Various mentalizing concepts in mothers with postpartum depression, comorbid anxiety, and personality disorders

Mentalization is defined as the human capacity to reflect upon one's own or others’ behaviors in terms of underlying mental states and intentions. Several concepts mentalizing exist, which differ content, assessment, clinical prediction. The present study examines relationship between three main mentalizing, namely, reflective functioning (RF), parental (PRF), Mind-Mindedness (MM), mothers with postpartum depression. It was hypothesized that their convergent divergent variance, well validity regarding comorbid anxiety personality disorders (PDs). Fifty clinically referred depression infants aged 3–10 months were examined by means Reflective Functioning Scale, Parental Questionnaire, Coding-System. No significant associations found RF PRF, PRF MM; higher associated more MM-nonattuned mind-related comments. Increased linked lower PRF-prementalizing. Lower RF, but not PDs. Specifically, obsessive–compulsive PD considerably fewer Distinct represent competencies, differentially maternal psychopathology. Trasfondo: La mentalización se define como la capacidad humana para reflexionar sobre las conductas propias y de otros en términos estados mentales e intenciones subyacentes. Varios conceptos existen, los cuales difieren contenido, evaluación predicción clínica. Propósitos: El presente estudio examina relación entre tres principales mentalización, llamados Funcionamiento Reflexivo del Progenitor el Estado Conciencia Mente (MM) madres con depresión postparto. hipótesis es que mentalizar variantes convergentes divergentes, así también su validez clínica acerca ansiedad comórbida trastornos personalidad (PD). Método: Se examinaron cincuenta referencia por postparto infantes a diez meses, usando Escala Reflexivo, Cuestionario Sistema Codificación Mente. Resultados: encontraron significativas asociaciones o un más alto asoció comentarios relacionados mente MM no sintonía sensible. estableció una conexión aumento bajo pre-mentalización. aunque comórbido. Específicamente, obsesivo-compulsivo considerablemente menos Conclusión: Distintos representan competencias diferencialmente enlazadas sicopatología materna Contexte: mentalisation est définie comme capacité humaine refléchir à ses propres comportements et les des autres terme d’états mentaux sous-jacents Plusieurs existent, qui diffèrent contenu, évaluation prédiction clinique. Buts: Cette étude examine relation trois principaux mentalisation, soit le Fonctionnement Réfléchi (FR), (FRP), l'Esprit-Qualité Mentale (en anglais mind-mindedness, abrégé ici par EQM), chez mères avec une dépression postpartum. On posé hypothèse dans leur variance convergente divergente, ainsi validité clinique concernant l'anxiété comorbide troubles personnalité (TP). Méthode: Cinquante cliniquement envoyées consulter nourrissons âgés 10 mois ont été examinés au moyen l'Echelle Réfléchi, du Questionnaire Parental, Système d'Evaluation Mentale; FR plus élevé était lié commentaires EQM. Résultats: Aucun lien important n'a trouvé FRP, ou l'EQM; EQM-nonadapté. Une accentuées étaient liées FRP bas termes FRP-prémentalisation élevée. Un bas, mais pas TP comorbide. Plus particulièrement obsessionnel compulsif beaucoup moins EQM-nonadaptés. Conclusion: Des distincts représentent compétences manière différentielle psychopathologie maternelle Verschiedene Mentalisierungskonzepte bei Müttern mit postpartaler Depression sowie komorbiden Angst- und Persönlichkeitsstörungen Hintergrund: Mentalisierung ist definiert als die menschliche Fähigkeit, eigenes oder fremdes Verhalten bezüglich zugrunde liegender mentaler Zustände Absichten zu reflektieren. Es gibt verschiedene Konzepte der Mentalisierung, sich hinsichtlich ihres Inhalts, ihrer Untersuchungsweise klinischer Prognose unterscheiden. Ziele: Die vorliegende Studie untersucht Beziehung zwischen den drei Hauptkonzepten nämlich (elterliches) (PRF) (MM). wurde Hypothese aufgestellt, dass konvergenten divergenten Varianz klinischen Validität Bezug auf komorbide (personality disorders; PD) Methode: Fünfzig aus Kontexten überwiesene Mütter Säuglinge im Alter von bis zehn Monaten wurden dem Coding-System untersucht. Ergebnisse: keine signifikanten Assoziationen gefunden. Eine höhere war mehr MM- „nonattuned comments“ (nicht abgestimmten gedankenbezogenen Kommentaren) assoziiert. Erhöhte Depressions- Angstwerte waren durch PRF-Prementalisierungwerte einer insgesamt niedrigeren Niedrigere jedoch nicht komorbider Insbesondere zwanghafte erheblich Werten Kategorie Schlussfolgerung: Unterschiedliche stellen unterschiedliche Kompetenzen dar, unterschiedlicher Weise mütterlicher Psychopathologie Zusammenhang stehen. 産後うつ病、併存する不安神経症、およびパーソナリティ障害のある母親におけ るさまざまなメンタライジングの概念 背景:メンタライゼーションとは、基底にある心理状態や意図の観点から、自己や他者の行為を省察する人の能力と定義される。メンタライジングにはいくつかの概念が存在し、それは内容、評価、臨床的な予測において異なるものである。 目的:この研究においては、産後うつ病の母親を対象に、メンタライゼーションの主要な3つの概念の関連について調査した。すなわち、省察機能 (RF) 、養育者省察機能 、マインドマインドネス である。不安とパーソナリティ障害の合併に関して、メンタライゼーションの概念は、臨床的妥当性と同様に収束および発散分散において異なると仮定された。 方法:50人の産後うつ病と臨床的に診断された母親と3～10カ月の乳児を、省察機能尺度、養育者省察機能質問票、マインドマインドネスの符号化方式によって検査した。 結果:RFとPRF,或いはPRFとMMの間には有意差は認められなかった。高い省察機能 は、マインドマインドネスの不調律な気持ちについての発言の多さと相関があった。抑うつと不安の高まりは、プリメンタライジングが高いという点で低いPRFと関連していた。PRFではなく、低いRFはパーソナリティ障害の合併と関連が示された。特に、強迫性パーソナリティー障害と非常に少ないマインドマインドネスの不調律な気持ちについての発言に相関を認めた。 結論:それぞれのメンタライジングの概念は様々な能力を示し、母親の産後の精神病理にそれぞれ関連している。 研究背景:心智化是指人类根据潜在的心理状态和意图对自己或他人的行为进行反思的能力。存在几种心智化的概念, 它们在内容、评估和临床预测上有所不同。 研究目的:本研究探讨了患有产后抑郁症的母亲心智化的三个主要概念, 即反思功能 (RF)、育儿反思功能 和心智 之间的关系。我们假设, 心智化概念在其收敛和发散方差, 以及对焦虑和人格障碍 (PD) 共病患者的临床有效性上存在差异。 研究方法:采用反思功能量表、育儿反思功能问卷和心智编码系统对50例临床转诊的产后抑郁症母亲和3-10个月婴儿进行了调查。 研究结果:在RF和PRF之间, 或PRF和MM之间未发现显著关联;较高的RF与更多的MM不协调的心理相关评论关联。在较高的PRF预心智化下, 抑郁和焦虑的增加与较低的PRF相关。较低的RF, 而非PRF, 与PD共病关联。具体而言, 强迫型PD与相当少的MM不协调的心理相关评论关联。 研究结论:心智化的不同概念代表不同的能力, 与产妇产后心理病理学有不同的联系。 مفاهيم مختلفة في التصور الذهني عن الأمهات المصابات باكتئاب ما بعد الولادة، والقلق المصاحب لتعدد الأمراض، واضطرابات الشخصية الخلفية: يتم تعريف التمثيل بأنه القدرة البشرية على التفكير سلوكيات الذات أو الآخرين من حيث الحالات والنوايا العقلية الكامنة. توجد عدة لهذا الذهني، والتي تختلف المحتوى، والتقييم، والتنبؤ الاكلينيكي.الأهداف: تتناول هذه الدراسة العلاقة بين المفاهيم الرئيسية الثلاثة للتمثيل وهي الأداء التأملي ، والأداء للوالدين ((PRF، والتصور (MM)، عند الولادة. تم افتراض أن تباينها المتقارب والمتباعد وكذلك صحتها الاكلينيكية فيما يتعلق بقلق التعدد المرضي الشخصية. الطريقة: فحص 50 أمّاً مصابات الولادة ورضّع تتراوح أعمارهم ثلاثة و10 أشهر طريق مقياس التأملي، واستبيان للوالدين، ونظام ترميز الذهني. النتائج: لم تظهر أي علاقات ذات دلالة إحصائية و وMM . وارتبط ارتفاع بالمزيد التعليقات المتعلقة بالتصور العقلي وارتبطت زيادة الاكتئاب بانخفاض الوالدي ارتبط باضطرابات وعلى وجه التحديد اضطرابات الوسواس القهري كانت مرتبطة بتعليقات أقل بكثير استنتاج: تمثل المتباينة كفاءات متباينة، وترتبط ارتباطاً تفاضلياً بطبيعة الأمراض النفسية مرحلة In recent years, concept (Fonagy, 1991; Fonagy al., 1991) has gained recognition developmental theory research. behavior intentions, such feelings, thoughts, desires, beliefs (Fonagy 2007). includes think about, understand, interpret, predict behavior. being intensively investigated context motherhood psychopathology (e.g., Bigelow 2018; Cordes 2017; Ensink Marcoux 2016; Pawlby 2010; Suchman 2010). Various methodologies mentalization exist. al.’s mentalization, termed “reflective functioning” refers predominantly self-referential adult attachment 1991, 1998), derived from Adult Attachment Interview (AAI; George 1996). Because relies mostly on reflection adult's experiences past, new approaches have been proposed for capturing child-focused parent. Mind-mindedness tendency treat infant an individual mind, first assessing parenting (Meins, 1997, 1998, 2001; Meins & Fernyhough, 1999). Another parent, designated developed research parent's child's internal (Aber 1985; Slade, 2005). Therefore, Parent Development (PDI) introduced (Slade, this same vein, (PRFQ) Luyten al. (2009) self-reported questionnaire PRF. PRFQ divided into subscales: interest curiosity subscale, certainty about prementalizing latter nonmentalizing modes. Conceptually, understanding infants’ function states, be differentiated empathy (i.e., understanding, resonating with, feeling concern infant's emotions), although two are often confused one another (Borelli 2020). A growing body evidence highlights particular predictor behavior, attachment, health outcomes. Maternal confirmed positively sensitivity (PRFQ, Krink PDI, Stacks 2014), distress tolerance Rutherford 2013) secure (PDI; Borelli 2020; Slade 2005; negatively disrupted (Grienenberger 2005) child externalizing difficulties (RF, 2016). parents shown stress only when low Nijssens 2018). Furthermore, high serving buffer against intergenerational transmission trauma parent Schechter However, because different used these studies, gaining insight impacts various PRFQ, RF-Scale necessary, order develop valid reliable diagnostic, prevention, intervention tools. MM, some points, interrelatedness rarely undertaken. Although captures adults’ experiences, mentalize appropriate/nonattuned comments while directly interacting child, assesses ability see, at time, oneself agent. Moreover, “online” measure, is, it applied during mother–infant interaction, whereas rated “offline,” interaction. contexts might impact differently. During depressed mother, example, preoccupied her feelings thoughts failing state mind. contrast, completing allows mother consciously retrospect. conceptualized positive assumed. mentioned above, conceptual methodological differences suggest varying forms unique. regard parent–infant psychotherapy early support, mother's lack implications than impairment few available studies properties revealed inconsistent findings. Mostly nonsignificant (Arnott Meins, 2007; Barreto Riva Crugnola 2018), suggesting distinct concepts. yet context, operationalized severely impaired adults (Bateman Fonagy, 2008a; Bouchard 2008; 1996), depression, eating (Fischer-Kern 2013; Lemma 2011; 2012; Skarderud, Kuijpers Bekker, 2012), (PDs) (Antonsen Chiesa including borderline (BPD; Badoud Fischer-Kern 1996, Ha 2013), avoidant 2016), antisocial 2008b; Bateman 2013). failure (as RF) mediating factor childhood adversity development (Chiesa 2014; 2000). Mentalizing recently become relevant women suffering Its affects caregiving also (Ensink 2016, This seems particularly (PPD), highly prevalent year following birth. 3 after childbirth, rates PPD ranged 6.1% (Reck 2008) 19.2% if minor included (O'Hara, 2009); 49% 60% continue satisfy criteria major 12–15 (Vliegen 2014). Regarding comorbidity, prevalence rate disorder (PPA) 11.1%, 33.9% among 2008). (Paul Wenzel 2003). Additionally, Apter (2012) showed thirds suffered least PD. (OCPD) correlated depressive symptoms pregnancy (Van Broekhoven 2019), increased OCPD (Akman and/or severe capacities, need clarify MM. regard, (2017) reported healthy controls, Taubner (2011) association chronic study, rather female inpatients related Concerning negative correlations approaching statistical significance (2010), (2018) age 6 weeks appropriate later, depression-related parent–child interaction patterns compromise mothers’ engage (Bigelow subscale stance, other subscales (Krink 2017). Two severity (Stacks Thus, operationalizations aspects contributed diverging results. (2017), focuses stance (2010) (2014), involves both perspectives, self-focused children birth 36 months. (2014) overall summarized endorse symptoms. Recently, multidimensionality measured PDI confirmed, revealing child-focused, self-focused, relation-focused dimensions sample 123 exhibiting risk factors suboptimal (Smaling validation postnatal problems emotionality 20 Notwithstanding PPA (Apter Conroy O'Hara, 2009; Reck 2008), its mentalizing. Rudden (2006, panic unrelated period, specifically panic-specific psychophysiological bodily changes (Rudden 2006, could assumed find difficult see mind behind entirely determined changes, hunger tiredness; mothers, therefore, show lesser PDs postpartum, primarily focused BPD Crandell 2003; Newman With respect compared mixed controls. They argued less symptomatology most diagnosed otherwise specified result (Cordes PD, (2016) mothers: significantly BPD, showing likely misread (Marcoux To date, exists Overall, depend comorbidity. presumably specified, BPD. correspond aim investigate constructs’ anxiety, Due prevalence, considered separately. would partially overlap, demonstrating shared specific characteristics; MM-appropriate comments, PRF-prementalizing; further expected (a) presence OCPD; (b) nonattuned PD; (c) severity. Considering absence examination exploratory investigation respect, results facilitate mentalizing-based conducted University Medical Center Hamburg-Eppendorf (UKE) part aimed evaluating treatment (Ramsauer Mother–child pairs recruited outpatient unit Department Child Adolescent Psychiatry, Psychotherapy, Psychosomatics. Inclusion current psychiatric diagnosis mood dysthymia, disorders) speak fluent German. Exclusion primary ICD-10/DSM-IV substance abuse, schizophrenia psychotic disorders, intellectual impairments (estimated IQ < 80), acute suicidality. inclusion criterion months, retardation exclusion Written informed consent obtained parents. All procedures comply ethical standards national institutional committees experimentation World Association's Declaration Helsinki – Ethical Principles Research involving Human Subjects (1975, revised subjects/patients approved ethics committee Association Hamburg, authorized entire project. procedure completion Symptom Checklist-90-R (SCL-90-R; Franke, 2002), Structured Clinical DSM-IV (SCID) (American Psychiatric Association, 1994; Wittchen 1997), AAI interview assess videotaping video laboratory (5 min free play, 5 diaper changing, book sharing) classify Axis-I Axis-II diagnoses, German version SCID, well-established method satisfactory reliability (Lobbestael 2011), completed trained researchers. scales SCL-90-R measure Adequate excellent construct documented (Franke, 2002). consistencies (Cronbach's α) .94 .87, respectively. translation time (Luyten 2009). evaluates up years provides time- cost-saving evaluation child-related easy administer varied socioeconomic educational backgrounds 2009, consists 18 items. Each item belongs subscales, modes, states. scaled 7-point Likert scale 1 (strongly disagree) 7 agree). exhibit toward children's (in)ability recognize transparent. For relevance former (Georg parents’ refusal inability influence child´s “My sometimes gets sick keep me doing what I want do”; “When my fussy, he she does just annoy me”; cries around strangers embarrass me”). three-factor structure supported confirmatory analyses demonstrated good consistency similar prior α = .52; Burkhart Georg assessed Scale scored (George 1985, semistructured interview, across relationships. demand questions must rated, permit questions, carry weight responses questions. are, “Why did your behave they childhood?” “Do you who today?” (Reflective-Functioning Manual, Version 5, Application Interviews, London: Anna Freud Centre). 9-point ranging –1 (negative RF), (absent repudiated (questionable (definite ordinary (marked 9 (full exceptional 1998). raters independently coded interviews (AAI) mothers. purpose testing, (40%) classified twice. Interrater .74 α), “good” according Cicchetti's (1994) guidelines. According Coding 2.0 (Meins 2010), needs last 15–20 include free-play episode, diaper-changing book-sharing episode. clearly faces baby, split-screen technique used. using outlined (2013). speech sessions transcribed verbatim.