Rifkin-Zybutz R P, Moran P, Nolte T, Feigenbaum Janet, King-Casas Brooks, Fonagy P, Montague R P
Centre for Academic Mental Health, University of Bristol, Oakfield House, Bristol, BS8 2BN, UK.
Virginia Tech Carilion Research Institute (BK-C, PHC), Roanoke, USA.
Borderline Personal Disord Emot Dysregul. 2021 May 4;8(1):15. doi: 10.1186/s40479-021-00153-x.
Mentalizing, the ability to understand the self and others as well as behaviour in terms of intentional mental states, is impaired in Borderline Personality Disorder (BPD). Evidence for mentalizing deficits in other mental disorders, such as depression, is less robust and these links have never been explored while accounting for the effects of BPD on mentalizing. Additionally, it is unknown whether BPD symptoms might moderate any relationship between depressive symptoms and mentalizing.
Using multivariate regression modelling on cross-sectional data obtained from a sample of 274 participants recruited from clinical settings, we investigated the association between mentalizing impairment and depression and examined whether this was moderated by the presence and number of concurrent BPD symptoms, while adjusting for socio-demographic confounders.
Impaired mentalizing was associated with depressive symptoms, after adjustment for socio-demographic confounders and BPD symptoms (p = 0.002, β = - 0.18). BPD symptoms significantly moderated the association between impaired mentalizing and depressive symptoms (p = 0.003), with more severe borderline symptoms associated with a stronger effect of poor mentalization on increased depressive symptoms.
Mentalizing impairments occur in depression even after adjusting for the effect of BPD symptoms. Our findings help further characterise mentalizing impairments in depression, as well as the moderating effect of BPD symptoms on this association.. Further longitudinal work is required to investigate the direction of association.
心理化是一种依据意向性心理状态来理解自我、他人及行为的能力，在边缘型人格障碍（BPD）中受损。在其他精神障碍如抑郁症中，心理化缺陷的证据并不充分，而且在考虑BPD对心理化的影响时，从未对这些联系进行过探究。此外，尚不清楚BPD症状是否会调节抑郁症状与心理化之间的任何关系。
我们对从临床环境招募的274名参与者样本中获取的横断面数据进行多元回归建模，研究心理化受损与抑郁之间的关联，并检查这是否会受到同时存在的BPD症状及其数量的调节，同时对社会人口学混杂因素进行调整。
在对社会人口学混杂因素和BPD症状进行调整后，心理化受损与抑郁症状相关（p = 0.002，β = -0.18）。BPD症状显著调节了心理化受损与抑郁症状之间的关联（p = 0.003），边缘症状越严重，心理化不良对抑郁症状增加的影响越强。
即使在调整了BPD症状的影响后，抑郁症中仍存在心理化受损。我们的研究结果有助于进一步描述抑郁症中的心理化受损情况，以及BPD症状对这种关联的调节作用。需要进一步开展纵向研究来调查这种关联的方向。
