Reflective function mediates the relationship between emotional maltreatment and borderline pathology in adolescents: A preliminary investigation |
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| Institution: | 1. Centre for Developmental Psychiatry and Psychology, Department of Psychiatry, School of Clinical Sciences at Monash Health, Monash University, Melbourne, Australia;2. Centre for Women’s Mental Health, The Royal Women’s Hospital, Melbourne, Australia;3. Department of Psychiatry, The University of Melbourne, Melbourne, Australia;4. Early in Life Mental Health Service, Monash Health, Melbourne, Australia;1. Université Laval École de psychologie, 2325 rue des Bibliothèques, Québec (QC), Canada G1V 0A6;2. University College London, Psychoanalysis Unit, Research Department of Clinical, Educational and Health Psychology, Gower Street, London WC1E 6BT, UK;1. Department of Psychiatry, University of Helsinki and Helsinki University Hospital, Helsinki, Finland;2. Mental Health Unit, National Institute for Health and Welfare, Helsinki, Finland;3. Department of Social Services and Health Care, Helsinki, Finland;4. IBS, Unit of Personality, Work and Health Psychology, University of Helsinki, Helsinki, Finland;1. Developmental Clinical Psychology Research Unit, Faculty of Psychology and Educational Sciences, University of Geneva, Switzerland;2. Service of Psychiatric Specialties, Department of Mental Health and Psychiatry, University Hospitals of Geneva, Geneva, Switzerland;3. Department of Psychiatry, University of Geneva, Geneva, Switzerland;4. Department of Child and Adolescent Psychiatry, Versailles General Hospital, Faculty of Health Sciences, Research Unit EA4047, University of Versailles Saint-Quentin-en-Yvelines, France;5. Developmental Neuroimaging and Psychopathology Laboratory, Department of Psychiatry, University of Geneva School of Medicine, Switzerland;6. Research Department of Clinical, Educational and Health Psychology, University College London, United Kingdom |
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| Abstract: | Deficits in mentalizing, particularly within the context of attachment relationships i.e., reflective function (RF), are posited to result from childhood maltreatment and to influence the development of borderline personality disorder (BPD). Whilst a mentalization-based model of BPD provides a theoretical explanation, direct empirical support for this model, in linking childhood maltreatment to borderline pathology remains limited. This study examined the interrrelationships between childhood maltreatment, RF, and borderline pathology in a mixed adolescent sample, consisting of adolescents with BPD (n = 26) and a group of non-clinical adolescents (n = 25). With the aim of directly testing the mentalization-based model of BPD, we additionally investigated the influence of each form of childhood maltreatment within this developmental pathway. Self-report data supported the hypothesized indirect effect of childhood maltreatment on elevated borderline pathology through lowered RF in adolescents. Both emotional abuse and emotional neglect were found to indirectly influence borderline pathology through adolescent RF, however, only emotional abuse indirectly influenced borderline pathology through RF, after all other maltreatment types were controlled for. Findings support the promotion of mentalization, within attachment-related contexts, as an intervention target for adolescents with borderline pathology and as a potential target of prevention for at-risk children and adolescents with histories of childhood maltreatment, especially emotional abuse. Future research should delineate other underlying mechanisms, independent of RF, which may also link the influence of childhood maltreatment, and in particular, emotional abuse, to BPD. |
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| Keywords: | Childhood maltreatment Reflective function Mentalization Borderline personality disorder Adolescence Emotional abuse |
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