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Using the validated Reflective Functioning Questionnaire to investigate mentalizing in individuals presenting with eating disorders with and without self-harm

Cucchi, A., Hampton, J. A. ORCID: 0000-0002-0363-8232 and Moulton-Perkins, A. (2018). Using the validated Reflective Functioning Questionnaire to investigate mentalizing in individuals presenting with eating disorders with and without self-harm. PeerJ, 6, e5756. doi: 10.7717/peerj.5756

Abstract

Background
The present study builds on previous research which explored the relationship between mentalizing and eating disorders (ED) in a subgroup of patients with comorbid self-harm (SH). Whereas previous literature had linked this comorbidity to impulse-control difficulties, more recent advances have suggested that a lack of a mentalizing stance might be responsible for a more treatment-resistant and severe symptomatology in this subgroup of clients.

Methods
A cross-sectional, quasi-experimental, questionnaire-based, between-groups design was employed and a measure of mentalizing was compared in individuals presenting with ED only, individuals presenting with ED and concurrent SH and a control group.

Results
Individuals with ED with concurrent SH reported significantly more mentalizing ability impairment than individuals without concurrent SH. In addition, both groups differed significantly from the control group. Opposite scoring patterns were identified in hypo- and hypermentalizing with the comorbid group reporting the lowest scores in hypermentalizing and the highest scores in hypomentalizing.

Conclusions
The current findings confirm that individuals with concurrent ED and SH report more severe impairments in mentalizing ability. Such impairments entail difficulties in symbolic capacity and abstract thinking and a concretisation of inner life, exemplified by a rigid, often inflexible focus on the physical world. The clinical implications that a lack of a mentalizing stance can have on individuals’ ability to engage with the therapeutic process and to initiate change are reflected upon.

Publication Type: Article
Additional Information: © Copyright 2018 Cucchi et al. Distributed under Creative Commons CC-BY 4.0
Subjects: B Philosophy. Psychology. Religion > BF Psychology
Departments: School of Arts & Social Sciences > Psychology
URI: http://openaccess.city.ac.uk/id/eprint/21104
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