Cucchi Angie, Hampton James A, Moulton-Perkins Alesia
Department of Psychology, City, University of London, London, England, United Kingdom.
Department of Psychology, University of Surrey, Guildford, England, United Kingdom.
PeerJ. 2018 Oct 29;6:e5756. doi: 10.7717/peerj.5756. eCollection 2018.
The present study builds on previous research which explored the relationship between mentalizing and eating disorders (ED) in a subgroup of patients with comorbid self-harm (SH). Whereas previous literature had linked this comorbidity to impulse-control difficulties, more recent advances have suggested that a lack of a mentalizing stance might be responsible for a more treatment-resistant and severe symptomatology in this subgroup of clients.
A cross-sectional, quasi-experimental, questionnaire-based, between-groups design was employed and a measure of mentalizing was compared in individuals presenting with ED only, individuals presenting with ED and concurrent SH and a control group.
Individuals with ED with concurrent SH reported significantly more mentalizing ability impairment than individuals without concurrent SH. In addition, both groups differed significantly from the control group. Opposite scoring patterns were identified in hypo- and hypermentalizing with the comorbid group reporting the lowest scores in hypermentalizing and the highest scores in hypomentalizing.
The current findings confirm that individuals with concurrent ED and SH report more severe impairments in mentalizing ability. Such impairments entail difficulties in symbolic capacity and abstract thinking and a concretisation of inner life, exemplified by a rigid, often inflexible focus on the physical world. The clinical implications that a lack of a mentalizing stance can have on individuals' ability to engage with the therapeutic process and to initiate change are reflected upon.
本研究建立在先前的研究基础之上，先前的研究探讨了合并自我伤害（SH）的患者亚组中心理化与进食障碍（ED）之间的关系。尽管先前的文献将这种共病与冲动控制困难联系起来，但最近的进展表明，缺乏心理化立场可能是导致该客户亚组中治疗抵抗性更强和症状更严重的原因。
采用横断面、准实验、基于问卷的组间设计，比较仅患有进食障碍的个体、患有进食障碍且并发自我伤害的个体以及对照组的心理化测量结果。
患有进食障碍且并发自我伤害的个体报告的心理化能力损害明显多于没有并发自我伤害的个体。此外，这两组与对照组均有显著差异。在低心理化和高心理化方面发现了相反的评分模式，共病组在高心理化方面得分最低，在低心理化方面得分最高。
目前的研究结果证实，患有进食障碍且并发自我伤害的个体报告的心理化能力损害更为严重。这种损害导致符号能力和抽象思维困难以及内心生活的具体化，表现为对物质世界的僵化、往往不灵活的关注。文中思考了缺乏心理化立场对个体参与治疗过程和启动改变能力可能产生的临床影响。
