Mentalizing Subtypes in Eating Disorders: A Latent Profile Analysis

Frontiers in Psychology

article

Giulia Gagliardini¹  Salvatore Gullo²  Valeria Tinozzi¹  Monica Baiano³  Matteo Balestrieri⁴  Patrizia Todisco⁵  Tiziana Schirone¹  Antonello Colli¹ 

[1] Department of Humanities, “Carlo Bo” University of Urbino;Department of Psychology, Educational Science and Human Movement, University of Palermo;Centre for Eating Disorders, Azienda Sanitaria Universitaria Friuli Centrale (ASUFC);Psychiatric Clinic, Department of Medicine, University of Udine;Unit for Eating Disorders

关键词: mentalization;    eating disorders;    reflective functioning;    anorexia;    bulimia;   

DOI  :  10.3389/fpsyg.2020.564291

学科分类：社会科学、人文和艺术（综合）

来源: Frontiers

【 摘 要 】

Background: Mentalizing, the mental capacity to understand oneself and others in terms of mental states, has been found to be reduced in several mental disorders. Some studies have suggested that eating disorders (EDs) may also be associated with impairments in mentalizing. The aim of this work is to investigate the possible presence of mentalizing subtypes in a sample of patients with EDs. Method: A sample of patients with eating disorders ( N = 157) completed a battery of measures assessing mentalization and related variables, including the Reflective Functioning Questionnaire (RFQ), the Difficulties in Emotion Regulation Strategies (DERS), the Interpersonal Reactivity Index (IRI). Clinicians rated patients in relation to imbalances in different dimensions of mentalization to prementalizing modes and attachment style by using the Mentalization Imbalances Scale, the Modes of Mentalization Scale (MMS), and the Adult Attachment Questionnaire. A latent profile analysis was conducted to test the possible presence of different subgroups. MANOVA was used to test the possible differences between the four mentalizing profiles in relation to emotion dysregulation (DERS), empathy (IRI), and adequate and impairments in mentalizing (MMS and RFQ). Results: The latent profile analysis suggested the presence of four different profiles in relation to impairments in the dimensions of mentalization: (1) affective/self/automatic imbalances, (2) external imbalance, (3) cognitive/self/automatic imbalances, and (4) cognitive/other/automatic imbalances. Patients belonging to profile 1 are characterized by the prevalence of affective mentalization that overwhelms the capacity to reflect on mental states with an imbalance on the self-dimension; profile 2 patients are excessively focused on the external cues of mentalization; profile 3 patients are characterized by an over-involvement on the cognitive and self-facets of mentalization, with an impairment in adopting the other mind perspective; and profile 4 patients have similar impairments compared to profile 3 patients but with an excessive focus on others and deficits in self-reflection. These profiles were heterogeneous in terms of EDs represented in each group and presented significant differences on various variables such as attachment style, emotion dysregulation, empathy, interpersonal reactivity, and reflective function. This study represents, so far, the first work that confirms the presence of different mentalizing patterns in ED patients. Conclusions: ED patients can be classified in relation to impairments in different dimensions of mentalization above and beyond ED diagnosis.

【 授权许可】

CC BY