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The Mentalizing Approach to Psychopathology: State of the Art and Future Directions
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Mentalizing is the capacity to understand others and oneself in terms of internal mental states. It is assumed to be underpinned by four dimensions: automatic-controlled, internally-externally focused, self-other, and cognitive-affective. Research suggests that mental disorders are associated with different imbalances in these dimensions. Addressing the quality of mentalizing as part of psychosocial treatments may benefit individuals with various mental disorders. We suggest that mentalizing is a helpful transtheoretical and transdiagnostic concept to explain vulnerability to psychopathology and its treatment. This review summarizes the mentalizing approach to psychopathology from a developmental socioecological evolutionary perspective. We then focus on the application of the mentalizing approach to personality disorders, and we review studies that have extended this approach to other types of psychopathology, including depression, anxiety, and eating disorders. We summarize core principles of mentalization-based treatments and preventive interventions and the evidence for their effectiveness. We conclude with recommendations for future research.
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“To date, the few studies carried out in the context of loss have shown that mentalizing deficits are related to major depressive disorder and complicated grief [17,18].”
From Failures in Reflective Functioning and Reported Symptoms of Anxiety and Depression in Bereaved Individuals: A Study on a Sample of Family Caregivers of Palliative Care Patients (2022) · cites this paper as [17]
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“Imbalance in mentalizing processes has been suggested as key to the understanding of psychopathology irrespective of diagnostic category [23].”
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Self-citation
Metadata
- Authors
- Luyten, P., Campbell, C., Allison, E., & Fonagy, P.
- Affiliations
- University College London (GB)
- Research Department of Clinical, Educational and Health Psychology, University College London, London WC1E 7HB, United Kingdom
- Venue
- Annual Review of Clinical Psychology
- Publisher
- Annual Reviews
- Published
- 2020-05-07
- Volume
- 16
- Issue
- 1
- Pages
- 297-325
- ISSN
- 1548-5943 (ISSN-L)
- 1548-5951
- OpenAlex
- W2994905377
- Cited by
- 748
- References
- 146
- Citations by year
- 2026: 121 · 2025: 137 · 2024: 172 · 2023: 117 · 2022: 87 · 2021: 88 · 2020: 25
- FWCI
- 6.22
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Annual Review of Clinical Psychology (publishedVersion)
- PubMed (publishedVersion)
- UCL Discovery (University College London) (submittedVersion)
- Lirias (submittedVersion, other-oa)
- Funders
- National Institute for Health and Care Research (NF-SI-0514-10157)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
- Social Sciences › Psychology › Clinical Psychology › Psychoanalysis and Psychopathology Research
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Keywords
- mentalization, mentalization-based treatment, psychopathology, transdiagnostic model, personality disorders, depression, anxiety, eating disorders, preventive interventions
- MeSH terms
- Mentalization, Mental Disorders, Humans, Psychotherapy
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