Mentalization Profiles of Adolescents with Internalizing Disorders: Domain-specific Differences Compared to Typically Developing Adolescents.

Abstract

Background: Adolescence is a sensitive period for mentalization development and also marks the onset and exacerbation of psychiatric conditions. Mentalization impairments are transdiagnostic, but the literature primarily focuses on younger children and adults in Western cultures, with limited exploration in adolescents. This study aimed to explore the differences between mentalization profiles of adolescents with internalizing disorders (AID) and typically developing adolescents (TDA) in India.

Methods: The sample included 166 adolescents (aged 12-17), divided into the AID group (n = 83) diagnosed with either depression, anxiety, or somatoform/dissociative disorders, and the TDA group (n = 83) without any psychiatric illness, group-matched on age, gender, and years of formal education. The Mentalization Scale (MentS), the Reflective Functioning Questionnaire for Youth (RFQ-Y), and the Strengths and Difficulties Questionnaire (SDQ) were administered to both groups. In contrast, the Depression Anxiety and Stress Scale for Youth was administered only to the AID group to assess symptom severity.

Results: Mann-Whitney U tests revealed the AID group had significantly lower "self-mentalization" (r_rb = 0.177) and "Overall mentalization Ability" (r_rb = 0.311). No significant differences were found in "other-mentalization" and "motivation to Mentalize." Spearman's Rank-Order Correlation revealed that "Overall mentalization ability" was significantly negatively correlated with internalizing and externalizing problems on the SDQ, whereas "motivation to Mentalize" was significantly positively correlated with emotional symptoms on the SDQ.

Conclusion: This study highlights differential impairments in mentalization domains between AID and TDA, providing novel insights into mentalization profiles of adolescents through a developmental lens with theoretical and clinical implications in addressing this transdiagnostic vulnerability.