Mentalization, attachment, and defense mechanisms: a Psychodynamic Diagnostic Manual-2-oriented empirical investigation

Research in Psychotherapy

Tommaso Boldrini¹  Annalisa Tanzilli²  Guido Giovanardi²  Vittorio Lingiardi²  Giorgio Caviglia³  MariagraziaDi Giuseppe⁴  Ciro Conversano⁴ 

[1] Department of Developmental Psychology and Socialization, University of Padua, Padua;Department of Dynamic and Clinical Psychology, and Health Studies, Faculty of Medicine and Psychology, La Sapienza University of Rome, Rome;Department of Psychology, University of Campania Luigi Vanvitelli, Caserta;Department of Surgical, Medical and Molecular Pathology, Critical and Care Medicine, University of Pisa, Pisa;

关键词: Mentalization;    attachment;    defense mechanisms;    Psychodynamic Diagnostic Manual-2;    defense mechanisms rating scale Q-sort.;   

DOI  :  10.4081/ripppo.2021.531

来源: DOAJ

【 摘 要 】

Mentalizing capacities depends on the quality of primary attachment interactions with caregivers who thinks of the child as a subject with mental states. Operationalized as reflective functioning, mentalization is crucial for regulating emotions and developing of a coherent sense of identity, for interacting with individuals making sense to own and others mental states, and for distinguishing internal and external realities without distortions. Although the clinical literature on interplay between mentalization, attachment, and emotional regulation is rich, the empirical research is limited. This study sought to explore connections between reflective functioning, attachment styles, and implicit emotion regulation, operationalized as defense mechanisms, in a group of depressive patients. Twenty-eight patients were interviewed using the adult attachment interview (AAI) and diagnosed using the Psychodynamic Chart-2 of the Psychodynamic Diagnostic Manual, Second Edition. The reflective functioning scale and the defense mechanisms rating scale Q-sort were applied to AAI transcriptions to assess reflective functioning and defensive profile. Patients with secure attachment showed significantly higher levels in reflective functioning and overall defensive functioning as compared to those with insecure attachment. Good reflective functioning and secure attachment correlated with mature defenses and specific defensive mechanisms that serve in better regulating affective states. Overall, the relationship between mentalization, attachment and emotion regulation lay the foundations for the delineation of defensive profiles associated with attachment patterns and reflective functioning in depressive patients. The systematic assessment of these psychological dimensions with gold-standard tools may help in tailoring personalized therapeutic interventions and promoting more effective treatments.

【 授权许可】

Unknown