Mentalization and mental health outcomes in adolescents with internalizing disorders: a systematic review and multilevel meta-analysis

IF 4.4 3区医学 Q1 PEDIATRICS

Child and Adolescent Mental Health Pub Date : 2026-10-14 Epub Date: 2026-03-08 DOI:10.1111/camh.70080

Areas Malenka, Candela García Domench, Anna Babl, Nick Midgley, Andres Roussos, Juan Martín Gómez Penedo

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引用次数: 0

Abstract

Background

Adolescence is a period marked by critical developmental milestones, during which many mental health issues, including internalizing disorders, often first emerge.

These disorders can significantly impair socialization, a key process for developing identity, social skills, and supportive relationships. Mentalization has gained attention as a crucial factor in effective socialization. While mentalization deficits have been widely studied in adults with mental health issues, evidence of this association in adolescents remains limited.

Methods

Following PRISMA reporting guidelines, we performed a systematic search and multilevel meta-analysis of studies examining the association between mentalization and mental health indicators in adolescents with internalizing disorders. Records were screened independently by two reviewers, with additional studies identified via reference-list checks. Studies were included if they assessed mentalization and internalizing-related mental health outcomes in adolescents and provided correlational data. Methodological quality was appraised using a tailored 7-domain checklist. Correlational multilevel meta-analyses were conducted using Fisher's z transformation and a three-level random-effects model to address variability at within-effect size, between-effect size, and between-study levels.

Results

The final sample included 23 studies (reporting 154 effect sizes) that met inclusion criteria. Included studies showed overall moderate-to-low risk of bias. The models showed a significant, medium-sized negative correlation between mentalization and mental health indicators (z = −0.24, p < .001, r = −0.24). Sensitivity analyses found no significant effect of the moderators.

Conclusion

This is the first meta-analytic study to estimate the association between mentalization and mental health outcomes in adolescents with internalizing disorders. Findings suggest a moderate association, underscoring the importance of assessing mentalization in these populations. Further research should explore the clinical implications of mentalization for internalizing disorders in adolescence.

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内化障碍青少年的心理化和心理健康结果：一项系统回顾和多水平荟萃分析

背景：青春期是一个具有重要发展里程碑的时期，在此期间，许多心理健康问题，包括内化障碍，往往首先出现。这些障碍会严重损害社会化，而社会化是发展身份、社交技能和支持性关系的关键过程。心理化作为有效社会化的关键因素而受到关注。虽然心智缺陷在有心理健康问题的成年人中得到了广泛的研究，但在青少年中这种关联的证据仍然有限。方法：遵循PRISMA报告指南，我们对内化障碍青少年心理化与心理健康指标之间关系的研究进行了系统检索和多水平荟萃分析。记录由两名审稿人独立筛选，并通过参考列表检查确定其他研究。如果研究评估了青少年心理化和内化相关的心理健康结果，并提供了相关数据，则纳入研究。采用定制的7域检查表对方法学质量进行评价。使用Fisher’s z变换和三水平随机效应模型进行了相关的多水平荟萃分析，以解决效应内大小、效应间大小和研究之间水平的可变性。结果：最终样本包括符合纳入标准的23项研究（报告154个效应量）。纳入的研究显示总体偏倚风险为中低。模型显示心理化与心理健康指标之间存在显著的中等负相关（z = -0.24, p）。结论：这是第一个评估内化障碍青少年心理化与心理健康结果之间关系的荟萃分析研究。研究结果表明存在适度的关联，强调了评估这些人群心理化的重要性。进一步的研究应探讨心理化对青少年内化障碍的临床意义。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Child and Adolescent Mental Health PEDIATRICS-PSYCHIATRY

CiteScore

8.30

自引率

3.30%

发文量

审稿时长

>12 weeks

期刊介绍： Child and Adolescent Mental Health (CAMH) publishes high quality, peer-reviewed child and adolescent mental health services research of relevance to academics, clinicians and commissioners internationally. The journal''s principal aim is to foster evidence-based clinical practice and clinically orientated research among clinicians and health services researchers working with children and adolescents, parents and their families in relation to or with a particular interest in mental health. CAMH publishes reviews, original articles, and pilot reports of innovative approaches, interventions, clinical methods and service developments. The journal has regular sections on Measurement Issues, Innovations in Practice, Global Child Mental Health and Humanities. All published papers should be of direct relevance to mental health practitioners and clearly draw out clinical implications for the field.