Proposal for an empirical model of mentalization for clinical and research purposes
DOI:
https://doi.org/10.22544/rcps.v44i02.12Keywords:
Mentalization, Cognitive Mentalization, Emotional Mentalization, Factorial Analysis, Clinical PsychologyAbstract
Mentalization is a psychological construct that has gained more and more attention over the last few years. Despite this growing interest, researchers have emphasized its multidimensional and complex nature, suggesting it encompasses several interrelated polarities under a broader, unified framework. This study aims to examine the underlying factor structure of key mentalization measures, with the objective of proposing an empirically grounded and comprehensive model applicable in both clinical and research settings. In addition, we provided normative data (percentile ranks) for each individual measure as well as for the extracted factors. A total of 1,190 Spanish adults from the general population (Mage = 34.38; 68.2% female) completed an online survey including the Interpersonal Reactivity Index, the Toronto Alexithymia Scale, the Reading the Mind in the Eyes Test, and the Mindful Attention Awareness Scale. Exploratory and confirmatory factor analysis of these instruments supported a two-factor solution, labelled Cognitive Mentalization and Emotional Mentalization. Furthermore, these dimensions contributed to a higher-order global factor, termed Mentalization. Overall, we observed small negative correlations with age, and women scored higher than menReferences
Bagby, R., Parker, J., & Taylor, G. (1994). The twenty-item Toronto Alexithymia Scale--I. Item selection and cross-validation of the factor structure. Journal of Psychosomatic Research, 38, 23-32. https://doi.org/10.1016/0022-3999(94)90005-1
Baron-Cohen, S., Wheelwright, S., Hill, J., Raste, Y., & Plumb, I. (2001). The "Reading the Mind in the Eyes" Test revised version: a study with normal adults, and adults with Asperger syndrome or high-functioning autism. Journal of Child Psychology and Psychiatry 42(2), 241-251. https://doi.org/10.1111/1469-7610.00715
Bate, J., Hauschild, S., & Talia, A. (2019). From pretending to play to playing pretend: The role of epistemic trust in mentalization-based therapy with children. Prax Kinderpsychol Kinderpsychiatr, 68(8), 742-759. https://doi.org/10.13109/prkk.2019.68.8.742
Bateman, A., O'Connell, J., Lorenzini, N., Gardner, T., & Fonagy, P. (2016). A randomised controlled trial of mentalization-based treatment versus structured clinical management for patients with comorbid borderline personality disorder and antisocial personality disorder. BMC Psychiatry, 16(1), 304. https://doi.org/10.1186/s12888-016-1000-9
Bentler, P. M. (1977). Factor simplicity index and transformations. Psychometrika, 59, 567-579.
Bentler, P. M. (2005). EQS 6.1: Structural equations program manual. Encino, CA: Multivariate Software Inc.
Bogdan-Ganea, & Herrero-Fernández, D. (2018). Aggressive thinking on the road. The mediation effect of aggressive thinking in the relationship between driving anger and aggression in Romanian drivers. Transportation Research Part F-Traffic Psychology and Behaviour, 55, 153-166. https://doi.org/10.1016/j.trf.2018.02.028
Bonfils, K. A., Lysaker, P. H., Minor, K. S., & Salyers, M. P. (2017). Empathy in schizophrenia: A meta-analysis of the Interpersonal Reactivity Index. Psychiatry Research, 249, 293-303. https://doi.org/10.1016/j.psychres.2016.12.033
Brown, K. W., & Ryan, R. M. (2003). The benefits of being present: mindfulness and its role in psychological well-being. Journal of Personlity Social Psycholgy, 84(4), 822-848. https://doi.org/10.1037/0022-3514.84.4.822
Browne, M. W., & Cudeck, R. (1993). Alternative ways of assessing fit. In K. A. Bollen (Ed.), Testing Structural Equation Models (pp. 136-162). Sage: Newbury Park, CA.
Choi-Kain, L. W., & Gunderson, J. G. (2008). Mentalization: ontogeny, assessment, and application in the treatment of borderline personality disorder. American Journal of Psychiatry, 165(9), 1127-1135. https://doi.org/10.1176/appi.ajp.2008.07081360
Clarke, A., Meredith, P. J., & Rose, T. A. (2020). Exploring mentalization, trust, communication quality, and alienation in adolescents. PLoS One, 15(6), e0234662. https://doi.org/10.1371/journal.pone.0234662
Cruise, K. E., & Becerra, R. (2018). Alexithymia and problematic alcohol use: A critical update. Addictive Behaviors, 77, 232-246. https://doi.org/10.1016/j.addbeh.2017.09.025
Di Tella, M., Tesio, V., Bertholet, J., Gasnier, A., Gonzalez Del Portillo, E., Spalek, M., . . . Franco, P. (2020). Professional quality of life and burnout among medical physicists working in radiation oncology: The role of alexithymia and empathy. Phys Imaging Radiat Oncol, 15, 38-43. https://doi.org/10.1016/j.phro.2020.07.001
Espinós, U., Fernández-Abascal, E. G., & Ovejero, M. (2019). Theory of mind in remitted bipolar disorder: Interpersonal accuracy in recognition of dynamic nonverbal signals. PLoS One, 14(9), e0222112. https://doi.org/10.1371/journal.pone.0222112
Espinós, U., Fernández-Abascal, E. G., Ovejero, M., & Lahera, G. (2021). Social cognition in first-degree relatives of bipolar disorder: Theory of Mind and nonverbal sensitivity. PLoS One, 16(3), e0246908. https://doi.org/10.1371/journal.pone.0246908
Evans, S., Ferrando, S., Findler, M., Stowell, C., Smart, C., & Haglin, D. (2008). Mindfulness-based cognitive therapy for generalized anxiety disorder. Journal of Anxiety Disorders, 22(4), 716-721. https://doi.org/10.1016/j.janxdis.2007.07.005
Fekete, K., Torok, E., Kelemen, O., Makkos, Z., Csigo, K., & Keri, S. (2019). Dimensions of mentalization in psychotic disorders. Neuropsychopharmacol Hung, 21(1), 5-11.
Ferrando, P. J., & Lorenzo-Seva, U. (2018). Assessing the quality and appropriateness of factor solutions and factor score estimates in exploratory item factor analysis. Educational and Psychological Measurement, 78, 762-780. https://doi.org/doi:10.1177/0013164417719308
Field, A. (2005). Discovering statistics using SPSS (3 ed.). London: SAGE.
Fischer-Kern, M., & Tmej, A. (2019). Mentalization and Depression: Theoretical Concepts, Treatment Approaches and Empirical Studies - an Overview. Z Psychosomatic Medicine and Psychotherapy, 65(2), 162-177. https://doi.org/10.13109/zptm.2019.65.2.162
Fonagy, P., Gergely, G., Jurist, E. L., & Target, M. (2002). Affect regulation, mentalization, and the development of the self. Other Press.
Gilanifar, M., & Delavar, M. A. (2017). The relationship between alexithymia and general symptoms of pregnant women. Romanian Journal of Internal Medicine, 55(1), 14-18. https://doi.org/10.1515/rjim-2016-0048
Grynberg, D., Chang, B., Corneille, O., Maurage, P., Vermeulen, N., Berthoz, S., & Luminet, O. (2012). Alexithymia and the processing of emotional facial expressions (EFEs): systematic review, unanswered questions and further perspectives. PLoS One, 7(8), e42429. https://doi.org/10.1371/journal.pone.0042429
Herrero-Fernández, D. (2015). A comparison of internet-based and paper-and-pencil questionnaires in assessing driving anger in a Spanish sample. REMA: Revista Electrónica de Metodología Aplicada, 20(1), 1-15.
Hu, L., & Bentler, P. M. (1999). Cutoff criteria for fit indexes in covariance structure analysis: Conventional criteria versus new alternatives. Structural Equation Modeling, 6, 1-55.
Iskric, A., Ceniti, A. K., Bergmans, Y., McInerney, S., & Rizvi, S. J. (2020). Alexithymia and self-harm: A review of nonsuicidal self-injury, suicidal ideation, and suicide attempts. Journal of Psychiatric Research, 288, 112920. https://doi.org/10.1016/j.psychres.2020.112920
Islam, M. A., & Siddique, S. (2016). Validation of the Bangla Mindful Attention Awareness Scale. Asian J Psychiatr, 24, 10-16. https://doi.org/10.1016/j.ajp.2016.08.011
Jørgensen, C. R., Freund, C., Bøye, R., Jordet, H., Andersen, D., & Kjølbye, M. (2013). Outcome of mentalization-based and supportive psychotherapy in patients with borderline personality disorder: a randomized trial. Acta Psychiatrica Scandinvca, 127(4), 305-317. https://doi.org/10.1111/j.1600-0447.2012.01923.x
Kelley, T. L. (1935). Essential traits of mental life, Harvard studies in education (Vol. 26). Harvard University Press.
Kiers, H. A. L. (1994). Simplimax: Oblique rotation to an optimal target with simple structure. Psychometrika, 59(4), 567-579. doi:10.1007/bf02294392
Kılıç, F., Demirdaş, A., Işık, Ü., Akkuş, M., Atay İ, M., & Kuzugüdenlioğlu, D. (2020). Empathy, Alexithymia, and Theory of Mind in Borderline Personality Disorder. Journal of Nervous Mental Diseases, 208(9), 736-741. https://doi.org/10.1097/nmd.0000000000001196
Krach, S., Blümel, I., Marjoram, D., Lataster, T., Krabbendam, L., Weber, J., . . . Kircher, T. (2009). Are women better mindreaders? Sex differences in neural correlates of mentalizing detected with functional MRI. BMC Neuroscience, 10, 9. https://doi.org/10.1186/1471-2202-10-9
Lieberman, M. D. (2007). Social cognitive neuroscience: a review of core processes. Annual Review of Psychology, 58, 259-289. https://doi.org/10.1146/annurev.psych.58.110405.085654
Lorenzo-Seva, U., & Ferrando, P. J. (2013). FACTOR 9.2 A Comprehensive Program for Fitting Exploratory and Semiconfirmatory Factor Analysis and IRT Models. Applied Psychological Measurement, 37(6), 497-498.
Lahera, G., Boada, L., Pousa, E., Mirapeix, I., Morón-Nozaleda, G., Marinas, L., . . . Parellada, M. (2014). Movie for the Assessment of Social Cognition (MASC): Spanish validation. Journal of Autism and Developmental Disorders, 44(8), 1886-1896. https://doi.org/10.1007/s10803-014-2061-6
Luyten, P., Campbell, C., Allison, E., & Fonagy, P. (2020). The Mentalizing Approach to Psychopathology: State of the Art and Future Directions. The Annual Review of Clinical Psychology, 16, 297-325. https://doi.org/10.1146/annurev-clinpsy-071919-015355
Luyten, P., Mayes, L. C., Nijssens, L., & Fonagy, P. (2017). The parental reflective functioning questionnaire: Development and preliminary validation. PLoS One, 12(5), e0176218. https://doi.org/10.1371/journal.pone.0176218
Luyten, P., & Fonagy, P. (2015). The neurobiology of mentalizing. Journal Personaityl Disorder, 6(4), 366-379. https://doi.org/10.1037/per0000117
Mardia, K. V. (1970). Measures of multivariate skewness and kurtosis with applications. Biometrika, 57, 519-530.
Martínez-Sánchez, F. (1996). Adaptación española de la escala de Alexitimia de Toronto (TAS-20) [The Spanish version of the Toronto Alexithymia Scale (TAS-20)]. Clínica y Salud, 7, 19-32.
Parada-Fernández, P., Herrero-Fernández, D., Oliva-Macías, M., & Rohwer, H. (2020). Stressful life events and hopelessness in adults: the mediating role of mentalization and emotional dysregulation. Brazilian Journal of Psychiatry. https://doi.org/10.1590/1516-4446-2020-1061
Parada-Fernández, P., Herrero-Fernández, D., Oliva-Macías, M., & Rohwer, H. (2021). Analysis of the mediating effect of mentalization on the relationship between attachment styles and emotion dysregulation. Scandinvin Journal of Psycholgy. https://doi.org/10.1111/sjop.12717
Parola, A., Salvini, R., Gabbatore, I., Colle, L., Berardinelli, L., & Bosco, F. M. (2020). Pragmatics, Theory of Mind and executive functions in schizophrenia: Disentangling the puzzle using machine learning. PLoS One, 15(3), e0229603. https://doi.org/10.1371/journal.pone.0229603
Pérez-Albéniz, A., Paúl, J., Torres, E., Montes, M., & Etxebarria, J. (2003). Adaptación de Interpersonal Reactivity Index (IRI) al español [Spanish adaptation of the Interpersonal Reactivity Index]. Psicothema, 15(2), 267-272.
Poznyak, E., Morosan, L., Perroud, N., Speranza, M., Badoud, D., & Debbané, M. (2019). Roles of age, gender and psychological difficulties in adolescent mentalizing. J Adolesc, 74, 120-129. https://doi.org/10.1016/j.adolescence.2019.06.007
Quaglia, J. T., Zeidan, F., Grossenbacher, P. G., Freeman, S. P., Braun, S. E., Martelli, A., . . . Brown, K. W. (2019). Brief mindfulness training enhances cognitive control in socioemotional contexts: Behavioral and neural evidence. PLoS One, 14(7), e0219862. https://doi.org/10.1371/journal.pone.0219862
Redondo, I., & Herrero-Fernandez, D. (2018). Validation of the Reading the Mind in the Eyes Test in a healthy Spanish sample and women with anorexia nervosa. Cogn Neuropsychiatry, 23(4), 201-217. https://doi.org/10.1080/13546805.2018.1461618
Rutherford, H. J., Wareham, J. D., Vrouva, I., Mayes, L. C., Fonagy, P., & Potenza, M. N. (2012). Sex differences moderate the relationship between adolescent language and mentalization. Journal Personality Disorder, 3(4), 393-405. https://doi.org/10.1037/a0028938
Simonsen, C. B., Jakobsen, A. G., Grøntved, S., & Kjaersdam Telléus, G. (2020). The mentalization profile in patients with eating disorders: a systematic review and meta-analysis. Nordic Journal of Psychiatry, 74(5), 311-322. https://doi.org/10.1080/08039488.2019.1707869
Soler, J., Tejedor Vinent, R., Feliu-Soler, A., Pascual, Y., Cebolla, A., & Soriano, J. (2012). Propiedades psicométricas de la versión española de la escala Mindful Attention Awareness Scale (MAAS) [Psychometric proprieties of Spanish version of Mindful Attention Awareness Scale (MAAS)]. Actas Españolas de Psiquiatría, 40, 18-25.
Thompson, N. M., Uusberg, A., Gross, J. J., & Chakrabarti, B. (2019). Empathy and emotion regulation: An integrative account. Progress in Brain Research, 247, 273-304. https://doi.org/10.1016/bs.pbr.2019.03.024
Timmerman, M. E., & Lorenzo-Seva, U. (2011). Dimensionality assessment of ordered polytomous items with parallel analysis. Psychological Methods, 16, 209-220.
Vogt, K. S., & Norman, P. (2019). Is mentalization-based therapy effective in treating the symptoms of borderline personality disorder? A systematic review. Psychol Psychother, 92(4), 441-464. https://doi.org/10.1111/papt.12194
Volkert, J., Hauschild, S., & Taubner, S. (2019). Mentalization-Based Treatment for Personality Disorders: Efficacy, Effectiveness, and New Developments. Curr Psychiatry Rep, 21(4), 25. https://doi.org/10.1007/s11920-019-1012-5
Wheaton, B., Muthén, B., Alwil, D., & Summers, G. (1977). Assessing reliability and stability in panel models. In D. R. Heise (Ed.), Sociological Methodology (pp. 84-136). Jossey-Bass.
Downloads
Published
How to Cite
Issue
Section
License
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
El Colegio, como institución editora, tiene todos los derechos reservados (copyright) sobre lo que se publica en la revista. Los autores y las autoras firman una declaración de cesión de derechos de autoría en el caso de aceptación de sus manuscritos para publicación en la revista, conforme con lo establecido en la legislación vigente.
Los artículos publicados representarán el punto de vista de su autoría y no de la revista, por lo que la autoría asume responsabilidad ante cualquier litigio o reclamación relacionada con derechos de propiedad intelectual y exonera de cualquier responsabilidad a la Revista Costarricense de Psicología y al Colegio.
La revista publicará en cada edición su política de acceso abierto (p.ej., Creative Commons). El material publicado en la revista puede ser copiado, fotocopiado, duplicado y compartido siempre y cuando sea expresamente atribuido al Colegio. El material de la revista no puede ser usado para fines comerciales.
