Mentalization-based treatment (MBT) is a spectrum of interventions that share a central focus on improving the capacity for mentalizing. Although MBT was originally developed as a treatment for individuals with borderline personality disorder, its scope and focus have been broadened to become a socioecological approach that stresses the role of broader sociocultural factors in determining the closely related capacities for mentalizing and epistemic trust. This special issue brings together some of the newest developments in MBT that illustrate this shift. These contributions also highlight several current limitations in mentalization-based approaches, providing important pointers for further research. In this editorial, we first outline the broadening scope of the mentalizing approach, and then provide a discussion of each of the contributions to this special issue in the context of the need for further research concerning some of the key assumptions of mentalization-based approaches and their implementation in clinical practice. We close this editorial with considerations concerning future research.

[This corrects the article DOI: 10.3389/fpsyt.2024.1380532.].

Many social cognitive assessments that were developed specifically for use in clinical populations are now being widely used in undergraduate populations, either to provide a comparison for clinical groups or to explore performance across the continuum from healthy to subclinical populations. However, the appropriateness of using these assessments in the general population is unclear. The current study, therefore, seeks to determine whether the Social Cognition Psychometric Evaluation (SCOPE) battery retains its psychometric properties when used in an undergraduate sample.The initial SCOPE battery was administered to 265 undergraduate participants, and the utility of the tasks was measured by assessing floor and ceiling effects. Internal consistency, discriminant and convergent validity are reported for each task, and the relationship between task performance and neurocognition and social functioning were assessed.Several of the tasks demonstrated limited utility, with the Hinting Task specifically demonstrating a pronounced ceiling effect. Only two measures of social cognitive biases achieved satisfactory internal consistency. Select tasks demonstrated small, but significant relationships with social functioning outcomes and significantly predicted 2-3% of variance above neurocognition alone.Despite the association with social functioning, results indicate that the psychometric properties demonstrated in the initial SCOPE study with a clinical sample do not fully extend to a healthy undergraduate population and highlight the need for social cognitive tasks that validly assess ability across the continuum.

UNASSIGNED: The relationship between neural social cognition patterns and performance on social cognition tasks in daily life is a topic of debate, with key consideration given to the extent to which theory of mind (ToM) brain circuits share properties reflecting everyday social functioning. To test the efficacy of ecological stimuli in eliciting brain activation within the ToM brain circuits, we adapted the Edinburgh Social Cognition test social scenarios, consisting of dynamic ecological contextually embedded social stimuli, to a fMRI paradigm.
UNASSIGNED: Forty-two adults (21 men, mean age ± SD = 34.19 years ±12.57) were enrolled and underwent an fMRI assessment which consisted of a ToM task using the Edinburgh Social Cognition test scenarios. We used the same stimuli to prompt implicit (movie viewing) and explicit (silent and two-choice answers) reasoning on cognitive and affective mental states. The fMRI analysis was based on the classical random effect analysis. Group inferences were complemented with supplemental analyses using overlap maps to assess inter-subject variability.
UNASSIGNED: We found that explicit mentalizing reasoning yielded wide neural activations when two-choice answers were used. We also observed that the nature of ToM reasoning, that is, affective or cognitive, played a significant role in activating different neural circuits.
UNASSIGNED: The ESCoT stimuli were particularly effective in evoking ToM core neural underpinnings and elicited executive frontal loops. Future work may employ the task in a clinical setting to investigate ToM network reorganization and plasticity.

Susceptibility to misinformation and belief polarization often reflect people\'s tendency to incorporate information in a biased way. Despite the presence of competing theoretical models, the underlying neurocognitive mechanisms of motivated reasoning remain elusive as previous empirical work did not properly track the belief formation process. To address this problem, we employed a design that identifies motivated reasoning as directional deviations from a Bayesian benchmark of unbiased belief updating. We asked members of a pro-immigration or an anti-immigration group how much they endorse factual messages on foreign criminality, a polarizing political topic. Both groups exhibited a desirability bias by over-endorsing attitude-consistent messages and under-endorsing attitude-discrepant messages and an identity bias by over-endorsing messages from ingroup members and under-endorsing messages from outgroup members. In both groups, neural responses to the messages predicted subsequent expression of desirability and identity biases suggesting a common neural basis of motivated reasoning across ideologically opposing groups. Specifically, brain regions implicated in encoding value, error detection, and mentalizing tracked the degree of desirability bias. Less extensive activation in the mentalizing network tracked the degree of identity bias. These findings illustrate the distinct neurocognitive architecture of desirability and identity biases and inform existing cognitive models of politically motivated reasoning.

UNASSIGNED: The Theory of Mind (ToM) assessment is becoming essential to evaluate the response to a social cognition intervention and to monitor the progression of social abilities impairment in atypical conditions. In the Italian setting, the Yoni task has been recently validated in its short version (the Yoni-48 task) to evaluate ToM in the clinical setting. The present study aimed to verify the test-retest reliability and the Minimal Detectable Change (MDC) of the Yoni-48 task.
UNASSIGNED: The Yoni-48 task was administered to 229 healthy adults at two evaluation sessions 3 weeks apart (mean days between sessions = 20.35 ± 1.75) by a psychologist. The test-retest reliability of the Yoni-48 task accuracy and response time was tested by the Intraclass Correlation Coefficient (ICC2,1, two-way random model, absolute agreement type). Then, the MDC95 and MDC90 were computed based on the standard error of measurement. Finally, the 95% limits of agreement were plotted (LOA plot) to visualize the difference and mean score of each pair of measurements.
UNASSIGNED: The total Yoni-48 task accuracy, but not the response time score, showed a high ICC (>0.80), with an MDC of 0.10. By plotting the LOA plot for the accuracy score no systematic trends were observed.
UNASSIGNED: This evidence will support the adoption of the Yoni task in longitudinal designs.

In traditional game theory tasks, social decision-making is centered on the prediction of the intentions (i.e., mentalizing) of strangers or manipulated responses. In contrast, real-life scenarios often involve familiar individuals in dynamic environments. Further research is needed to explore neural correlates of social decision-making with changes in the available information and environmental settings. This study collected fMRI hyperscanning data (N = 100, 46 same-sex pairs were analyzed) to investigate sibling pairs engaging in an iterated Chicken Game task within a competitive context, including two decision-making phases. In the static phase, participants chose between turning (cooperate) and continuing (defect) in a fixed time window. Participants could estimate the probability of different events based on their priors (previous outcomes and representation of other\'s intentions) and report their decision plan. The dynamic phase mirrored real-world interactions in which information is continuously changing (replicated within a virtual environment). Individuals had to simultaneously update their beliefs, monitor the actions of the other, and adjust their decisions. Our findings revealed substantial choice consistency between the two phases and evidence for shared neural correlates in mentalizing-related brain regions, including the prefrontal cortex, temporoparietal junction (TPJ), and precuneus. Specific neural correlates were associated with each phase; increased activation of areas associated with action planning and outcome evaluation were found in the static compared with the dynamic phase. Using the opposite contrast, dynamic decision-making showed higher activation in regions related to predicting and monitoring other\'s actions, including the anterior cingulate cortex and insula. Cooperation (turning), compared with defection (continuing), showed increased activation in mentalizing-related regions only in the static phase, while defection, relative to cooperation, exhibited higher activation in areas associated with conflict monitoring and risk processing in the dynamic phase. Men were less cooperative and had greater TPJ activation. Sibling competitive relationship did not predict competitive behavior but showed a tendency to predict brain activity during dynamic decision-making. Only individual brain activation results are included here, and no interbrain analyses are reported. These neural correlates emphasize the significance of considering varying levels of information available and environmental settings when delving into the intricacies of mentalizing during social decision-making among familiar individuals.

UNASSIGNED: Major gaps remain in our knowledge regarding childhood sexual abuse (CSA) related symptoms in adolescent psychiatric inpatients, as well as potential resilience factors like mentalizing. CSA is a risk factor for the early emergence of borderline personality features, posttraumatic stress, and sexual concerns. Mentalizing, which involves the capacity to understand our reactions and that of others in psychological terms, is a resilience factor for self and interpersonal functioning. The aim of this study was to address knowledge gaps by examining the contributions of CSA and mentalizing in a latent factor composed of borderline personality features, posttraumatic stress, and sexual concerns in a sample of adolescent psychiatric inpatients. We hypothesized that CSA and mentalizing would independently explain the variance in this latent factor.
UNASSIGNED: Participants were 273 adolescents aged 12-17 recruited from an adolescent inpatient psychiatric clinic. They completed the Reflective Function Questionnaire for Youth (RFQ-Y), the Trauma Symptom Checklist for Children (TSCC), and the Borderline Personality Features Scale for Children (BPFS-C). CSA was assessed using the Child Attachment Interview (CAI), the Computerized Diagnostic Interview Schedule for Children (C-DISC), as well as the Childhood Trauma Questionnaire (CTQ).
UNASSIGNED: 27.5% of adolescent psychiatric inpatients reported CSA. CSA and mentalizing were independently associated with a latent factor consisting of posttraumatic stress, borderline personality features, and sexual concerns. CSA explained 5.0% and RF explained 16.7% of the variance of the latent factor. When we consider both the unique and the shared contribution of CSA and mentalizing, the model explained 23.0% of the variance of this factor.
UNASSIGNED: CSA and mentalizing independently explained variance in a latent factor constituted of borderline personality features, posttraumatic stress, and sexual concerns. The direct effect of mentalizing was stronger and mentalizing explained comparatively more variance of trauma-related symptoms in adolescent psychiatric inpatients. The findings are consistent with the theory that mentalizing is an internal resilience factor in adolescent psychiatric inpatients. By implication, clinical interventions focused on promoting the development of mentalizing, such as Mentalization Based Treatment, may palliate mental health difficulties manifested by adolescent psychiatric inpatients including those associated with CSA.

In this paper, we explore the rationale for a combined art therapy and mentalization-based treatment (MBT) group course for those experiencing a first episode of psychosis (FEP). We discuss the theoretical background for how art and MBT theory can help us better understand and work with groups of individuals experiencing FEP, particularly focusing on avoidance and insecure attachment styles. We outline the delivery of a ten-week psychoeducational Art MBT course within an Early Intervention in Psychosis (EIP) Service and discuss our experiential insights into this new modality as co-therapists. We conclude by proposing that art therapy and mentalizing practice together offer an accessible, useful and practical group structure for EIP services, which could improve individuals\' mentalizing capacity and overall social functioning.

Parent-child informant discrepancies on psychopathology provide important knowledge on the parent-child relationship and the child\'s mental health, but mechanisms underlying parent-child informant discrepancies are largely unknown. Therefore, we investigated the relationship between attachment problems and mentalizing capacity and parent-child informant discrepancies on borderline personality disorder (BPD) severity, internalizing, and externalizing pathology in a clinical sample of 91 adolescent girls with BPD and their parents. Results showed that more attachment problems to parents and peers were related to adolescents reporting more severe BPD than parents. Adolescents who described more internalizing symptoms relative to parents, reported more parental attachment problems, but enhanced peer attachment, suggesting those adolescents who do not feel recognized by their parents might turn to their friends. When parents rated adolescents higher on externalizing behaviors, the adolescent reported more attachment problems to parents and lower mentalizing capacity, indicating that this sub-group of adolescents may reflect less about how their behavior affects others.