Mentalization in borderline individuals: an attempt to integrate contradictory research results

Abstract

Researchers have been striving to explore the function ing of patients with borderline personality disorder from the perspective of their capacity to mentalize. Analyzing the expanding body of literature, it is nevertheless difficult to reach a clear conclusion. There are studies that con firm mentalization deficits in this group; however, there are also reports suggesting better or at last equal mental izing in borderline individuals compared to controls. This paper discusses a hypothetical explanation of these con tradictory results by analyzing three fundamental issues. It is assumed that: (1) different aspects of mentalization are measured in studies-some of them are disordered, while others remain intact in borderline individuals; (2) mentali zation can be understood not only as a trait but also as a state, and its level may differ in the same person depend ing on measurement conditions; (3) the borderline group is heterogeneous in terms of mentalizing because other varia bles determine the level of this capacity.

Polish adaptation and validation of the Mentalization Scale (MentS) – a self-report measure of mentalizing

“…Fonagy's theory is based on the assumption that nonoptimal early childhood experiences with the caregiver result in various deficits in mentalizing, which may manifest themselves in adult life, for instance, in the form of borderline personality disorder. In many places, researchers managed to find a relationship between low mentalizing ability and insecure attachment in developmental and psychopathological contexts, although there have also been studies that did not yield a clear conclusion (for a review, see: [5]). In the presented research, the relations between mentalization as measured by MentS and the anxiety and avoidance in attachment were consistent with expectations in terms of direction (H2)-a low mentalization was related to a higher insecure attachment; however, the strength of the observed relations was not high.…”

“…The literature suggests the high significance of the self-regulatory role of mentalizing in the pathomechanism of borderline personality disorder, where difficulties with identifying one's own mental states lead to abnormal emotion regulation and to a flood of strong emotional states, characteristic of borderline individuals [36,37]. It has also pointed out that mentalization deficit in borderline individuals is not all-embracing: it is restricted to close relationships and situations involving attachment system activation [4,5,22]. Perhaps this is why, particularly in self-report measures, sometimes deficits in identifying other people's mental states are not detected.…”

“…It is a construct related to empathy, emotional intelligence, and theory of mind [2]. The research conducted in recent years has shown a reduced level of mentalizing in individuals with various mental disorders, mainly with borderline personality disorder [3][4][5], depression [6], eating disorders [7], and PTSD [8]. And conversely: mentalizing is related to mental health and psychological resilience [9].…”

“…As all self-report methods, they are dependent on self-beliefs regarding the ability to mentalize; as a result, they measure emotional and cognitive repre-sentations of mentalizing, which do not necessarily reflect the actual mentalization ability. Self-report measures do not take account of the relational and interactional context of mentalizing-namely, the dynamic and changeable nature of this ability, thus reducing it to a relatively stable generalized personality trait [5,13,16]. They are, however, certainly more comfortable to use in the case of quantitative studies with large samples.…”

Mentalization and interpersonal problems in borderline personality disorder (BPD) traits

“…In part, this may be due to issues with the measurement of mentalization in current research. First, mentalization has been used to refer to other concepts that measure different processes (Jańczak, 2018); for example, mentalization is often used interchangeably with concepts such as "Theory of Mind" (ToM; Górska & Marszał, 2014). Mentalization is related to ToM; however, it is considered to be a broader concept (Luyten & Fonagy, 2015;; see Górska & Marszał, 2014 for a discussion on their differences).…”