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      I don’t understand how I feel: mediating role of impaired self-mentalizing in the relationship between childhood adversity and psychosis spectrum experiences

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          Abstract

          Introduction

          Childhood adversity is associated with the severity of multiple dimensions of psychosis, but the mechanisms underpinning the close link between the two constructs is unclear. Mentalization may underlie this relationship, as impaired mentalizing is found in various stages of the psychosis continuum. Nonetheless, the differential roles of self- and other-mentalizing in psychosis are not well understood.

          Methods

          Parallel multiple mediation was conducted for the relationship between a diverse range of childhood adversity types, including intentional and nonintentional harm, and schizotypy (positive, negative, disorganized), psychotic-like experiences (PLE) and paranoia via self-mentalizing (attention to emotions and emotional clarity) and other-mentalizing in n = 1,156 nonclinically ascertained young adults.

          Results

          Significant parallel multiple mediation models were found for all psychotic outcomes except negative schizotypy. The associations between intentionally harmful childhood adversity and psychotic outcomes were significantly mediated by increased attention to emotions for most models and decreased emotional clarity for some models. No significant mediation was found for parental loss. Paternal abuse was only mediated by attention to emotions whereas the effects of maternal abuse were mediated by attention to emotions and emotional clarity. Other-mentalizing only showed mediating effects on one of thirty models tested.

          Conclusion

          Results highlight the mediating role of impaired self-mentalizing in the association between childhood adversity and psychosis. This is consistent with disturbances of self-concept and self-boundary characterizing, in particular, the positive dimension of psychosis. Maternal versus paternal figures may contribute differentially to the development of mentalizing. These results could inform future preventative interventions, focusing on the development and maintenance of self-mentalizing.

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          Most cited references111

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          The moderator–mediator variable distinction in social psychological research: Conceptual, strategic, and statistical considerations

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            Development and validation of a brief screening version of the Childhood Trauma Questionnaire

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              The environment and schizophrenia.

              Psychotic syndromes can be understood as disorders of adaptation to social context. Although heritability is often emphasized, onset is associated with environmental factors such as early life adversity, growing up in an urban environment, minority group position and cannabis use, suggesting that exposure may have an impact on the developing 'social' brain during sensitive periods. Therefore heritability, as an index of genetic influence, may be of limited explanatory power unless viewed in the context of interaction with social effects. Longitudinal research is needed to uncover gene-environment interplay that determines how expression of vulnerability in the general population may give rise to more severe psychopathology.
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                Author and article information

                Contributors
                URI : https://loop.frontiersin.org/people/1524898/overviewRole: Role: Role: Role:
                URI : https://loop.frontiersin.org/people/1535476/overviewRole: Role: Role:
                URI : https://loop.frontiersin.org/people/138823/overviewRole: Role:
                URI : https://loop.frontiersin.org/people/708349/overviewRole: Role: Role:
                URI : https://loop.frontiersin.org/people/191881/overviewRole: Role: Role: Role: Role: Role: Role:
                Journal
                Front Psychiatry
                Front Psychiatry
                Front. Psychiatry
                Frontiers in Psychiatry
                Frontiers Media S.A.
                1664-0640
                30 November 2023
                2023
                : 14
                : 1268247
                Affiliations
                [1] 1Departament de Psicologia Clínica i de la Salut, Universitat Autònoma de Barcelona , Barcelona, Spain
                [2] 2Department of Psychology, University of Illinois at Urbana-Champaign , Champaign, IL, United States
                [3] 3CIBER de Salud Mental, Instituto de Salud Carlos III , Madrid, Spain
                Author notes

                Edited by: Javier Ortuño Sierra, University of La Rioja, Spain

                Reviewed by: Juan Francisco Rodríguez-Testal, Sevilla University, Spain; Rebeca Aritio, University of La Rioja, Spain

                *Correspondence: Neus Barrantes-Vidal, Neus.Barrantes@ 123456uab.cat
                Article
                10.3389/fpsyt.2023.1268247
                10719857
                38098634
                bc80d173-603a-4b95-9d46-4a4d67f38798
                Copyright © 2023 Nonweiler, Torrecilla, Kwapil, Ballespí and Barrantes-Vidal.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

                History
                : 27 July 2023
                : 13 November 2023
                Page count
                Figures: 1, Tables: 7, Equations: 0, References: 113, Pages: 17, Words: 12006
                Funding
                Funded by: Spanish Ministry of Science and Innovation, doi 10.13039/501100004837;
                Funded by: Generalitat de Catalunya, doi 10.13039/501100002809;
                Funded by: Generalitat de Catalunya, doi 10.13039/501100002809;
                Funded by: Generalitat de Catalunya, doi 10.13039/501100002809;
                The author(s) declare financial support was received for the research, authorship, and/or publication of this article. This study was supported by the Spanish Ministry of Science and Innovation (grant number: PID2020-119211RB-I00) and the Generalitat de Catalunya (Suport als Grups de Recerca: 2021SGR01010) granted to NB-V. NB-V is supported by the ICREA Academia Award, Generalitat de Catalunya. JN is supported by the predoctoral program FI-AGAUR Ajuts de Joan Oró (2023 FI-3 00065) of the Secretary of Universities and Research, Department of Research, Universities of the Generalitat de Catalunya and the European Social Plus Fund.
                Categories
                Psychiatry
                Original Research
                Custom metadata
                Schizophrenia

                Clinical Psychology & Psychiatry
                mentalization,self-other,schizotypy,parental loss,childhood adversity,paranoia,psychotic-like experiences

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