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.

The mentalizing approach to psychopathology: State of the art and future directions

Disorders of affect regulation: Alexithymia in medical and psychiatric illness.

Alexithymia in eating disorders: Systematic review and meta-analyses of studies using the Toronto Alexithymia Scale.

https://www.cambridge.org/core/services/aop-cambridge-core/content/view/06F8AA96D03679353022A52E6ACE2F50/S0924933800009007a.pdf/div-class-title-investigating-alexithymia-in-autism-a-systematic-review-and-meta-analysis-div.pdf

Investigating alexithymia in autism: A systematic review and meta-analysis

IIt is well known that alexithymic individuals may show significantly higher levels of anxiety, depression, and psychological suffering than nonalexithymics. There is an increasing evidence that alexithymia may be considered a risk factor for suicide, even simply increasing the risk of development of depressive symptoms or per se. Therefore, the purpose of this narrative review was to elucidate the possible relationships between alexithymia and suicide risk. The majority of reviewed studies pointed out a relationship between alexithymia and increased suicide risk. In several studies this relationship was mediated by depressive symptoms. In conclusion, the importance of alexithymia screening in everyday clinical practice and the evaluation of clinical correlates of alexithymic traits should be integral parts of all disease management programs and, especially, of suicide prevention plans and interventions. However, studies limitations are discussed and must be considered.

/pdf/alexithymia-and-suicide-risk-in-psychiatric-disorders-a-mini-1pplhc07ge.pdf

Alexithymia and suicide risk in psychiatric disorders: a mini review

Patients with depression exhibit high rates of alexithymia, representing a major public health concern. We sought to examine relationships between depression severity and alexithymia as assessed by the Toronto Alexithymia Scale (TAS-20) and the TAS-20 subscales of difficulty identifying feelings (DIF), difficulty describing feelings (DDF), and externally oriented thinking (EOT). Potentially relevant studies were obtained independently by two reviewers. Chi-square statistics based on the Q -test and I 2 index assessed statistical heterogeneity between studies. Subgroup analyses were mainly used to explore sources of heterogeneity. Begg׳s test and Duval and Tweedie' trim and fill were used to assess potential publication bias. Altogether, 3572 subjects from 20 study groups across 19 studies were included. Medium relationships were observed between depression and TAS-total score (TAS-TS), DIF, and DDF. There was also a weak relationship between EOT and depression. Subgroup analyses showed a stronger correlation between TAS-TS and depression assessed by self-reported tools than that assessed by the Hamilton Rating Scale for Depression. The heterogeneity significantly decreased only in the subgroup analysis by depression tool. We conclude that alexithymia, as assessed by the TAS-20 and its subscales DIF and DDF, is closely related to depression. These relationships were affected by depression measurement tools.

Bin Zhang

Papers

The association between alexithymia as assessed by the 20-item Toronto Alexithymia Scale and depression: A meta-analysis.