatient treatment, and approximately 6 months after discharge from hospital. RESULTS: Patterns of correlations were stable from admission to the hospital until follow-up. Treatment significantly increased the levels of mentalization and decreased the levels of interpersonal problems and symptom severity, whereas attachment was only partially targeted. Improvements in mentalization significantly predicted reduction in interpersonal distress at each point in time. CONCLUSION: Results revealed characteristic patterns of interpersonal problems, mentalization, symptom severity, and attachment. Mentalization was found to play a key role in the reduction of interpersonal distress.


Assuntos
Relações Interpessoais , Transtornos Mentais/fisiopatologia , Mentalização/fisiologia , Apego ao Objeto , Estresse Psicológico/fisiopatologia , Adulto , Feminino , Seguimentos , Hospitalização , Humanos , Masculino , Transtornos Mentais/terapia , Pessoa de Meia-Idade , Estresse Psicológico/terapia
20.
Psychiatry Res ; 268: 108-113, 2018 10.
Artigo em Inglês | MEDLINE | ID: mdl-30015108

RESUMO

Previous research has found an association between insecure attachment and increased somatization in adults. However, the mechanisms underlying this association are unknown. In the present study, we examined whether the association between attachment insecurity and somatization in psychiatric patients diagnosed with medically unexplained somatic symptoms (MUSS) is mediated by mentalization deficits. Attachment security of 58 outpatients diagnosed with MUSS was measured with the Experiences in Social Relationships Questionnaire (ECR). Difficulty with understanding own emotions was measured with the Toronto Alexithymia Scale-20. In addition, others' mental state comprehension was measured with the Reading the Mind in the Eyes Test (RMET). Somatic symptom severity experienced by MUSS patients was related to attachment anxiety and alexithymia. These associations remained significant after controlling for sex, age, medication use, and depressive symptoms. Moreover, alexithymia mediated the association between anxious attachment and severity of somatic symptoms. Somatic symptom severity was also related to better RMET performance, although this association was not significant after controlling for sex, age, medication use, and depressive symptoms. Our findings may indicate that individuals with an anxious attachment style have difficulties in clarifying own emotions. This may in turn result in somatic experience of emotional distress and risk for development of MUSS.


Assuntos
Sintomas Afetivos/psicologia , Ansiedade de Separação/psicologia , Depressão/psicologia , Sintomas Inexplicáveis , Mentalização/fisiologia , Apego ao Objeto , Adulto , Sintomas Afetivos/diagnóstico , Sintomas Afetivos/epidemiologia , Ansiedade de Separação/diagnóstico , Ansiedade de Separação/epidemiologia , Estudos Transversais , Depressão/diagnóstico , Depressão/epidemiologia , Manual Diagnóstico e Estatístico de Transtornos Mentais , Emoções/fisiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Inquéritos e Questionários/normas
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