Mentalization of complex emotions in borderline personality disorder: The impact of parenting and exposure to trauma on the performance in a novel cartoon-based task

Brüne, Martin; Walden, Sarah; Edel, Marc‐Andreas; Dimaggio, Giancarlo

doi:10.1016/j.comppsych.2015.08.003

Cited by 64 publications

(68 citation statements)

References 41 publications

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“…The current study further examined the relationship between attachment and mentalizing and found it to be bidirectional. Although previous studies found that attachment insecurity contributed to mentalizing [16,19], Fonagy and Bateman [41] pointed out that it would be appropriate to describe attachment and mentalizing as interrelated phenomena from different starting points in adulthood. They suggested that attachment and mentalizing may interact in a complex causal way, in which early experiences of maltreatment lead to disruptions of the attachment system, which in turn causes mentalizing failure when the attachment system is activated.…”

Section: Discussion/conclusionmentioning

confidence: 99%

“…This prevents traumatized individuals from effectively using social support to manage trauma and may contribute to poor posttraumatic adjustment and thus higher levels of PTSD symptomatology [12]. There is emerging evidence to indicate mentalizing failures in traumatized individuals, including lower emotional understanding [17], delayed onset of theory of mind [18], and increased difficulties in mentalizing [13,19,20]. Among survivors of childhood trauma, compromised mentalizing further acts as a risk factor for severe psychopathology such as personality disorders [21], as well as depressive symptoms and externalizing and sexualized behaviours [14,22], indicating that mentalizing can be considered a mediator of the relationship between trauma and posttraumatic symptomatology.…”

Section: Introductionmentioning

confidence: 99%

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Multidirectional Pathways between Attachment, Mentalizing, and Posttraumatic Stress Symptomatology in the Context of Childhood Trauma

Huang

Fonagy²,

Feigenbaum³

et al. 2020

Psychopathology

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Introduction: Exposure to traumatic stressful events in childhood is an important risk factor for the development of posttraumatic symptomatology. From a mentalization-based developmental perspective, childhood adversity can affect attachment in children and may result in insecure attachment and impaired mentalizing abilities, which increase the lifetime risk for psychopathology. The present cross-sectional study examined the potential mediating role of attachment insecurity and impaired mentalizing on the relationship between childhood trauma and posttraumatic symptomatology. Method: Adults who had experienced childhood neglect and abuse (n = 295, 184 patients with personality disorder and 111 community controls) completed self-report measures of posttraumatic stress disorder (PTSD) symptoms, dissociative experiences, adult attachment insecurity, and mentalizing. Results: Structural equation modelling results revealed that attachment insecurity together with lower mentalizing mediated the link between childhood trauma and PTSD symptoms, and lower mentalizing mediated the link between childhood trauma and dissociative experiences. Conclusion: The findings show that attachment insecurity and lower mentalizing play significant mediating roles in the reporting of posttraumatic symptomatology among survivors of childhood abuse and neglect, with treatment implications for mentalization-based therapy as beneficial for individuals with a history of childhood trauma.

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Section: Discussion/conclusionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Multidirectional Pathways between Attachment, Mentalizing, and Posttraumatic Stress Symptomatology in the Context of Childhood Trauma

Huang

Fonagy²,

Feigenbaum³

et al. 2020

Psychopathology

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“…These difficulties are made obvious when laboratory tasks are complex enough, mirror real-life conditions, or elicit distress (Brüne, Walden, Edel, & Dimaggio, 2016;New et al, 2012;Petersen, Brakoulias, & Langdon, 2016;Preissler et al, 2010) or when analysing patients' discourse in semi-structured interviews (Dimaggio et al, 2009;Dinger et al, 2014;Outcalt et al, 2016;Semerari et al, 2005;2015).…”

Section: Metacognition In Borderline Personality Disordermentioning

confidence: 99%

Metacognition as a predictor of change in the treatment for borderline personality disorder: A preliminary pilot study.

Maillard¹,

Dimaggio²,

Roten³

et al. 2017

Journal of Psychotherapy Integration

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There is evidence that a key feature in borderline personality disorder (BPD) is the difficulty to reflect on one's own as well as on other people's state of mind. So far, no study has examined the link between metacognition and symptom change presented by BPD patients across treatment. This preliminary pilot study represents a first step in describing impairments in different dimensions of metacognition and their connection with the symptoms presented by a N ϭ 10 BPD sample. The transcripts from the first and the penultimate session of a 10-session version of Good Psychiatric Management were analyzed. The global score and the 3 subscales of the Metacognition Assessment Scale-Revised were used to assess metacognitive abilities: Understanding of one's own mind, Understanding of other's mind, and Mastery. Symptoms were assessed with the Outcome Questionnaire-45.2. Results show a general low level of metacognition. Therapy sessions with BPD patients seem to be characterized by impairments in metacognition, notably in the reflection on other's states of mind and in the use of this information to solve conflicts and problems. Moreover, sessions highlighting a higher level of the Understanding of other's mind at the onset of treatment were linked with better outcome compared to sessions showing poorer metacognitive abilities in this area. Implications for an integrated treatment for BPD and future research are discussed.

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“…Aristotle (R.McKeon, Trans, ) defined anger as an impulse towards revenge for a slight directed without justification. Thus, the emotion of anger is considered more basic and impulsive compared with guilt, which is included among the complex emotions (Brüne, Walden, Edel, & Dimaggio, ) and is related to counterfactual thinking rather than impulse. Although the neural systems implicated in anger are not as reproducible as orbitofrontal cortex associations with guilt, anger has been associated with activation in the lateral orbitofrontal cortex (Moll et al ., ; Zahn, de Oliveira‐Souza, et al ., ; Zahn, Moll, et al ., ), dorsomedial pre‐frontal cortex (Moll et al ., ), amygdala (Blair, ; Moll et al ., ), hypothalamus (Blair, ) and periaqueductal grey (Blair, ), regions that generally do not overlap with areas found to be involved with guilt.…”

Section: Discussionmentioning

confidence: 99%

Impairment in judgement of the moral emotion guilt following orbitofrontal cortex damage

Funayama

Koreki

Muramatsu

et al. 2018

Journal of Neuropsychology

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Although neuroimaging studies have provided evidence for an association between moral emotions and the orbitofrontal cortex, studies on patients with focal lesions using experimental probes of moral emotions are scarce. Here, we addressed this topic by presenting a moral emotion judgement task to patients with focal brain damage. Four judgement tasks in a simple pairwise choice paradigm were given to 72 patients with cerebrovascular disease. These tasks consisted of a perceptual line judgement task as a control task; the objects' preference task as a basic preference judgement task; and two types of moral emotion judgement task, an anger task and a guilt task. A multiple linear regression analysis was performed on each set of task performance scores to take into account potential confounders. Performance on the guilt emotion judgement task negatively correlated with the orbitofrontal cortex damage, but not with the other variables. Results for the other judgement tasks did not reach statistical significance. The close association between orbitofrontal cortex damage and a decrease in guilt emotion judgement consistency might suggest that the orbitofrontal cortex plays a key role in the sense of guilt, a hallmark of morality.

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Mentalization of complex emotions in borderline personality disorder: The impact of parenting and exposure to trauma on the performance in a novel cartoon-based task

Cited by 64 publications

References 41 publications

Multidirectional Pathways between Attachment, Mentalizing, and Posttraumatic Stress Symptomatology in the Context of Childhood Trauma

Multidirectional Pathways between Attachment, Mentalizing, and Posttraumatic Stress Symptomatology in the Context of Childhood Trauma

Metacognition as a predictor of change in the treatment for borderline personality disorder: A preliminary pilot study.

Impairment in judgement of the moral emotion guilt following orbitofrontal cortex damage

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