Losing and regaining reflective functioning in the times of COVID-19: Clinical risks and opportunities from a mentalizing approach.

Abstract

Losing and regaining reflective functioning in the times of Covid-19: Clinical risks and opportunities from a mentalizing approach Much has been said about the severe mental health consequences of the Covid-19 pandemic-a "collective trauma", defined as an epidemiological and psychological crisis (APA, 2020)-both in the present and in the foreseeable future. A large body of evidence suggests that mentalizing is a beneficial transtheoretical and transdiagnostic concept not only for understanding vulnerability to psychopathology, but also in its treatment (for review, see: Luyten, Campbell, Allison, & Fonagy, 2020). The current commentary therefore seeks to consider the Covid-19 pandemic-related risks for psychopathology, but also discuss the clinical opportunities of the situation by incorporating a perspective of mentalization theory and practice. Mentalizing, reflective functioning, stress and trauma Mentalizing (or reflective functioning) is defined as the capacity of an individual for understanding oneself and others in terms of intentional mental states, including beliefs, feelings, goals, and attitudes (Luyten et al., 2020). Mentalizing is an evolutionary prewired capacity and is closely associated with attachment, social learning and epistemic trust (Fonagy & Allison, 2014), as well as with emotion regulation (Fonagy, Gergely, & Jurist, 2018). The capacity to mentalize is essential for social, familial, and interpersonal functioning and is an effective buffer for a wide array of psychopathology (Luyten et al., 2020). Furthermore, impairments in mentalizing are seen as transdiagnostic factors implicated in multiple disorders such as depression and anxiety (Luyten & Fonagy, 2018; Nolte, Guiney, Fonagy, Mayes, & Luyten, 2011), personality disorders including BPD copy or cite without authors' permission. The final article will be available, upon publication, via its

Emerging adults facing the COVID-19 pandemic: emotion dysregulation, mentalizing, and psychological symptoms

“…Regarding our third hypothesis, the performed model displayed a significant moderating effect of RFQu – but not of RFQc – in the link between ED and GSI, so that at high levels of RFQu, reflecting an almost complete lack of knowledge about mental states, a marginally significant positive relation between ED and GSI was found, while at low levels of RFQu a significant negative relation between ED and GSI emerged. Settled in the context of the COVID-19 pandemic, which has been defined as an epidemiological and psychological crisis (APA, 2020 ), these results highlight that the stressful conditions related to the social isolation imposed by the lockdown measures during the first wave of the COVID-19 pandemic may have impacted emerging adults’ ER strategies, thus enhancing mental health vulnerabilities over the third wave of the COVID-19 pandemic (Lassri & Desatnik, 2020 ). Moreover, the reported moderation role acted by RFQu – and not by RFQc, which nevertheless showed a direct effect on GSI – may underline the central role performed by RF in influencing reported psychological symptoms, thus emphasizing possible different functions displayed by these two dimensions (Fonagy et al, 2016 ).…”

“…Social isolation, changes in routines and governmental restrictions may thus have affected subjective mental health (Alzueta et al, 2020 ; Boden et al, 2021 ) by reducing the range of strategies through which people usually regulate their emotions. As a consequence, people who in the past would present as very low risk, are now exposed to high levels of stress which increase their emotional vulnerability, with possible collapses in emotion regulation strategies and mentalizing abilities, as well as the emergence of psychological symptoms (Lassri & Desatnik, 2020 ). This could be the case of emerging adults that despite being less likely to get a severe COVID-19 infection, are involved in a developmental period characterized by search of autonomy and identity formation, and during which interpersonal relationships play a crucial role (Arnett, 2015 ; Li et al, 2021 ).…”

The interplay of Criterion A of the Alternative Model for Personality Disorders, mentalization and resilience during the COVID-19 pandemic

“…Accordingly, previous research has revealed that high levels of mentalization capacity may be used as predictors or protective factors of better mental health outcomes in times of stress ( Hayden et al, 2019 ; Schwarzer et al, 2021a , b ). There are only few studies that examined associations between mentalizing and distress or pathologies in healthy individuals and patients during the pandemic ( Lassri and Desatnik, 2020 ; Poulios et al, 2021 ; Kvarstein et al, 2022 ; Yatziv et al, 2022 ). Furthermore, some pre-pandemic studies have demonstrated a mediating protective influence of mentalizing capacity ( Hayden et al, 2019 ; Poulios et al, 2021 ; Schwarzer et al, 2021a , b ).…”

COVID-19 impact on employee flourishing: Parental stress as mediator.

“…An individual's mental stability under normal circumstances depends on the balance between self and the environment (Fitzpatrick et al, 2020). However, internal balance can be lost when exposed to an uncertain emergency (Lassri & Desatnik, 2020). Individuals try to deal with the uncertainty by organizing their physiological and psychological resources, referred to as the stress response (Grandey & Cropanzano, 1999).…”