Expressed emotion and reflective functioning across the schizotypy spectrum: Developmental experiential factors.

Abstract

EE) in relation to caregivers is predictive of relapse and symptom exacerbation over the course of schizophrenia and other severe mental disorders. Even individuals with milder, subclinical manifestations of the schizophrenia genotype, such as schizotypy, may be adversely affected by high levels of EE. A potential source of resilience in high EE caretaking environments might be the capacity for mentalization or reflective functioning (RF), which is the ability to accurately think about the mental states of others and the self. The main hypothesis of the present study is that when mentalization capacity or RF remains intact or is reestablished following childhood adversity, it can act to mitigate the impact of high EE environments. Participants (N = 252) were recruited from an online crowdsourcing site, Mturk. Participants completed a series of measures, including the Multidimensional Schizotypy Scale-Brief (MSS-B), the Level of Expressed Emotion Scale-Past (LEE-P), and one open-ended question from the Adult Attachment Interview (AAI). Results were attained through a series of regression analyses that looked at the relations between EE, Adverse Childhood Experiences (ACE), and schizotypy and general linear models (mediation analyses) that addressed the complex links among EE, ACE, schizotypy, and RF. As predicted by the present study and consistent with the hypothesized protective role of RF, participants with higher levels of overt childhood trauma who recalled higher levels of expressed emotion tended to report fewer schizotypal symptoms if they also maintained high levels of RF. These findings and their implications are discussed.

I don’t understand how I feel: mediating role of impaired self-mentalizing in the relationship between childhood adversity and psychosis spectrum experiences

“…While some evidence suggests that high positive and negative schizotypy dimensions are linked to deficits in emotional awareness and regulation (70), given the lack of clear grounding on the differential contributions of self-mentalizing factors versus other-mentalizing in schizotypy, and that most mentalization research in psychosis has only focused on other-mentalization, the study is exploratory regarding self-mentalization. For other-mentalization, we expected that the associations with schizotypy dimensions in this nonclinical sample would be aligned with previous research (i.e., negatively associated with other-mentalization) (36,44,45,47,71,72), albeit at an attenuated level. Next, we expected that self-and other-mentalization would mediate the association between childhood maltreatment and all schizotypy dimensions, PLE and paranoia.…”

“…To date, mentalization has been operationalized primarily using various Theory of Mind tasks, which overall evaluate other-mentalizing. These studies support (other-) mentalizing as a mediator of childhood neglect and psychosis symptoms ( 47 ), of trauma/expressed emotion and schizotypal symptoms ( 72 ) and have even found that (other-) mentalizing fully mediates the association between social perception difficulties and negative symptoms ( 71 ). Although role reversal and its impact on other-mentalizing has not been examined previously, one may speculate that assuming parental responsibilities and providing emotional support to the parent from a young age might subserve the development of an increased capacity to think about and understand other’s emotions and needs (i.e., other-mentalizing) and this, in turn, may increase one’s curiosity and openness to the world (i.e., diminished negative schizotypy).…”