General mentalizing, emotional theory of mind and interpersonal mistrust in anorexia nervosa: The validation of the Hebrew version of the Cambridge mindreading face‐task

Abstract

Objective: This study had two goals. The first was to validate and examine the potential of the Hebrew version of the Cambridge Mindreading face task (CAM Heb )-an ecological measure of emotional theory of mind (eToM)-to assess eToM in individuals with anorexia nervosa (AN). The second goal was to examine whether interpersonal mistrust would mediate the relation between mentalizing and eToM and the severity of AN. Method:The validity of the CAM Heb was examined using well-established measures of mentalizing ability and eToM in 45 young female patients with AN and 53 control participants. Next, the mediation model was assessed using a subsample of 33 AN patients and 34 controls, in which interpersonal mistrust was additionally assessed. Results:The CAM Heb correlated with the measures of mentalizing ability and eToM.The CAM Heb , along with the measure of general mentalizing, significantly differentiated between the AN and control groups. The associations of general mentalizing and CAM Heb with eating disorder (ED) symptoms were mediated by interpersonal mistrust. Conclusion:The CAM Heb is a valid measure of deficient eToM in AN. In therapy, an increase in mentalizing ability and accurate eToM may enhance interpersonal trust, which may further contribute to attenuation of AN symptoms.

The association between deficiencies in paternal and maternal reflective functioning and anorexia nervosa symptomatology

“…In this sense, ED symptoms are conceptualized as an attempt to establish a sense of viability, and self-regulation [ 28 , 29 ]. In line with this theoretical model, empirical studies show that in comparison to non-clinical samples, patients with AN are characterized by lower RF levels [ 30 , 31 ], a higher prevalence of alexithymia [ 32 ], and difficulties in recognizing others' emotions [ 31 , 33 ]. However, these studies are cross-sectional and causality is yet to be established.…”

“…The developmental mentalization model suggests that deficits in the parent's ability to ponder about his or her child's emotional experience and then adequately reflect the emotional experience back to the child, may result in the child's inability to comprehend his or her inner world, putatively leading to the development of ED symptoms as a concrete means of emotional regulation [ 28 ]. However, despite the vast body of research demonstrating reduced mentalizing abilities in adolescent and adult patients with AN [ 31 – 34 ], only a handful of studies have examined parents' mentalizing abilities in the context of EDs. Specifically, there is no data on the RF of fathers of patients with EDs and only one study has examined the RF levels of mothers of patients with AN [ 35 ].…”