{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T17:19:17Z","timestamp":1791566357415,"version":"4.3.4"},"reference-count":61,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2024,6,21]],"date-time":"2024-06-21T00:00:00Z","timestamp":1718928000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Psychiatry"],"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>Mentalizing difficulties are central to borderline personality disorder (BPD), have severe consequences, and are an explicit focus in mentalization-based treatment. The significance of mentalizing capacity as a predictor or mediator of change is however still uncertain due to a scarcity of research. The Mentalization Breakdown Interview (MBI) was developed as a time saving tool for studying psychotherapy processes and outcome in borderline pathology. This study aimed to investigate the convergent validity of reflective functioning (RF) ratings based on the MBI (MBI-RF) by a comparison with the gold standard, i.e., RF assessments based on the Adult Attachment Interview (AAI-RF). A secondary aim was to investigate how MBI-RF relates to core symptoms of BPD, levels of functional impairment and symptom distress compared with AAI-RF.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>Forty-five patients with BPD or significant BPD traits were included. MBI-RF and AAI-RF were rated using the Reflective Functioning Scale. Levels of MBI-RF and AAI-RF and the correlation between the measures were calculated, as well as their associations with the Difficulties in Emotion Regulation Scale, Levels of Personality Functioning-Brief Form 2.0, Work and Social Adjustment Scale, Patient Health Questionnaire, Depression, Generalized Anxiety Disorder-7, self-harm, suicide attempts, and PD diagnostics.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The correlation between MBI-RF and AAI-RF was 0.79 (<jats:italic>p<\/jats:italic>&amp;lt;0.01), indicating high convergent validity. There were few significant associations between MBI-RF and AAI-RF and clinical measures.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The study provides support for the convergent validity of the MBI as a BPD-focused RF assessment method. The MBI has the potential as a time saving, reliable and valid method to be applied in treatment research on patients with borderline pathology. The results indicate that measures of MBI-RF and AAI-RF are different from clinical symptoms.<\/jats:p><\/jats:sec><jats:sec><jats:title>Clinical trial registration<\/jats:title><jats:p>ClinicalTrials.gov ID NCT04157907.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fpsyt.2024.1380532","type":"journal-article","created":{"date-parts":[[2024,6,21]],"date-time":"2024-06-21T04:56:35Z","timestamp":1718945795000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Minding mentalizing - convergent validity of the Mentalization Breakdown Interview"],"prefix":"10.3389","volume":"15","author":[{"given":"Dag Anders","family":"Ulvestad","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Merete Selsbakk","family":"Johansen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elfrida Hartveit","family":"Kvarstein","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Geir","family":"Pedersen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Theresa","family":"Wilberg","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2024,6,21]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1017\/S0954579409990198","article-title":"A developmental, mentalization-based approach to the understanding and treatment of borderline personality disorder [Review]","volume":"21","author":"Fonagy","year":"2009","journal-title":"Dev Psychopathol"},{"key":"B2","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1080\/10503307.2023.2226812","article-title":"Observer-based and computerized measures of the patient\u2019s mentalization in psychotherapy: a scoping review","author":"H\u00fcwe","year":"2023","journal-title":"Psychother Res"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.bp.113.143842","article-title":"Transference-focused psychotherapy for borderline personality disorder: change in reflective function","volume":"207","author":"Fischer-Kern","year":"2015","journal-title":"Br J Psychiatry"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1037\/per0000256","article-title":"Mentalizing as a mechanism of change in the treatment of patients with borderline personality disorder: A parallel process growth modeling approach","volume":"9","author":"De Meulemeester","year":"2018","journal-title":"Pers Disord"},{"key":"B5","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1037\/per000046433030949","article-title":"Two-year follow-up and changes in reflective functioning in specialist and nonspecialist treatment models for personality disorder [Peer Reviewed]","volume":"12","author":"Chiesa","year":"2021","journal-title":"Pers Disorders: Theory Res Treat"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1002\/(ISSN)1097-0355","article-title":"The capacity for understanding mental states: The reflective self in parent and child and its significance for security of attachment","volume":"12","author":"Fonagy","year":"1991","journal-title":"Infant Ment Health J"},{"key":"B7","volume-title":"Reflective functioning manual: Version 5 for application to adult attachment interviews","author":"Fonagy","year":"1998"},{"key":"B8","volume-title":"The Adult Attachment Interview","author":"George","year":"1985"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.1016\/j.cpr.2013.12.003","article-title":"Reflective functioning: a review","volume":"34","author":"Katznelson","year":"2014","journal-title":"Clin Psychol Rev"},{"key":"B10","doi-asserted-by":"publisher","first-page":"1","DOI":"10.3390\/ijerph18179161","article-title":"Systematic review on mentalization as key factor in psychotherapy","volume":"18","author":"Ludemann","year":"2021","journal-title":"Int J Environ Res Public Health"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.1177\/00030651090570060803","article-title":"Comparison of reflective functioning as measured on the adult attachment interview and the object relations inventory in patients with a personality disorder: a preliminary study","volume":"57","author":"Lowyck","year":"2009","journal-title":"J Am Psychoanal Assoc"},{"key":"B12","doi-asserted-by":"publisher","first-page":"699","DOI":"10.1080\/10503307.2012.709325","article-title":"Is a self-rated instrument appropriate to assess mentalization in patients with mental disorders? 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