Cited by 565Personality Disorders and PsychopathologyPsychoanalysis and Psychopathology ResearchPsychotherapy Techniques and Applications

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Mentalization: Ontogeny, Assessment, and Application in the Treatment of Borderline Personality Disorder

Choi-Kain, Lois W., Gunderson, John G.·2008·American Journal of Psychiatry

DOI 10.1176/appi.ajp.2008.07081360

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Abstract

This article aims to review the development of the concept of mentalization, its applications in the understanding and treatment of borderline personality disorder, and the issue of its assessment. While conceptually derivative of theory of mind, Fonagy's concept of mentalization concerns more affectively and interpersonally complex understandings of oneself and others, reflecting abilities that enable an individual not only to navigate the social world effectively but also to develop an enriched, stable sense of self. The components of mentalization can be organized around self-/other-oriented, implicit/explicit, and cognitive/affective dimensions. Concepts of mindfulness, psychological mindedness, empathy, and affect consciousness are shown to partially overlap with mentalization within these three dimensions. Mentalization is assessed by the measure of reflective function, a scale to be used adjunctively on semistructured narrative interviews such as the Adult Attachment Interview. Its validity has not been fully tested, and its usage has been hampered by the time and expense it requires. Although the concept of mentalization is a useful heuristic that enables clinicians to adopt a coherent treatment approach, it may be too broad and multifaceted to be operationalized as a marker for specific forms of psychopathology such as borderline personality disorder. Research elucidating the relationship between reflective function, overlapping concepts, and features of borderline psychopathology is needed.

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Authors: Choi-Kain, L. W., & Gunderson, J. G.
Affiliations: Harvard University (US)
ORCID: Choi-Kain, Lois W.
Venue: American Journal of Psychiatry
Publisher: American Psychiatric Association Publishing
Published: 2008-09
Volume: 165
Issue: 9
Pages: 1127-1135
ISSN: 0002-953X (ISSN-L)
1535-7228
DOI: 10.1176/appi.ajp.2008.07081360
OpenAlex: W2018329493
Cited by: 565
References: 59
Citations by year: 2026: 31 · 2025: 22 · 2024: 38 · 2023: 33 · 2022: 23 · 2021: 42 · 2020: 28 · 2019: 33 · 2018: 50 · 2017: 34 · 2016: 39 · 2015: 38 · 2014: 31 · 2013: 26 · 2012: 33
FWCI: 3.67
Type: journal article
Language: en
Open access: closed
Locations: American Journal of Psychiatry (publishedVersion)
PubMed (publishedVersion)
Topics: Social Sciences › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
Social Sciences › Psychology › Clinical Psychology › Psychoanalysis and Psychopathology Research
Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
Keywords: mentalization, borderline personality disorder, theory of mind, reflective functioning, Adult Attachment Interview, mindfulness, psychological mindedness, empathy, self-other orientation, attachment, treatment of borderline personality disorder
MeSH terms: Affect, Borderline Personality Disorder, Cognition Disorders, Consciousness, Culture, Humans, Interpersonal Relations, Interview, Psychological, Mental Processes, Object Attachment, Psychological Theory, Severity of Illness Index, Narration

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Mentalization: Ontogeny, Assessment, and Application in the Treatment of Borderline Personality Disorder

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