Oriented mentalization-based treatment for borderline personality disorder patients: preliminary results at Camposampiero Mental Health Center

Abstract

This contribution presents two brief reports about preliminary results of 18 months of oriented Mentalization-Based Treatment (MBT), with Borderline Personality Disorder patients, recruited at the Camposampiero Mental Health Center. Following in large part Bateman and Fonagy guidelines for MBT in institutional settings, this paper presents preliminary results in two brief reports related to two cohorts of patient underwent to the oriented MBT in Camposampiero Mental Health Center (MHC). In the first study, we analyzed a group of 9 patients: an anamnestic schedule was administered; then, symptoms (SCL-90-R), psychodiagnostic scale and global health functioning (Health of the Nation Outcome Scale, Structured Clinical Interview for DSM-IV Axis II Disorder [SCID-II], Global Assessment of Functioning, [GAF]), data on service impact and service costs (Cassel Community Adjustment Questionnaire, Patient Evaluation Schedule and folder data) were provided at the beginning (T0), at the end of the treatment (T2) and 1 year after the end of the MBT project. The second study showed a micro-analytical change on a second patient cohort (n=6) at T0, 3, 6 and 9 months (T1) were presented considering specifically mentalization (Comparative Psychotherapy Process Scale, Modes of Mentalization Scale, Mentalization Imbalances Scale) and patienttherapist session evaluation trends (Session Evaluation Questionnaire) and patient reflective functioning at T0 and T2 (Reflective Functioning Questionnaire). Aims and hypotheses of the two studies pointed out how the oriented MBT bring to an improvement of the overall functioning of the patients, a reduction of the symptoms, a decrease of the diagnostic criteria for the Borderline Personality Disorder (BPD) and the other Axis II disorders, a reduction of the workload hours for the MHC staff and of the costs of the assistance. The analyses of both the studies were carried out using non-parametric statistics (Friedman test, Spearman correlation, Chi-square). Preliminary results confirmed the improvement in the overall functioning of patients (GAF), the reduction in BPD-related symptoms and in diagnostic criteria for BPD (SCID-II), the improvement of patients’ mentalization skills, and a significant reduction in workload for health staff. Standing the limits and the preliminary results, the two brief reports demonstrate the feasibility of an oriented MBT within an Italian Public Service and the effectiveness of this treatment pathway for patients with BPD, leaving some open questions to stimulate a fruitful clinical discussion.

Mentalizing Subtypes in Eating Disorders: A Latent Profile Analysis

“…without reflecting on inner mental states (e.g., beliefs, desires, thoughts, emotions). The MIS has been used in previous studies (Carrera et al, 2018;Gagliardini et al, 2018Gagliardini et al, , 2020 in which it has shown a good reliability. In the present study, the scale has shown sufficient to good psychometric properties (Cronbach, 1951), with alphas of 0.84 (imbalance on the self), 0.80 (cognitive imbalance), 0.79 (automatic imbalance), 0.78 (affective imbalance), 0.61 (imbalance on the others), and 0.60 (external imbalance).…”

The Spanish version of the reflective functioning questionnaire: Validity data in the general population and individuals with personality disorders

“…The RFQ-8 has been extensively used to assess RF in research aimed at (a) defining its dysfunction (usually hypomentalization) in groups of patients or other populations [ 39 – 47 ], and how it mediates symptomatic expression [ 35 , 48 – 67 ]; (b) assessing change in psychotherapy [ 68 – 75 ]; and (c) understanding the relationship of RF to attachment and parenting [ 27 , 60 , 76 – 79 ]. Surprisingly, much of this research [ 27 , 43 – 48 , 50 , 52 , 53 , 57 , 59 – 68 , 71 , 77 ] suggest that higher RFQc scores may indicate more appropriate mentalization [ 51 , 68 ], perhaps reflecting confidence in mental states as valid explanations for emotional experiences and behaviors [ 48 ].…”

“…Additionally, evidence has being provided via exploratory factor analysis (EFA) and CFA that a one-factor model can sufficiently explain the observed covariation of the responses to RFQ-8 items when using this new way of scoring [ 28 , 29 , 38 ]. Finally, neither RFQ-8 certainty pole (using new proposed way of scoring), nor its certainty scale (using the previously proposed way of scoring) tend to show positive associations with negative outcomes (i.e., psychopathology) when looking for U shape [ 28 , 29 ] or linear correlations [ 27 , 38 , 43 – 48 , 50 , 52 , 53 , 57 , 59 – 68 , 71 , 77 ], thus suggesting the inability of the RFQ-8 to assess hypermentalization [ 29 , 51 ]. In this sense, the CAMSQ [ 25 ] has been recently validated to fill the gap of specifically assess hypermentalization.…”

Changes in mentalization in patients with personality disorders during sequential brief—Adlerian psychodynamic psychotherapy: The role of therapists’ technique and countertransference.

“…On the contrary, the cognitive imbalance subscale (five items) indicates an excessive focus on the cognitive facets of mentalization, which can lead to intellectualizing, and that is not balanced by the affective facets of experience. The MIS has been used in previous studies (Carrera et al, 2018;Gagliardini et al, 2023, Gagliardini, Gatti, & Colli, 2020, Gagliardini, Gullo, et al, 2020 in which it has shown a good reliability. In relation to the validity of the MIS scale, two studies (Gagliardini et al, 2018(Gagliardini et al, , 2023 have previously investigated the factor structure of the scale and suggested that it can be considered adequate.…”