Cortés-García Laura, Akça Ömer Faruk, Wall Kiana, Sharp Carla
PROMENTA Research Center, Department of Psychology, University of Oslo, Oslo, Norway.
Department of Child and Adolescent Psychiatry, Necmettin Erbakan University Meram School of Medicine, Konya, Turkey.
Scand J Child Adolesc Psychiatr Psychol. 2021 Feb 22;9:16-26. doi: 10.21307/sjcapp-2021-003. eCollection 2021.
Impaired mentalizing, i.e., difficulties in understanding oneself and others in terms of mental states, has been associated with the development of Anorexia Nervosa (AN), mainly among adults. However, few studies have addressed this question in clinical samples of adolescents with AN. Moreover, no study has explored mentalizing abilities among inpatient adolescents presenting with AN and Borderline Personality Disorder (BPD), despite their high comorbidity in a highly relevant age group.
This study attempted, for the first time, to further examine differences in mentalizing abilities and to identify specific mentalizing impairments in different psychiatric inpatient groups and healthy adolescents.
Using samples of female adolescents aged 12-17, comparison analyses were performed between psychiatric inpatient adolescents with AN ( = 44), BPD ( = 101), AN+BPD ( = 48), other psychopathology ( = 163) and healthy adolescents ( = 129). Structured and semi-structured clinical interviews, and two experimental tasks were administered to assess AN, BPD and mentalizing, respectively.
Comparison analyses showed that patients with BPD and other psychiatric disorders evidenced higher levels of hypermentalizing compared to healthy adolescents. Hypermentalizing was also reported among inpatients with AN+BPD, although to a lesser extent. BPD and AN scores were positively correlated with hypermentalizing responses.
Our results suggest that hypermentalizing is a specific mentalization impairment in inpatient adolescents, particularly with BPD and both AN+BPD. Further investigation into the efficacy of mentalization based treatments for adolescents with BPD and AN+BPD is recommended. Prospective studies are needed to assess mentalizing using experimental tasks among adolescents with AN, taking into account the potential influence of temporality and severity of the disorders' symptoms.
心理化受损，即在理解自己和他人心理状态方面存在困难，已被证明与神经性厌食症（AN）的发展有关，主要是在成年人中。然而，很少有研究在患有AN的青少年临床样本中探讨这个问题。此外，尽管在一个高度相关的年龄组中，AN与边缘型人格障碍（BPD）的共病率很高，但尚无研究探讨患有AN和BPD的住院青少年的心理化能力。
本研究首次尝试进一步检验心理化能力的差异，并确定不同精神科住院患者组和健康青少年中特定的心理化损伤。
以12 - 17岁的女性青少年为样本，对患有AN（n = 44）、BPD（n = 101）、AN + BPD（n = 48）、其他精神病理学疾病（n = 163）的精神科住院青少年和健康青少年（n = 129）进行比较分析。分别采用结构化和半结构化临床访谈以及两项实验任务来评估AN、BPD和心理化。
比较分析表明，与健康青少年相比，患有BPD和其他精神疾病的患者表现出更高水平的过度心理化。AN + BPD的住院患者中也报告存在过度心理化，尽管程度较轻。BPD和AN得分与过度心理化反应呈正相关。
我们的结果表明，过度心理化是住院青少年中一种特定的心理化损伤，特别是在患有BPD以及AN + BPD的青少年中。建议进一步研究针对患有BPD和AN + BPD的青少年的基于心理化的治疗方法的疗效。需要进行前瞻性研究，以考虑疾病症状的时间性和严重性的潜在影响，通过实验任务评估患有AN的青少年的心理化情况。
