Introduction: The concept of mentalizing is nowadays widely used in research as well as in clinical practice. Despite its popularity, the development of an economic assessment is still challenging. The Mentalization Scale appears to be a promising measurement with good psychometric properties but lacking convergent validity with the Reflective Functioning Scale.Objective: This study aims to test the construct validity of the Mentalization Scale through correlations with the gold standard, the Reflective Functioning Scale, within a clinical sample. Furthermore, it was of interest to replicate its internal consistency.Methods: Twenty-six inpatients of an acute psychiatric ward in Vienna were given the Mentalization Scale (MentS). They were interviewed with the Brief Reflective Function Interview, which was coded with the Reflective Functioning Scale. Correlations and internal consistency were calculated.Results: Concerning the primary aim of this study, the validity was satisfactory for the MentS whole-scale mentalizing as well as for the subscales self- and other-oriented mentalizing. Internal consistency was lower to the findings of the developer and close to the 0.70 threshold.Conclusion: Our findings could foster the psychometric properties of the MentS. Furthermore, the MentS seems to be a promising measurement tool for detecting different dimensions of reflective functioning. Limitations and further research are discussed.

Mentalizing describes the human ability to comprehend one’s own and others’ mental states and is seen as one of the core competencies of psychotherapists. Current research has emphasized the importance of both early dyadic attachment as well as broader sociocultural environmental input on the development of mentalizing. This study investigates whether mentalizing skills, operationalized via reflective functioning (RF), might be influenced by training and working conditions. This study was a matched case-control comparison, cross-sectional study. RF was assessed in a total of 10 psychotherapy trainees working in private practice at the beginning (group A; n = 5) and end (group B; n = 5) of their psychotherapy training (training association: Gestalt Therapy, Institute of Integrative Gestalttherapy Vienna) and in a total of 40 health professionals (institution: General Hospital Vienna—Social Medical Center South, Vienna, Department of Psychiatry, acute psychiatric ward) at the beginning of (group C; n = 20) and without (group D; n = 20) mentalization based therapy training. The participants differed from each other regarding their training, but participants of the same institution were matched. RF scores were significantly higher in group A and B than in group C and D (A,C: p = 0.0065, Odds Ratio (OR): 0.0294; A,D: p = 0.0019, OR: 0.0132; B,C: p = 0.0065, OR: 0.0294, B,D: p = 0.0019, OR: 0.0132). RF scores were not significantly different among groups A and group B (A,B: p > 0.9999) or between groups C and D (C,D: p = 0.6050). The current study suggests that mentalizing skills might be rather slow to improve by training, but that they might be influenced by the context.

The psychological strain of many psychiatric disorders arises from difficulties encountered in social interactions. Social withdrawal is often the first symptom of neuropsychiatric disorders. The authors explore the various options for training social cognition skills. Social cognition was assessed using the Movie for the Assessment of Social Cognition (MASC). After completion of mentalization-based therapy (MBT) training, MASC scores improved significantly in health care providers (p = .006, r = .57). Mentalizing (operationalized with reflective functioning [RF]) was assessed in the MBT group (Group A) and compared with RF in a control group (Group B). RF was significantly higher in Group A (RF = 4.35, SD = 1.19) than in Group B (RF = 3.43, SD = 1.70) (p = .0385; Cohen's d = 0.65). MBT might be a promising intervention in social cognition training. Mentalizing skills might be associated with attitude.

ZusammenfassungDas Konzept der Mentalisierungsfähigkeit, etabliert ausgehend von der Theory of Mind (ToM), beinhaltet jene menschliche Fähigkeit, die eigenen mentalen Zustände (z. B. Gedanken, Gefühle, Motive) sowie entsprechend jene des Gegenübers, in einen Sinn- und Bedeutungszusammenhang zu bringen und aus diesem mehr oder weniger tiefen Verständnis hilfreiche Erklärungsmodelle für Verhalten zu generieren. Entwickeln und entfalten sich menschliche mentale Funktionen und Fähigkeiten im „Gegenseitigen-aufeinander-bezogen-Sein“, so impliziert diese Weltsicht das Individuum als im Wesentlichen sozial determiniert. Leidensdruck infolge depressiver als auch schizophreniformer Störungen resultiert ganz wesentlich aus eingeschränkter Mentalisierungsfähigkeit, dies unabhängig von der unterschiedlichen Ätiologie der genannten Störungen.Die folgenden Ausführungen legen dar, inwieweit Defizite in der Mentalisierung bei schizophreniformen Störungsbildern in Erscheinung treten. Diese Defizite sind gekennzeichnet durch eine mangelhafte Ausbildung von Metarepräsentationen und zeigen je nach Symptomatik verschiedene prämentalistische Verarbeitungsmodi und deren spezifische Ausformungen (Hypo‑/Hypermentalisieren). An einer geschilderten Fallvignette wird dies verständlich.