Mentalization, attachment, and defense mechanisms: a Psychodynamic Diagnostic Manual-2-oriented empirical investigation
Open accessAbstract
Mentalizing capacities depends on the quality of primary attachment interactions with caregivers who thinks of the child as a subject with mental states. Operationalized as reflective functioning, mentalization is crucial for regulating emotions and developing of a coherent sense of identity, for interacting with individuals making sense to own and others mental states, and for distinguishing internal and external realities without distortions. Although the clinical literature on interplay between mentalization, attachment, and emotional regulation is rich, the empirical research is limited. This study sought to explore connections between reflective functioning, attachment styles, and implicit emotion regulation, operationalized as defense mechanisms, in a group of depressive patients. Twenty-eight patients were interviewed using the adult attachment interview (AAI) and diagnosed using the Psychodynamic Chart-2 of the Psychodynamic Diagnostic Manual, Second Edition. The reflective functioning scale and the defense mechanisms rating scale Q-sort were applied to AAI transcriptions to assess reflective functioning and defensive profile. Patients with secure attachment showed significantly higher levels in reflective functioning and overall defensive functioning as compared to those with insecure attachment. Good reflective functioning and secure attachment correlated with mature defenses and specific defensive mechanisms that serve in better regulating affective states. Overall, the relationship between mentalization, attachment and emotion regulation lay the foundations for the delineation of defensive profiles associated with attachment patterns and reflective functioning in depressive patients. The systematic assessment of these psychological dimensions with gold-standard tools may help in tailoring personalized therapeutic interventions and promoting more effective treatments.
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Dysregulation is due to excessive conditioned anxiety or defense mechanisms that create defensive affects.
“Dysregulation is due to excessive conditioned anxiety or defense mechanisms that create defensive affects (for the assessment of defense mechanisms see [63,64,65]).”
From Interoceptive Ability and Emotion Regulation in Mind–Body Interventions: An Integrative Review (2024) · cites this paper as [65]
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- Authors
- Tanzilli, A., Di Giuseppe, M., Giovanardi, G., Boldrini, T., Caviglia, G., Conversano, C., & Lingiardi, V.
- Affiliations
- Sapienza University of Rome (IT)
- University of Padua (IT)
- University of Campania "Luigi Vanvitelli" (IT)
- University of Pisa (IT)
- Corresponding author
- Tanzilli, Annalisa
- Giovanardi, Guido
- Boldrini, Tommaso
- Caviglia, Giorgio
- Conversano, Ciro
- Lingiardi, Vittorio
- ORCID
- Venue
- Research in Psychotherapy: Psychopathology, Process and Outcome
- Publisher
- PAGEPress Publications
- Published
- 2021-03-29
- Volume
- 24
- Issue
- 1
- Pages
- 531-531
- ISSN
- 2239-8031 (ISSN-L)
- 2499-7552
- PMC
- PMC8082535
- OpenAlex
- W3142844975
- Cited by
- 66
- References
- 63
- Citations by year
- 2026: 9 · 2025: 16 · 2024: 12 · 2023: 8 · 2022: 9 · 2021: 11 · 2020: 1
- FWCI
- 6.82
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Research in Psychotherapy Psychopathology Process and Outcome (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- IRIS Research product catalog (Sapienza University of Rome) (submittedVersion, cc-by-nc-nd)
- CINECA IRIS Institutial research information system (University of Pisa) (submittedVersion, cc-by-nc)
- Cineca Institutional Research Information System (Tor Vergata University) (submittedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Archivio Istituzionale della Ricerca - Università degli Studi della Campania "Luigi Vanvitelli" (submittedVersion)
- Padua Research Archive (University of Padova) (submittedVersion, cc-by-nc)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Psychoanalysis and Psychopathology Research
- Social Sciences › Psychology › Social Psychology › Attachment and Relationship Dynamics
- Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
- Keywords
- mentalization, reflective functioning, attachment styles, defense mechanisms, emotion regulation, depression, secure attachment, insecure attachment, Adult Attachment Interview, affective states
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