Mentalization and Self-Efficacy as Mediators between Psychological Symptom Severity and Disabilities in Activities and Participation in Psychotherapy Patients.

BACKGROUND

Psychotherapy patients can be more or less disabled by their psychological symptoms. The present study investigated whether mentalization and self-efficacy contribute to the association between psychological symptom severity and disabilities in activities and participation.

METHODS

The data of 216 psychotherapy inpatients were examined in a cross-sectional design. Bootstrapping-enhanced mediation analyses were performed to investigate whether self-efficacy and mentalization are mediators between psychological symptom severity and disabilities in activities and participation. The Hamburg Modules for the Assessment of Psychosocial Health-49 were used to measure psychological symptom severity and self-efficacy, mentalization was assessed with the Mentalization Questionnaire, and disabilities in activities and participation were operationalized with the ICF-Mental-A & P questionnaire.

RESULTS

Mentalization as well as self-efficacy functioned as mediators between psychological symptom severity and disabilities in activities and participation (p < 0.05). They were equally strong mediators, and both remained significant mediators when statistically controlling for the other mediator (p < 0.05).

CONCLUSIONS

Mentalization as well as self-efficacy explain a significant proportion of the relationship between psychological symptom severity and disabilities in activities and participation. Working on mentalizing and self-efficacy might be important mechanisms to reduce disability due to symptoms. The cross-sectional design is a limitation of the study.