Psychological mindedness and symptom reduction after psychotherapy in a heterogeneous psychiatric sample

Nyklíček, Ivan; Majoor, Daphne; Schalken, Pierre A.A.M.

doi:10.1016/j.comppsych.2010.02.004

Cited by 35Psychotherapy Techniques and ApplicationsAnxiety, Depression, Psychometrics, Treatment, Cognitive ProcessesPsychoanalysis and Psychopathology Research

Psychological mindedness and symptom reduction after psychotherapy in a heterogeneous psychiatric sample

Nyklíček, Ivan, Majoor, Daphne, Schalken, Pierre A.A.M.·2010·Comprehensive Psychiatry

DOI 10.1016/j.comppsych.2010.02.004

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Abstract

Background Psychological mindedness (PM) has been claimed to be beneficial for outcome of various forms of psychotherapy. The purpose of this study was to investigate the influence of PM on the therapy results of a psychiatric patient sample with heterogeneous psychological symptoms.Methods Participants were 110 patients with different diagnoses who were hospitalized at the Center for Psychological Recovery (Rosmalen, Netherlands). Before and after treatment, they were asked to complete the Balanced Index of Psychological Mindedness and the Symptom Checklist-90.Results Baseline PM was not associated with a decrease in symptom scores (F(8,73) < 1.0; P > .20; partial eta(2) < 0.10). However, PM increased over the course of the intervention (F(2,84) = 43.54; P < .001; eta(2) = 0.51) and larger increases in the insight component of PM were associated with larger decreases on 6 of 8 symptom scores (F(8,70) = 3.55; P < .005; partial eta(2) = 0.29).Conclusions These results suggest that although a high PM is not a prerequisite for successful cognitive behavioral therapy, an increase in insight is associated with better outcome.

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Psychological mindedness has inverse correlations with depressive symptoms and other indices of psychopathology.
“PM has been found in previous studies to have inverse correlations with depressive symptoms and other indices of psychopathology [11,12].”
From Relationships between psychopathology, psychological process variables, and sociodemographic variables and comparison of quarantined and non-quarantined groups of malaysian university students in the covid-19 pandemic (2021) · cites this paper as [12]

SCL-90: an outpatient psychiatric rating scale--preliminary report.
Derogatis, L. R., Lipman, R. S., & Covi, L. (1973) · PubMed · Cited by 3,815 · see citing works
Mentalization-Based Treatment of BPD
BATEMAN, A. W., & Fonagy, P. (2004) · Journal of Personality Disorders · doi:10.1521/pedi.18.1.36.32772 · Cited by 688 · see citing works
Handbook of Mentalization‐Based Treatment
(2006) · doi:10.1002/9780470712986 · Cited by 631 · see citing works
SCL-90. Handleiding bij een multidimensionele psychopathologie-indicator
Arrindell, W. A., & Ettema, J. H. M. (2003) · Research portal (Tilburg University) · Cited by 629 · see citing works
A controlled study of alexithymia in eating disorders
Schmidt, U. H., Jiwany, A., & Treasure, J. L. (1993) · Comprehensive Psychiatry · doi:10.1016/0010-440x(93)90036-4 · Cited by 292 · see citing works
Psychological-mindedness: word, concept and essence.
Appelbaum, S. A. (1973) · PubMed · Cited by 194 · see citing works
The Mentalization‐Focused Approach to Social Development
Fonagy, P. (2006) · Wiley eBooks · doi:10.1002/9780470712986.ch3 · Cited by 175 · see citing works
Alexithymia, depression, and treatment outcome in bulimia nervosa
de Groot, J. M., Rodin, G., & Olmsted, M. P. (1995) · Comprehensive Psychiatry · doi:10.1016/0010-440x(95)90099-h · Cited by 171 · see citing works
Interpretive and supportive forms of psychotherapy and patient personality variables.
Piper, W. E., Joyce, A. S., McCallum, M., & Azim, H. F. A. (1998) · Journal of Consulting and Clinical Psychology · doi:10.1037/0022-006x.66.3.558 · Cited by 156 · see citing works
Patient Personality and Time-limited Group Psychotherapy for Complicated Grief
Piper, W. E., McCallum, M., Joyce, A. S., Rosie, J. S., & Ogrodniczuk, J. S. (2001) · International Journal of Group Psychotherapy · doi:10.1521/ijgp.51.4.525.51307 · Cited by 152 · see citing works
Psychological Mindedness as a predictor of psychotherapy outcome: A preliminary report
Conte, H. R., Plutchik, R., Jung, B. B., Picard, S., Karasu, T. B., & Lotterman, A. C. (1990) · Comprehensive Psychiatry · doi:10.1016/0010-440x(90)90027-p · Cited by 133 · see citing works
Psychological mindedness : a contemporary understanding
McCallum, M., & Piper, W. E. (1997) · Medical Entomology and Zoology · Cited by 132 · see citing works
Development and evaluation of the Balanced Index of Psychological Mindedness (BIPM)
Nyklíček, I., & Denollet, J. (2009) · Psychological Assessment · doi:10.1037/a0014418 · Cited by 99 · see citing works
The Psychological Mindedness Scale: Factor structure, convergent validity and gender in a non‐psychiatric sample
Shill, M. A., & Lumley, M. A. (2002) · Psychology and Psychotherapy Theory Research and Practice · doi:10.1348/147608302169607 · Cited by 95 · see citing works
A prospective study of alexithymia in obsessive–compulsive patients treated with multimodal cognitive-behavioral therapy
Rufer, M., Hand, I., Braatz, A., Alsleben, H., Fricke, S., & Peter, H. (2004) · Psychotherapy and Psychosomatics · doi:10.1159/000075541 · Cited by 90 · see citing works
Psychological-Mindedness: A Conceptual Model
Hall, J. A. (1992) · American Journal of Psychotherapy · doi:10.1176/appi.psychotherapy.1992.46.1.131 · Cited by 84 · see citing works
The Psychological Mindedness Assessment Procedure.
McCallum, M., & Piper, W. E. (1990) · Psychological Assessment · doi:10.1037/1040-3590.2.4.412 · Cited by 77 · see citing works
Alexithymia and cognitive behaviour therapy outcome for subthreshold depression
Spek, V., Nyklı́ček, I., Cuijpers, P. J., & Pop, V. J. M. (2008) · Acta Psychiatrica Scandinavica · doi:10.1111/j.1600-0447.2008.01199.x · Cited by 67 · see citing works
A prospective long-term follow-up study of alexithymia in obsessive–compulsive disorder
Rufer, M., Ziegler, A., Alsleben, H., Fricke, S., Ortmann, J., Brückner, E., Hand, I., & Peter, H. (2006) · Comprehensive Psychiatry · doi:10.1016/j.comppsych.2005.12.004 · Cited by 66 · see citing works
Psychological mindedness and cognitive style
Beitel, M., Ferrer, E., & Cecero, J. J. (2004) · Journal of Clinical Psychology · doi:10.1002/jclp.10258 · Cited by 60 · see citing works
Correlates of psychological mindedness
Trudeau, K. J., & Reich, R. (1995) · Personality and Individual Differences · doi:10.1016/0191-8869(95)00110-r · Cited by 56 · see citing works
The effect of alexithymic features on response to antidepressant medication in patients with major depression
Özşahin, A., Uzun, Ö., Cansever, A., & Gülçat, Z. (2003) · Depression and Anxiety · doi:10.1002/da.10117 · Cited by 52 · see citing works
Psychological Mindedness, Work, and Outcome in Day Treatment
Piper, W. E., Joyce, A. S., Rosie, J. S., & Azim, H. F. A. (1994) · International Journal of Group Psychotherapy · doi:10.1080/00207284.1994.11490755 · Cited by 48 · see citing works
Relationships between psychological mindedness and personality traits and ego functioning: Validity studies
Conte, H. R., Buckley, P., Picard, S., & Karasu, T. B. (1995) · Comprehensive Psychiatry · doi:10.1016/0010-440x(95)90093-b · Cited by 37 · see citing works
Exploring the relationships among early maladaptive schemas, psychological mindedness and self‐reported college adjustment
Cecero, J. J., Beitel, M., & Prout, T. A. (2007) · Psychology and Psychotherapy Theory Research and Practice · doi:10.1348/147608307x216177 · Cited by 34 · see citing works
Cognitive Behavioral Therapy Promotes Mentalizing
Björgvinsson, Þ., & Hart, J. (2006) · doi:10.1002/9780470712986.ch7 · Cited by 27 · see citing works
Predicting Patient Benefit from a Group-Oriented, Evening Treatment Program
McCallum, M., Piper, W. E., & O’Kelly, J. G. (1997) · International Journal of Group Psychotherapy · doi:10.1080/00207284.1997.11490831 · Cited by 27 · see citing works
Psychological-mindedness and the alexithymia construct
Taylor, G. J., Bagby, M. R., & Parker, J. D. A. (1989) · The British Journal of Psychiatry · doi:10.1192/bjp.154.5.731c · Cited by 20 · see citing works

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Jennissen, S., Huber, J., Ehrenthal, J. C., Schauenburg, H., & Dinger, U. (2018) · American Journal of Psychiatry · doi:10.1176/appi.ajp.2018.17080847 · Cited by 148 · see citing works
Early in-session predictors of response to trauma-focused cognitive therapy for posttraumatic stress disorder
Brady, F., Warnock‐Parkes, E., Barker, C., & Ehlers, A. (2015) · Behaviour Research and Therapy · doi:10.1016/j.brat.2015.10.001 · Cited by 55 · see citing works
“Identifying and Describing Emotions”
Byrne, G., Bogue, J., Egan, R., & Lonergan, E. (2014) · Sexual Abuse · doi:10.1177/1079063214558940 · Cited by 51 · see citing works
Client-focused psychotherapy research.
Fuertes, J. N., & Williams, E. N. (2017) · Journal of Counseling Psychology · doi:10.1037/cou0000214 · Cited by 36 · see citing works
Resilience Protective Factors Checklist (RPFC): Buffering Childhood Adversity and Promoting Positive Outcomes
Powell, K. M., Rahm-Knigge, R., & Conner, B. T. (2020) · Psychological Reports · doi:10.1177/0033294120950288 · Cited by 30 · see citing works
Psychological mindedness as a mediator in the relationship between dysfunctional coping styles and depressive symptoms in caregivers of children with autism spectrum disorder
Ping Pang, N. T., Masiran, R., Tan, K., & Kassim, A. (2020) · Perspectives in Psychiatric Care · doi:10.1111/ppc.12481 · Cited by 22 · see citing works
Making Your Emotions Work for You: A pilot brief intervention for alexithymia with personality‐disordered offenders
McMurran, M., & Jinks, M. (2011) · Personality and Mental Health · doi:10.1002/pmh.170 · Cited by 21 · see citing works
Relationships between psychopathology, psychological process variables, and sociodemographic variables and comparison of quarantined and non-quarantined groups of malaysian university students in the covid-19 pandemic
Pang, N. T. P., James, S., Giloi, N., Rahim, S. S. S. A., Omar, A., Jeffree, M. S., Hayati, F., Lim, M. C., Kassim, M. A. M., & Ng, J. R. (2021) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph18189656 · Cited by 19 · see citing works
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Insight as a mechanism of change in dynamic therapy for major depressive disorder.
Jennissen, S., Gibbons, M. B. C., Crits-Christoph, P. F., Schauenburg, H., & Dinger, U. (2021) · Journal of Counseling Psychology · doi:10.1037/cou0000554 · Cited by 18 · see citing works
Process expectations: Differences between therapists, patients, and lay individuals in their views of what works in psychotherapy
Bitan, D. T., & Abayed, S. (2019) · Journal of Clinical Psychology · doi:10.1002/jclp.22872 · Cited by 17 · see citing works
Efficacy of Intellect’s self-guided anxiety and worry mobile health programme: A randomized controlled trial with an active control and a 2-week follow-up
Kosasih, F. R., Yee, V. T. S., Toh, S. H. Y., & Sündermann, O. (2023) · PLOS Digital Health · doi:10.1371/journal.pdig.0000095 · Cited by 15 · see citing works
Understanding the relationship between psychopathic traits and client variables: variable-centered and person-centered analytic approaches
Athar, M. E. (2023) · Current Psychology · doi:10.1007/s12144-023-05322-5 · Cited by 14 · see citing works
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Hill, S., & McMahon, C. A. (2015) · Infant and Child Development · doi:10.1002/icd.1947 · Cited by 12 · see citing works
Insight and Outcome in Long-Term Psychotherapies of Depression
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The role of emotional intelligence in symptom reduction after psychotherapy in a heterogeneous psychiatric sample
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Psychological Mindedness and Alexithymia Predict Symptom Reduction in Cognitive Behavior Therapy for Major Depressive Disorder
Kishon, R., Geronazzo‐Alman, L., Westphal, M., Chen, Y., Green, D., Sarda, A., Love, M., Cheng, B., Stewart, J. W., & Hollon, S. D. (2019) · International Journal of Cognitive Therapy · doi:10.1007/s41811-019-00062-6 · Cited by 9 · see citing works
Development of a scale quantifying expectations regarding active processes in therapy: The Expectations of Active Processes in Psychotherapy Scale (EAPPS).
Bitan, D. T., Lazar, A., & Siton, B. (2018) · Psychiatry Research · doi:10.1016/j.psychres.2018.05.040 · Cited by 7 · see citing works
Individual goal achievement in group psychotherapy: The roles of psychological mindedness and group process in interpretive and supportive therapy for complicated grief
Kealy, D., Piper, W. E., Ogrodniczuk, J. S., Joyce, A. S., & Weideman, R. (2018) · Clinical Psychology & Psychotherapy · doi:10.1002/cpp.2346 · Cited by 7 · see citing works
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Musa, N., Pang, N. T. P., Kamu, A., Ho, C. M., Waters, C., Berrett, J., Moghaddam, N., & Wider, W. (2022) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph19159624 · Cited by 6 · see citing works
Cognitive-Emotional Functioning in Somatic Symptom and Related Disorders: Self-Reports Versus Observer-Rated Findings
van Dijke, A., & Lenstra, S. (2016) · Journal of Psychology & Psychotherapy · doi:10.4172/2161-0487.1000271 · Cited by 4 · see citing works
Borderline Personality Disorder: Treatment from the Contextual Perspective
Stone, M. H. (2017) · Psychodynamic Psychiatry · doi:10.1521/pdps.2017.45.1.1 · Cited by 4 · see citing works
Validity and Reliability of Turkish Version of the Balanced Index of Psychological Mindedness
Denizli, S., Meydan, B., & Pamukçu, B. (2022) · International Journal for the Advancement of Counselling · doi:10.1007/s10447-021-09452-y · Cited by 4 · see citing works
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Die Messung Psychologischer Mentalität: eine Validierungsstudie zur deutschsprachigen Version des Balanced Index of Psychological Mindedness (BIPM)
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Psychological Mindedness and Psychotherapy Process in Short-Term Group Therapy
Kealy, D., Hernandez, C. A. S., Piper, W. E., Joyce, A. S., Weideman, R., & Ogrodniczuk, J. S. (2017) · Psychodynamic Psychiatry · doi:10.1521/pdps.2017.45.3.343 · Cited by 3 · see citing works
Ergenlerin Psikolojik Zihinliliklerinin Yordayıcıları Olarak Aleksitimi ve Bilinçli Farkındalık Deneyimi
Uzun, K., & Karataş, Z. (2023) · Abant İzzet Baysal Üniversitesi Eğitim Fakültesi Dergisi · doi:10.17240/aibuefd.2023..-909660 · Cited by 1 · see citing works
L’intelligence psychologique et son utilité clinique
Csillik, A. S., & Bigeard, É. (2014) · Annales Médico-psychologiques revue psychiatrique · doi:10.1016/j.amp.2013.05.030 · Cited by 1 · see citing works
Measures of Psychological Mindedness: A Systematic Review of Psychometric Properties
Thompson, J. E., Haddock, G., & Berry, K. (2025) · Clinical Psychology & Psychotherapy · doi:10.1002/cpp.70064 · Cited by 2 · see citing works
Psychometric evaluation of the Persian version of the balanced index of psychological mindedness in a university student sample
Karimi, S., zanganeh, S. N., Athar, M. E., Kargaripadar, L., Farjampanah, Z., Esmaeili, H., Mojtahed, M., Mostafavi, E. S., Alinezhad, M., Kargaripadar, Z., et al. (2025) · Acta Psychologica · doi:10.1016/j.actpsy.2025.105147 · Cited by 1 · see citing works
Time In, Time Out: Resilience Narratives of Formerly Incarcerated Emerging Adults
Buser, J. J. (2015) · Scholarship & Creative Works - Digital UNC a service of University Libraries (University of Northern Colorado)
The Dual Mediation Effects of Difficulty in Emotional Differentiation and Maladaptive Cognitive Emotion Regulation on the Relationship between Self-absorption and Interpersonal Problems
조은실, HyunMyoungHo, & 신미연 (2018) · Korean Journal of Health Psychology · doi:10.17315/kjhp.2018.23.1.009
“Intellect”, a Mobile Health Application based on cognitive-behavioral therapy principles, improves Anxiety and Worry: A Randomized Controlled Trial with an Active Control and a 2-Week Follow-UpPreprint
Kosasih, F. R., Yee, V. T. S., Toh, S. H. Y., & Sündermann, O. (2022) · medRxiv · doi:10.1101/2022.07.25.22278034
Using Yalom’s When Nietzsche Wept to Enhance Psychological Mindedness in Future Counselors
Uzun, K. (2026) · The Counseling Psychologist · doi:10.1177/00110000251352571

The Relationship Between Psychological Mindedness and Psychotherapeutic Outcome.
Miller, K. D. (1997) · Surrey Research Insight Open Access (The University of Surrey)
Psychological Mindedness as a predictor of psychotherapy outcome: A preliminary report
Conte, H. R., Plutchik, R., Jung, B. B., Picard, S., Karasu, T. B., & Lotterman, A. C. (1990) · Comprehensive Psychiatry · doi:10.1016/0010-440x(90)90027-p · Cited by 133 · see citing works
Relationships among psychological mindedness, alexithymia and outcome in four forms of short‐term psychotherapy
McCallum, M., Piper, W. E., Ogrodniczuk, J. S., & Joyce, A. S. (2003) · Psychology and Psychotherapy Theory Research and Practice · doi:10.1348/147608303765951177 · Cited by 136 · see citing works
Psychological mindedness: An overview
Rai, S., Punia, V., Choudhury, S., & Mathew, K. J. (2015) · Indian Journal of Positive Psychology · doi:10.15614/ijpp/2015/v6i1/88511 · Cited by 5 · see citing works
The psychological mindedness assessment procedure – validation study of a Dutch version
Smith, A. J. M., Kleijn, W. C., Trijsburg, W., Segaar, J. A., van der Staak, C. P. F., & Hutschemaekers, G. J. M. (2008) · Psychology and Psychotherapy Theory Research and Practice · doi:10.1348/147608308x377150 · Cited by 4 · see citing works

Authors: Nyklíček, I., Majoor, D., & Schalken, P. A. A. M.
Affiliations: Tilburg University (NL)
Venue: Comprehensive Psychiatry
Publisher: Elsevier BV
Published: 2010-09
Volume: 51
Issue: 5
Pages: 492-496
ISSN: 0010-440X (ISSN-L)
DOI: 10.1016/j.comppsych.2010.02.004
OpenAlex: W2014322307
Cited by: 35
References: 29
Citations by year: 2026: 1 · 2025: 2 · 2023: 3 · 2022: 4 · 2021: 3 · 2020: 5 · 2019: 2 · 2018: 4 · 2017: 3 · 2016: 1 · 2015: 3 · 2014: 3
FWCI: 0.35
Type: journal article
Language: en
Open access: closed
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations: Comprehensive Psychiatry (publishedVersion)
Research portal (Tilburg University) (publishedVersion)
PubMed (publishedVersion)
Data Archiving and Networked Services (DANS) (submittedVersion)
DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
Topics: Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
Social Sciences › Psychology › Clinical Psychology › Psychoanalysis and Psychopathology Research
Keywords: psychological mindedness, psychotherapy outcome, symptom relief, cognitive behavioral therapy, insight, psychiatric inpatients, SCL-90
MeSH terms: Adult, Aged, Awareness, Mental Disorders, Female, Humans, Inpatients, Male, Middle Aged, Netherlands, Psychotherapeutic Processes, Cognitive Behavioral Therapy, Multivariate Analysis, Treatment Outcome

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Psychological mindedness and symptom reduction after psychotherapy in a heterogeneous psychiatric sample

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