Department of Dynamic and Clinical Psychology, Faculty of Medicine and Psychology, Sapienza University of Rome, Via degli Apuli, 1, 00185 Rome, Italy.
Department of Dynamic and Clinical Psychology, Faculty of Medicine and Psychology, Sapienza University of Rome, Via degli Apuli, 1, 00185 Rome, Italy.
Psychiatry Res. 2017 Oct;256:169-175. doi: 10.1016/j.psychres.2017.06.045. Epub 2017 Jun 15.
Mentalization, operationalized as reflective functioning (RF), can play a crucial role in the psychological mechanisms underlying personality functioning. This study aimed to: (a) study the association between RF, personality disorders (cluster level) and functioning; (b) investigate whether RF and personality functioning are influenced by (secure vs. insecure) attachment; and (c) explore the potential mediating effect of RF on the relationship between attachment and personality functioning. The Shedler-Westen Assessment Procedure (SWAP-200) was used to assess personality disorders and levels of psychological functioning in a clinical sample (N = 88). Attachment and RF were evaluated with the Adult Attachment Interview (AAI) and Reflective Functioning Scale (RFS). Findings showed that RF had significant negative associations with cluster A and B personality disorders, and a significant positive association with psychological functioning. Moreover, levels of RF and personality functioning were influenced by attachment patterns. Finally, RF completely mediated the relationship between (secure/insecure) attachment and adaptive psychological features, and thus accounted for differences in overall personality functioning. Lack of mentalization seemed strongly associated with vulnerabilities in personality functioning, especially in patients with cluster A and B personality disorders. These findings provide support for the development of therapeutic interventions to improve patients' RF.
心理化，即体现为反省功能（RF），在人格功能的心理机制中起着至关重要的作用。本研究旨在：(a) 研究 RF、人格障碍（聚类水平）和功能之间的关联；(b) 调查 RF 和人格功能是否受到（安全型与不安全型）依恋的影响；以及 (c) 探索 RF 在依恋和人格功能关系中可能存在的中介效应。使用 Shedler-Westen 评估程序（SWAP-200）对临床样本（N=88）进行人格障碍和心理功能水平评估。使用成人依恋访谈（AAI）和反省功能量表（RFS）评估依恋和 RF。研究结果表明，RF 与 A 群和 B 群人格障碍呈显著负相关，与心理功能呈显著正相关。此外，RF 和人格功能水平受依恋模式的影响。最后，RF 完全中介了（安全/不安全）依恋与适应心理特征之间的关系，从而解释了整体人格功能的差异。缺乏心理化似乎与人格功能的脆弱性密切相关，尤其是在具有 A 群和 B 群人格障碍的患者中。这些发现为开发改善患者 RF 的治疗干预措施提供了支持。
