The DOI matches its Crossref record; 59 of the 59 references it cites were found in a registry or an index.
Mentalization: Ontogeny, Assessment, and Application in the Treatment of Borderline Personality Disorder
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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“Whilst mentalising impairments or differences have not been previously linked to self-injury as such, they are a feature of borderline personality disorder [27–30], which is itself strongly linked with self-injury [31–33].”
From A 'choice', an 'addiction', a way 'out of the lost': Exploring self-injury in autistic people without intellectual disability (2019) · cites this paper as [29]
Citations
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Cited by
Sorted by citations
Fonagy, P., & Luyten, P. (2009) · Development and Psychopathology · doi:10.1017/s0954579409990198 · Cited by 1,146
“The concept of mentalization has been appropriately criticized as a marker of a specific form of psychopathology such as BPD because in its original formulation the concept was too broad and multifaceted to be operationalized (Choi-Kain & Gunderson, 2008; Holmes, 2005).”
BackgroundFonagy, P., Luyten, P., Moulton-Perkins, A., Lee, Y.-W., Warren, F., Howard, S., Ghinai, R., Fearon, P., & Lowyck, B. (2016) · PLOS ONE · doi:10.1371/journal.pone.0158678 · Cited by 754
“Although several self-report measures have been developed to assess constructs related to mentalizing [19, 20], such as mindfulness, perspective-taking, empathy, theory of mind, alexithymia, and psychological mindedness, no self-report questionnaire of RF currently exist [20].”
BackgroundMethodThe mentalizing approach to psychopathology: State of the art and future directions
Luyten, P., Campbell, C., Allison, E., & Fonagy, P. (2020) · Annual Review of Clinical Psychology · doi:10.1146/annurev-clinpsy-071919-015355 · Cited by 748
“Mentalizing encompasses and subsumes a wide range of related concepts focusing on various aspects of social cognition, including empathy, mindfulness, ToM, psychological mindedness, alexithymia, and insightfulness (Choi-Kain & Gunderson 2008).”
BackgroundHow we know our own minds: The relationship between mindreading and metacognition
Carruthers, P. (2009) · Behavioral and Brain Sciences · doi:10.1017/s0140525x09000545 · Cited by 610
“There is less evidence for a primary deficit of mindreading (Choi-Kain & Gunderson 2008).”
BackgroundGuendelman, S., Medeiros, S., & Rampes, H. (2017) · Frontiers in Psychology · doi:10.3389/fpsyg.2017.00220 · Cited by 577
“The notion of mentalization has a heterogeneous origin, starting from the construct of theory of mind developed in the field of etiology/cognitive science (Premack and Wooddruff, 1978), the concept of symbolization from psychoanalysis (Choi-Kain and Gunderson, 2008) and the notion of meta-cognition from novel developm…”
Background
Metadata
- Authors
- Choi-Kain, L. W., & Gunderson, J. G.
- Affiliations
- Harvard University (US)
- ORCID
- Choi-Kain, Lois W.
- Venue
- American Journal of Psychiatry
- Published
- 2008-09
- Volume
- 165
- Issue
- 9
- Pages
- 1127-1135
- ISSN
- 0002-953X (ISSN-L)
- 1535-7228
- 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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