Depression and mentalizing: A psychodynamic therapy process study.

Abstract

The present study aimed to explore the relationship between changes in depressive symptoms and the capacity to mentalize over the course of a 3-month inpatient psychodynamic therapy in a sample of 56 patients with depression. Depressive symptoms and mentalizing were assessed weekly during treatment and at 1-year follow-up with the Beck Depression Inventory and the Reflective Functioning Questionnaire (RFQ). Data were analyzed using Latent Growth Curve (LGC) modeling with structured residuals. In the total sample, depressive symptoms improved on average from baseline to the end of treatment, while mentalizing skills did not. However, individual variations were observed in mentalizing skills, with some patients improving while others did not. Within-patient residual changes in mentalizing skills did not predict residual changes in depressive symptoms. Accordingly, the results did not support mentalizing as a mechanism of change at this level. Nonetheless, between-patient effects were found, showing that patients with higher levels of mentalizing at baseline and patients whose mentalizing skills improved over the course of therapy also had greater reductions in depressive symptoms. We suggest that the presence of relatively higher mentalizing skills might be a factor contributing to moderately depressed individuals' ability to benefit from treatment, while relatively poor or absent mentalizing capacity might be part of the dynamics underlying treatment resistance in individuals with severe depression. Public Significance StatementEmotional and relational changes related to psychodynamic therapy are likely to be followed by reductions in depressive symptoms over the course of therapy. Between-person improvements in mentalizing were related to reductions in depressive symptoms, but within-person change in mentalizing was not found to be a mechanism of change in depression. Further research is needed to examine the role of mentalizing skills as a factor contributing to the depressed individual's ability to profit from treatment.

Addressing patients’ relationships with god in psychotherapy: Exploring psychodynamic therapy, depressive symptoms, and attachment to God.

“…As previously described, Halstensen et al (2021) found a complex pattern of change in BDI-II with improved fit for a nonlinear change model including the quadratic function for depressive symptoms over the 12-week treatment period (baseline: M = 15.34, SD = 7.61; linear change during treatment: M = 1.01, p = .005; SD = 1.97, p = .010; quadratic change during treatment: M = −0.08, p < .001; SD = 0.13, p = .021; posttreatment to follow-up: M = −0.07, p = .016; SD = 0.13, p = .005). The model first showed a nonlinear increase in symptoms and then a reduction until the posttreatment time, with a lower level than that at baseline.…”

“…Some individual variation around this mean change was found, indicating that some patients experienced stronger reductions than others. See Halstensen et al (2021), for further analysis of the reduction in depressive symptoms.…”

“…Based on Rizzuto's (1979) object-relational theory of dynamic functions in the God relation, this treatment integrates a systematic exploration and processing of the God relation, and it has shown effectiveness in treating patients with depression. More recently, Halstensen et al (2021) assessed this treatment in a frequent-measures study and similarly find that depressive symptoms increase in the initial phase of therapy then level out, and at discharge decrease significantly compared to baseline levels. Moreover, reductions in depressive symptoms persist at the 1-year follow-up (FU).…”

“…It was developed by Gry Stålsett, Leif Gunnar Engedal, and Arne Austad (Stålsett, 2012). See Halstensen et al (2021), for further details regarding enrollment of participants.…”

Estudio Cualitativo: La Experiencia Subjetiva de Personas con Diferentes Niveles de Mentalización Durante la Pandemia por COVID-19

“…Es una capacidad transdiagnóstica, transteórica y dinámica, que favorece la regulación emocional, la empatía (Bilbao Bilbao, 2021), la resiliencia, la reducción del estrés, y la interpretación de las situaciones (Fonagy et al, 2002). Se ha evidenciado la eficacia de las intervenciones en mentalización en la disminución de problemas de salud mental (Luyten et al, 2020;Halstensen et al, 2021;Bo et al, 2017;Jørgensen et al, 2013). Dado que un modo reflexivo de funcionamiento puede adaptarse mejor a los entornos dominados por la incertidumbre (Carver et al, 2017), y entendiendo que una alta mentalización contribuye a la consolidación de dichos modos, se podrían sugerir, con el objetivo de fortalecer la protección de la salud mental para esta y futuras crisis, la implementación de intervenciones que aumenten y fomenten la capacidad de mentalizar de las personas.…”