Beyond diagnosis: Mentalization and mental health from a transdiagnostic point of view in adolescents from non-clinical population

Abstract

Corresponding Author HIGHLIGHTS• Mentalization contributes to mental health beyond symptoms • Mentalization deficit is not so much associated to general psychopathology • Higher mentalization deficit is not associated to higher comorbidity • Mentalization is associated to good role, social and general functioning • Mentalization is associated to self-esteem, resiliency and well-being ABSTRACT An increasing volume of evidence suggests that mentalization (MZ) can be an important factor in the transition from mental health to mental illness and vice versa. However, most studies are focused on the role of MZ in specific disorders. This study aims to evaluate the relationship between MZ and mental health as a trans-diagnostic process. A sample of 172 adolescents aged 12 to 18 years old (M=14.6, SD=1.7; 56.4% of girls) was assessed on measures of MZ, psychopathology and psychological functioning from a multimethod and multi-informant perspective. Contrary to predictions, MZ was not associated with general psychopathology and comorbidity, even when explored from a broad, trans-diagnostic perspective. However, we observed a robust association linking MZ to functioning and well-being across many dimensions, involving social, role and several psychological indicators of adjustment and mental health. These results suggest that MZ may contribute to mental health beyond symptoms, not so much associated with psychopathology, but rather resilience and well-being.

Self and Other Mentalizing Polarities and Dimensions of Mental Health: Association With Types of Symptoms, Functioning and Well-Being

“…This suggests an association between mentalizing and mental health which should be applicable to all the three evaluated elements: functioning, well-being, and also symptoms. Secondly, previous studies utilizing global measures of mentalizing found no association with general psychopathology (e.g., Ballespí et al, 2018), but it was expected that investigation with a multidimensional measure of mentalizing would provide different results. Finally, albeit limited, there is evidence supporting the association between the role of mentalizing in the development of internalizing and externalizing problems (Sharp et al, 2008).…”

“…Further, research shows that mentalizing is non-specifically affected in the presence of psychopathology regardless the type of disorder (Sharp et al, 2008). Mentalizing problems are prominent in personality disorders, especially in borderline and antisocial personality disorder, as well as in depression, anxiety, social anxiety, trauma-related disorders, attachment disorders, eating disorders, addictions, somatoform disorders, autism, and psychosis (see Ballespí et al, 2018;Bateman and Fonagy, 2019;Luyten et al, 2020, for a review). This nonspecific association suggests that mentalizing is decreased when mental health decreases.…”

Meta-mood knowledge moderates the relationship between neuroticism and depression but not between neuroticism and anxiety in a sample of nonclinical adolescents

“…It is more likely that emotional selfawareness is less stable than neuroticism and can be an effective therapeutic component for improvement through psychotherapy (De Gucht, 2003). Simply because it can serve as a tool for developing the necessary psychological resilience mechanisms (Ballespí et al, 2018). In other words, based on a social-communicative approach, the perception and understanding of emotions as less stable intrapersonal traits may play a role as a moderating factor in the relationship between neuroticism and internalizing psychopathology such as depression and anxiety.…”

“…In the current study, therefore, we considered a multidimensional approach to attention to emotion and emotional clarity, which also provides the opportunity to capture emotion-based individual differences in the development of internalizing psychopathology. It seems crucial to understand potentially effective resilience mechanisms from a transdiagnostic perspective (Ballespí et al, 2018). Given that neuroticism is a common risk factor and a central feature of internalizing psychopathology (Spiroiu, 2018;Wilkinson, 2009).…”

Attachment representation to caregivers and mentalizing ability in early adolescents with primary headache

“…Therefore, an individual who is able to reflect upon the mental states of the self and others can engage in complex reasoning regarding interpersonal interactions and relationships (Fonagy et al, 1991), perceive and label emotions regarding difficult life experiences, as well as to engage in a reflective process about these experiences reducing their negative impact (Fonagy, Gergely, Jurist, & Target, 2002). In turn, this ability is linked with well‐being and resilience (Ballespí, Vives, Debbané, Sharp, & Barrantes‐Vidal, 2018; Borelli et al, 2019) facilitating the relationship between an individual's internal and external world, and it is considered a protective factor against developmental problems (Katznelson, 2014). Conversely, mentalizing impairments linked with attachment deactivating and hyperactivating strategies lead to further distress and behaviours that perpetuate symptoms and complaints as well as interpersonal problems (Luyten, van Houdenhove, Lemma, Target, & Fonagy, 2012).…”