Deficits in mentalization: a risk factor for future development of eating disorders among pre-adolescent girls

Abstract

Modern psychoanalytic developmental theory suggests that a child's inability to make sense of her own mind and those of others (i.e. mentalization) leaves her vulnerable to communicate through action instead of words, which can include somatization in the form of an eating disorder (ED). This pilot study tested the correlation between ED risk and insecure attachment among 76 preadolescent girls and compared the mentalization capacities of girls with high and low vulnerability to EDs. Girls in fourth through sixth grades were given tests measuring their ED risk and attachment styles. Thirty subjects with the highest and lowest scores on measures of ED were then administered a mentalization picture task to measure their capacity to mentalize. The analysis of the data indicated a significant negative correlation between ED risk and attachment style as well as ED risk and mentalization capacity, i.e. girls in the high-risk group for ED had significantly lower scores on attachment and mentalization. Implications of findings for future development of ED prevention programs are discussed, including the importance of psychological variables in prevention of EDs and incorporating a mentalization component into existing ED prevention programs.

Keywords:

• attachment
• eating disorders risk factors
• mentalization
• childhood
• psychodynamic

Notes on contributors

Rebecca Cate, Psy.D. is a Behavioral Health Consultant at the Naval Hospital Family Medicine Residency program at Marine Corps Base in Camp Pendleton, California, and Clinical Supervisor for CAPS at Alliant International University, San Diego. Dr Cate is a licensed Clinical Psychologist and received her Psy.D. from Alliant, San Diego, in 2010.

Mojgan Khademi, Psy.D. is an Assistant Professor of Psychology at Alliant International University, Psy.D. Department and Director of the Center for Applied Psychological Services (CAPS) at Alliant. Dr Khademi is a nationally certified psychoanalyst in private practice in San Diego. She received her Psy.D. from Indiana University of Pennsylvania in 1992.

Patricia Judd, Ph.D. is Clinical Professor of Psychiatry at the UCSD School of Medicine. She directs the Center for Study of Personality and Co-occurring Disorders, the Outpatient clinical training program and the Attachment Institute. She received her PhD in Clinical Psychology from the California School of Professional Psychology, San Diego, in 1989.

Heidi Miller is an advanced Doctoral Candidate at California School of Professional Psychology, Alliant International University, San Diego. She received her Master's degree in psychology from Alliant in 2010.