95 results on '"Ensink K."'
Search Results
2. Different epistemic stances for different traumatic experiences: implications for mentalization
- Author
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Benzi, I, Carone, N, Parolin, L, Martin-Gagnon, G, Ensink, K, Fontana, A, Benzi I. M. A., Carone N., Parolin L., Martin-Gagnon G., Ensink K., Fontana A., Benzi, I, Carone, N, Parolin, L, Martin-Gagnon, G, Ensink, K, Fontana, A, Benzi I. M. A., Carone N., Parolin L., Martin-Gagnon G., Ensink K., and Fontana A.
- Abstract
Traumatic experiences may impair reflective functioning (RF), making it difficult for individuals to understand their own and others' mental states. Epistemic trust (ET), which enables evaluating social information as reliable and relevant, may vary in association with RF. In this study, we explored the implications of different ET stances (i.e., trust, mistrust, and credulity) in the relation between different childhood traumatic experiences (i.e., emotional abuse, physical abuse, sexual abuse, emotional neglect, and physical neglect) and different types of RF impairments (uncertainty and certainty about mental states). A non-clinical community sample of 496 cisgender emerging adults (mage = 24.91, standard deviation = 2.66, 71.85% assigned female at birth, 63.63% heterosexual) reported on their childhood traumatic experiences, ET, and RF. We used structural equation models to examine direct and indirect associations. The results showed significant indirect effects between emotional abuse and uncertainty about mental states through credulity. We also observed significant indirect effects between emotional abuse and certainty about mental states through mistrust and credulity. The findings suggest that a lack of discrimination when evaluating knowledge from others (i.e., credulity) might promote increased uncertainty in RF when emerging adults have experienced emotional abuse in their childhood. Conversely, a tendency to view all information sources as unreliable or ill-intentioned (i.e., mistrust) may foster greater certainty in RF as a protective mechanism against an unreliable and potentially harmful world when combined with childhood emotional abuse. The implications for clinical practice and intervention are discussed.
- Published
- 2023
3. Emerging personality in adolescence: developmental trajectories, internalizing and externalizing problems, and the role of mentalizing abilities
- Author
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Benzi, I, Fontana, A, Barone, L, Preti, E, Parolin, L, Ensink, K, Benzi I. M. A., Fontana A., Barone L., Preti E., Parolin L., Ensink K., Benzi, I, Fontana, A, Barone, L, Preti, E, Parolin, L, Ensink, K, Benzi I. M. A., Fontana A., Barone L., Preti E., Parolin L., and Ensink K.
- Abstract
Introduction: Identifying longitudinal trajectories of emerging personality (EP) is crucial to highlight developmental patterns that might foster personality pathology in adolescence and early adulthood. Research on the exacerbation of personality pathology in adolescence identifies the significant contribution of internalizing and externalizing problems and suggests the importance of considering aspects such as mentalization, while accounting for gender differences. Methods: In our study, we adopted a mixed-model approach to (1) explore longitudinally EP (Adolescent Personality Structure Questionnaire; APS-Q) over 12 months in a sample of adolescents (N = 178, 62% females, mAGE = 15.04, SD = 1.27), accounting for gender effects. Moreover, (2) we assessed the longitudinal effect of internalizing and externalizing problems (Youth Self-Report; YSR-112) on EP. Finally, (3) we addressed the moderating role of mentalization (Movie Assessment for Social Cognition; MASC) in this developmental pathway. Results: Results highlighted a two-way pattern of EP. No changes were found in the level of difficulties in Self-acceptance, Investments and Goals, and Relationships with family dimensions. However, significant changes were found in personality functioning in the dimensions of Sense of Self, Aggression, and Relationships with friends. More, changes in difficulties in Sexuality emerged only in females. Also, gender differences emerged in the level of severity of EP. In addition, Internalizing and Externalizing problems differentially predicted difficulties in personality dimensions. Finally, mentalizing features moderated the relationship between Internalizing problems and Sense of Self and Internalizing problems and Self-acceptance, respectively. Conclusions: Our contribution aligns with recent developmental models of personality pathology, suggesting that different personality dimensions develop at different paces. More, it highlights the predictive power of externalizing an
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- 2023
4. The latent structure of the adult attachment interview: Large sample evidence from the collaboration on attachment transmission synthesis
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Lee Raby, K, Verhage, M, Pasco Fearon, R, Chris Fraley, R, Roisman, G, van IJzendoorn, M, Schuengel, C, Madigan, S, Oosterman, M, Bakermans-Kranenburg, M, Bernier, A, Ensink, K, Hautamaki, A, Mangelsdorf, S, Priddis, L, Wong, M, Aviezer, O, Behrens, K, Brisch, K, Cassibba, R, Cassidy, J, Coppola, G, Costantini, A, Dozier, M, Duschinsky, R, Ierardi, E, Finger, B, de Millan, S, Harder, S, Hazen, N, Jin, M, Myung, S, Jongenelen, I, Leerkes, E, Lionetti, F, Lyons-Ruth, K, Mcmahon, C, Meins, E, Pace, C, Pederson, D, Riva Crugnola, C, Sagi-Schwartz, A, Schoppe-Sullivan, S, Speranza, A, Steele, H, Tarabulsy, G, Vaever, M, Ward, M, Arnott, B, Bailey, H, Behringer, J, Brice, P, Castoro, G, Costantino, E, Cyr, C, George, C, Gloger-Tippelt, G, Howes, C, Jacobsen, H, Jacobvitz, D, Juffer, F, Kazui, M, Koppe, S, Millan, S, Murray, L, Simonelli, A, Solomon, J, Steele, M, Teti, D, Monique van Londen-Barentsen, W, Lee Raby K., Verhage M. L., Pasco Fearon R. M., Chris Fraley R., Roisman G. I., van IJzendoorn M. H., Schuengel C., Madigan S., Oosterman M., Bakermans-Kranenburg M. J., Bernier A., Ensink K., Hautamaki A., Mangelsdorf S., Priddis L. E., Wong M. S., Aviezer O., Behrens K. Y., Brisch K. -H., Cassibba R., Cassidy J., Coppola G., Costantini A., Dozier M., Duschinsky R., Ierardi E., Finger B., de Millan S. G., Harder S., Hazen N. L., Jin M. M., Myung S., Jongenelen I., Leerkes E. M., Lionetti F., Lyons-Ruth K., McMahon C., Meins E., Pace C. S., Pederson D. R., Riva Crugnola C., Sagi-Schwartz A., Schoppe-Sullivan S. J., Speranza A. M., Steele H., Tarabulsy G. M., Vaever M. S., Ward M. J., Arnott B., Bailey H., Behringer J., Brice P. J., Castoro G., Costantino E., Cyr C., George C., Gloger-Tippelt G., Howes C., Jacobsen H., Jacobvitz D., Juffer F., Kazui M., Koppe S., Millan S., Murray L., Simonelli A., Solomon J., Steele M., Teti D. M., Monique van Londen-Barentsen W., Lee Raby, K, Verhage, M, Pasco Fearon, R, Chris Fraley, R, Roisman, G, van IJzendoorn, M, Schuengel, C, Madigan, S, Oosterman, M, Bakermans-Kranenburg, M, Bernier, A, Ensink, K, Hautamaki, A, Mangelsdorf, S, Priddis, L, Wong, M, Aviezer, O, Behrens, K, Brisch, K, Cassibba, R, Cassidy, J, Coppola, G, Costantini, A, Dozier, M, Duschinsky, R, Ierardi, E, Finger, B, de Millan, S, Harder, S, Hazen, N, Jin, M, Myung, S, Jongenelen, I, Leerkes, E, Lionetti, F, Lyons-Ruth, K, Mcmahon, C, Meins, E, Pace, C, Pederson, D, Riva Crugnola, C, Sagi-Schwartz, A, Schoppe-Sullivan, S, Speranza, A, Steele, H, Tarabulsy, G, Vaever, M, Ward, M, Arnott, B, Bailey, H, Behringer, J, Brice, P, Castoro, G, Costantino, E, Cyr, C, George, C, Gloger-Tippelt, G, Howes, C, Jacobsen, H, Jacobvitz, D, Juffer, F, Kazui, M, Koppe, S, Millan, S, Murray, L, Simonelli, A, Solomon, J, Steele, M, Teti, D, Monique van Londen-Barentsen, W, Lee Raby K., Verhage M. L., Pasco Fearon R. M., Chris Fraley R., Roisman G. I., van IJzendoorn M. H., Schuengel C., Madigan S., Oosterman M., Bakermans-Kranenburg M. J., Bernier A., Ensink K., Hautamaki A., Mangelsdorf S., Priddis L. E., Wong M. S., Aviezer O., Behrens K. Y., Brisch K. -H., Cassibba R., Cassidy J., Coppola G., Costantini A., Dozier M., Duschinsky R., Ierardi E., Finger B., de Millan S. G., Harder S., Hazen N. L., Jin M. M., Myung S., Jongenelen I., Leerkes E. M., Lionetti F., Lyons-Ruth K., McMahon C., Meins E., Pace C. S., Pederson D. R., Riva Crugnola C., Sagi-Schwartz A., Schoppe-Sullivan S. J., Speranza A. M., Steele H., Tarabulsy G. M., Vaever M. S., Ward M. J., Arnott B., Bailey H., Behringer J., Brice P. J., Castoro G., Costantino E., Cyr C., George C., Gloger-Tippelt G., Howes C., Jacobsen H., Jacobvitz D., Juffer F., Kazui M., Koppe S., Millan S., Murray L., Simonelli A., Solomon J., Steele M., Teti D. M., and Monique van Londen-Barentsen W.
- Abstract
The Adult Attachment Interview (AAI) is a widely used measure in developmental science that assesses adults' current states of mind regarding early attachment-related experiences with their primary caregivers. The standard system for coding the AAI recommends classifying individuals categorically as having an autonomous, dismissing, preoccupied, or unresolved attachment state of mind. However, previous factor and taxometric analyses suggest that: (a) adults' attachment states of mind are captured by two weakly correlated factors reflecting adults' dismissing and preoccupied states of mind and (b) individual differences on these factors are continuously rather than categorically distributed. The current study revisited these suggestions about the latent structure of AAI scales by leveraging individual participant data from 40 studies (N = 3,218), with a particular focus on the controversial observation from prior factor analytic work that indicators of preoccupied states of mind and indicators of unresolved states of mind about loss and trauma loaded on a common factor. Confirmatory factor analyses indicated that: (a) a 2-factor model with weakly correlated dismissing and preoccupied factors and (b) a 3-factor model that further distinguished unresolved from preoccupied states of mind were both compatible with the data. The preoccupied and unresolved factors in the 3-factor model were highly correlated. Taxometric analyses suggested that individual differences in dismissing, preoccupied, and unresolved states of mind were more consistent with a continuous than a categorical model. The importance of additional tests of predictive validity of the various models is emphasized.
- Published
- 2022
5. Conceptual comparison of constructs as first step in data harmonization: Parental sensitivity, child temperament, and social support as illustrations
- Author
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Verhage, M, Schuengel, C, Holopainen, A, Bakermans-Kranenburg, M, Bernier, A, Brown, G, Madigan, S, Roisman, G, Vaever, M, Wong, M, Barone, L, Behrens, K, Behringer, J, Bovenschen, I, Cassibba, R, Cassidy, J, Coppola, G, Costantini, A, Dozier, M, Ensink, K, Fearon, R, Finger, B, Hautamaki, A, Hazen, N, Ierardi, E, Jongenelen, I, Koppe, S, Lionetti, F, Mangelsdorf, S, Oosterman, M, Pace, C, Raby, K, Riva Crugnola, C, Simonelli, A, Spangler, G, Tarabulsy, G, Arnott, B, Bailey, H, Brice, P, Brisch, K, Castoro, G, Costantino, E, Cyr, C, George, C, Gloger-Tippelt, G, Gojman, S, Harder, S, Howes, C, Jacobsen, H, Jacobvitz, D, Jin, M, Juffer, F, Kazui, M, Leerkes, E, Lyons-Ruth, K, Mcmahon, C, Meins, E, Millan, S, Murray, L, Nowacki, K, Pederson, D, Priddis, L, Sagi-Schwartz, A, Schoppe-Sullivan, S, Solomon, J, Speranza, A, Steele, M, Steele, H, Teti, D, van IJzendoorn, M, van Londen-Barentsen, W, Ward, M, Verhage M. L., Schuengel C., Holopainen A., Bakermans-Kranenburg M. J., Bernier A., Brown G. L., Madigan S., Roisman G. I., Vaever M. S., Wong M. S., Barone L., Behrens K. Y., Behringer J., Bovenschen I., Cassibba R., Cassidy J., Coppola G., Costantini A., Dozier M., Ensink K., Fearon R. M. P., Finger B., Hautamaki A., Hazen N. L., Ierardi E., Jongenelen I., Koppe S., Lionetti F., Mangelsdorf S., Oosterman M., Pace C. S., Raby K. L., Riva Crugnola C., Simonelli A., Spangler G., Tarabulsy G. M., Arnott B., Bailey H., Brice P. J., Brisch K. -H., Castoro G., Costantino E., Cyr C., George C., Gloger-Tippelt G., Gojman S., Harder S., Howes C., Jacobsen H., Jacobvitz D., Jin M. K., Juffer F., Kazui M., Leerkes E. M., Lyons-Ruth K., McMahon C., Meins E., Millan S., Murray L., Nowacki K., Pederson D. R., Priddis L., Sagi-Schwartz A., Schoppe-Sullivan S. J., Solomon J., Speranza A. M., Steele M., Steele H., Teti D. M., van IJzendoorn M. H., van Londen-Barentsen W. M., Ward M. J., Verhage, M, Schuengel, C, Holopainen, A, Bakermans-Kranenburg, M, Bernier, A, Brown, G, Madigan, S, Roisman, G, Vaever, M, Wong, M, Barone, L, Behrens, K, Behringer, J, Bovenschen, I, Cassibba, R, Cassidy, J, Coppola, G, Costantini, A, Dozier, M, Ensink, K, Fearon, R, Finger, B, Hautamaki, A, Hazen, N, Ierardi, E, Jongenelen, I, Koppe, S, Lionetti, F, Mangelsdorf, S, Oosterman, M, Pace, C, Raby, K, Riva Crugnola, C, Simonelli, A, Spangler, G, Tarabulsy, G, Arnott, B, Bailey, H, Brice, P, Brisch, K, Castoro, G, Costantino, E, Cyr, C, George, C, Gloger-Tippelt, G, Gojman, S, Harder, S, Howes, C, Jacobsen, H, Jacobvitz, D, Jin, M, Juffer, F, Kazui, M, Leerkes, E, Lyons-Ruth, K, Mcmahon, C, Meins, E, Millan, S, Murray, L, Nowacki, K, Pederson, D, Priddis, L, Sagi-Schwartz, A, Schoppe-Sullivan, S, Solomon, J, Speranza, A, Steele, M, Steele, H, Teti, D, van IJzendoorn, M, van Londen-Barentsen, W, Ward, M, Verhage M. L., Schuengel C., Holopainen A., Bakermans-Kranenburg M. J., Bernier A., Brown G. L., Madigan S., Roisman G. I., Vaever M. S., Wong M. S., Barone L., Behrens K. Y., Behringer J., Bovenschen I., Cassibba R., Cassidy J., Coppola G., Costantini A., Dozier M., Ensink K., Fearon R. M. P., Finger B., Hautamaki A., Hazen N. L., Ierardi E., Jongenelen I., Koppe S., Lionetti F., Mangelsdorf S., Oosterman M., Pace C. S., Raby K. L., Riva Crugnola C., Simonelli A., Spangler G., Tarabulsy G. M., Arnott B., Bailey H., Brice P. J., Brisch K. -H., Castoro G., Costantino E., Cyr C., George C., Gloger-Tippelt G., Gojman S., Harder S., Howes C., Jacobsen H., Jacobvitz D., Jin M. K., Juffer F., Kazui M., Leerkes E. M., Lyons-Ruth K., McMahon C., Meins E., Millan S., Murray L., Nowacki K., Pederson D. R., Priddis L., Sagi-Schwartz A., Schoppe-Sullivan S. J., Solomon J., Speranza A. M., Steele M., Steele H., Teti D. M., van IJzendoorn M. H., van Londen-Barentsen W. M., and Ward M. J.
- Abstract
This article presents a strategy for the initial step of data harmonization in Individual Participant Data syntheses, i.e., making decisions as to which measures operationalize the constructs of interest - and which do not. This step is vital in the process of data harmonization, because a study can only be as good as its measures. If the construct validity of the measures is in question, study results are questionable as well. Our proposed strategy for data harmonization consists of three steps. First, a unitary construct is defined based on the existing literature, preferably on the theoretical framework surrounding the construct. Second, the various instruments used to measure the construct are evaluated as operationalizations of this construct, and retained or excluded based on this evaluation. Third, the scores of the included measures are recoded on the same metric. We illustrate the use of this method with three example constructs focal to the Collaboration on Attachment Transmission Synthesis (CATS) study: parental sensitivity, child temperament, and social support. This process description may aid researchers in their data pooling studies, filling a gap in the literature on the first step of data harmonization. • Data harmonization in studies using combined datasets is of vital importance for the validity of the study results. • We have developed and illustrated a strategy on how to define a unitary construct and evaluate whether instruments are operationalizations of this construct as the initial step in the harmonization process. • This strategy is a transferable and reproducible method to apply to the data harmonization process.
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- 2022
6. Persistent and Transitory Sexualized Behavior Problems in Children
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Ensink, K., Godbout, N., Bigras, N., Lampron, J., Sabourin, S., and Normandin, L.
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- 2018
- Full Text
- View/download PDF
7. Post-traumatic-stress in the context of childhood maltreatment: pathways from attachment through mentalizing during the transition to parenthood
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Ensink, K., Bégin, M., Martin-Gagnon, G., Biberdzic, M., Berthelot, N., Normandin, L., Fonagy, P., Bernazzani, O., Borelli, J. L., Ensink, K., Bégin, M., Martin-Gagnon, G., Biberdzic, M., Berthelot, N., Normandin, L., Fonagy, P., Bernazzani, O., and Borelli, J. L.
- Abstract
Introduction: This study aimed to clarify the role of mentalizing in pathways from attachment to Post Traumatic Stress Symptoms (PTSS) in survivors of childhood maltreatment (CM). We focused on the transition to parenting, a critical period for reworking parenting representations to reduce intergenerational maltreatment cycles. Method: Study participants included 100 pregnant CM survivors. We assessed PTSS with the SCID and attachment and mentalizing with the Adult Attachment Interview (AAI), which was rated for Attachment and Reflective Functioning (RF). Results: Regarding Re-experiencing trauma symptoms, the results of the path analysis were consistent with mediation. CM survivors' mentalizing about their early relationships with their parents (RF-Other) directly impacted Re-experiencing trauma symptoms, and attachment had an effect on Re-experiencing trauma symptoms through mentalizing (RF-Other). Regarding Arousal/Reactivity symptoms, the results of the pathways analysis were consistent with partial mediation by mentalizing about early relationships with parents (RF-Other). In addition to the pathway from attachment via mentalizing (RF-Other) to Arousal/Reactivity, the pathway between attachment and Arousal/Reactivity also remained significant. Discussion: This study provides new evidence of a mentalizing and attachment model of PTSS in CM survivors. The findings indicate that increased mentalizing about early relationships with parents is an important process associated with lower PTSS. Finally, we discuss the implications of developing interventions for CM survivors to reduce PTSS. Scaffolding the development of mentalizing regarding attachment relationships in which CM occurred may help CM survivors reduce the intrusion of traumatic memories and decrease trauma-related arousal and reactivity symptoms. Interventions to help CM survivors mentalize regarding parents and attachment relationships in which trauma occurred may be particularly important duri
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- 2023
8. Adolescence in lockdown: The protective role of mentalizing and epistemic trust
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Locati, F, Milesi, A, Conte, F, Campbell, C, Fonagy, P, Ensink, K, Parolin, L, Locati, Francesca, Milesi, Alberto, Conte, Federica, Campbell, Chloe, Fonagy, Peter, Ensink, Karin, Parolin, Laura, Locati, F, Milesi, A, Conte, F, Campbell, C, Fonagy, P, Ensink, K, Parolin, L, Locati, Francesca, Milesi, Alberto, Conte, Federica, Campbell, Chloe, Fonagy, Peter, Ensink, Karin, and Parolin, Laura
- Abstract
Objective Mentalizing is the ability to interpret one's own and others' behavior as driven by intentional mental states. Epistemic trust (openness to interpersonally transmitted information) has been associated with mentalizing. Balanced mentalizing abilities allow people to cope with external and internal stressors. Studies show that social isolation imposed by the COVID-19 pandemic was highly stressful for most people, especially for adolescents. Here we examine whether mentalizing and epistemic trust were protective factors in relation to emotional distress during the lockdown. Method A total of 131 nonclinical adolescents, aged between 12 and 18 years, were evaluated during the lockdown using the Reflective Functioning Questionnaire for Youth, Inventory of Parent and Peer Attachment, Perceived Stress Scale, and Difficulties in Emotion Regulation Scale. Results Results from network analysis showed that epistemic trust and mentalizing were negatively associated with perceived stress and emotion dysregulation. Epistemic trust in fathers was associated with level of perceived stress, and epistemic trust in mothers with emotion dysregulation. Conclusion These findings suggest that epistemic trust and the capacity to mentalize were low in adolescents during lockdown, and this was associated with high levels of stress. However, robust levels of epistemic trust and mentalizing may have acted as protective factors that buffered individuals from the risk of emotional dysregulation during the lockdown.
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- 2023
9. The latent structure of the adult attachment interview: Large sample evidence from the collaboration on attachment transmission synthesis
- Author
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Lee Raby K., Verhage M. L., Pasco Fearon R. M., Chris Fraley R., Roisman G. I., van IJzendoorn M. H., Schuengel C., Madigan S., Oosterman M., Bakermans-Kranenburg M. J., Bernier A., Ensink K., Hautamaki A., Mangelsdorf S., Priddis L. E., Wong M. S., Aviezer O., Behrens K. Y., Brisch K. -H., Cassibba R., Cassidy J., Coppola G., Costantini A., Dozier M., Duschinsky R., Ierardi E., Finger B., de Millan S. G., Harder S., Hazen N. L., Jin M. M., Myung S., Jongenelen I., Leerkes E. M., Lionetti F., Lyons-Ruth K., McMahon C., Meins E., Pace C. S., Pederson D. R., Riva Crugnola C., Sagi-Schwartz A., Schoppe-Sullivan S. J., Speranza A. M., Steele H., Tarabulsy G. M., Vaever M. S., Ward M. J., Arnott B., Bailey H., Behringer J., Brice P. J., Castoro G., Costantino E., Cyr C., George C., Gloger-Tippelt G., Howes C., Jacobsen H., Jacobvitz D., Juffer F., Kazui M., Koppe S., Millan S., Murray L., Simonelli A., Solomon J., Steele M., Teti D. M., Monique van Londen-Barentsen W., Lee Raby, K, Verhage, M, Pasco Fearon, R, Chris Fraley, R, Roisman, G, van IJzendoorn, M, Schuengel, C, Madigan, S, Oosterman, M, Bakermans-Kranenburg, M, Bernier, A, Ensink, K, Hautamaki, A, Mangelsdorf, S, Priddis, L, Wong, M, Aviezer, O, Behrens, K, Brisch, K, Cassibba, R, Cassidy, J, Coppola, G, Costantini, A, Dozier, M, Duschinsky, R, Ierardi, E, Finger, B, de Millan, S, Harder, S, Hazen, N, Jin, M, Myung, S, Jongenelen, I, Leerkes, E, Lionetti, F, Lyons-Ruth, K, Mcmahon, C, Meins, E, Pace, C, Pederson, D, Riva Crugnola, C, Sagi-Schwartz, A, Schoppe-Sullivan, S, Speranza, A, Steele, H, Tarabulsy, G, Vaever, M, Ward, M, Arnott, B, Bailey, H, Behringer, J, Brice, P, Castoro, G, Costantino, E, Cyr, C, George, C, Gloger-Tippelt, G, Howes, C, Jacobsen, H, Jacobvitz, D, Juffer, F, Kazui, M, Koppe, S, Millan, S, Murray, L, Simonelli, A, Solomon, J, Steele, M, Teti, D, and Monique van Londen-Barentsen, W
- Subjects
Adult ,Predictive validity ,Individuality ,050109 social psychology ,taxometric ,Developmental Science ,Developmental psychology ,Interview, Psychological ,Developmental and Educational Psychology ,Categorical models ,Humans ,0501 psychology and cognitive sciences ,Latent structure ,Individual participant data ,05 social sciences ,16. Peace & justice ,Object Attachment ,Large sample ,Standard system ,Psychiatry and Mental health ,factor analysi ,Psychology ,latent structure ,Attachment measures ,Adult Attachment Interview ,050104 developmental & child psychology - Abstract
The Adult Attachment Interview (AAI) is a widely used measure in developmental science that assesses adults’ current states of mind regarding early attachment-related experiences with their primary caregivers. The standard system for coding the AAI recommends classifying individuals categorically as having an autonomous, dismissing, preoccupied, or unresolved attachment state of mind. However, previous factor and taxometric analyses suggest that: (a) adults’ attachment states of mind are captured by two weakly correlated factors reflecting adults’ dismissing and preoccupied states of mind and (b) individual differences on these factors are continuously rather than categorically distributed. The current study revisited these suggestions about the latent structure of AAI scales by leveraging individual participant data from 40 studies (N = 3,218), with a particular focus on the controversial observation from prior factor analytic work that indicators of preoccupied states of mind and indicators of unresolved states of mind about loss and trauma loaded on a common factor. Confirmatory factor analyses indicated that: (a) a 2-factor model with weakly correlated dismissing and preoccupied factors and (b) a 3-factor model that further distinguished unresolved from preoccupied states of mind were both compatible with the data. The preoccupied and unresolved factors in the 3-factor model were highly correlated. Taxometric analyses suggested that individual differences in dismissing, preoccupied, and unresolved states of mind were more consistent with a continuous than a categorical model. The importance of additional tests of predictive validity of the various models is emphasized.
- Published
- 2020
10. Additional file 1 of A bifactor model of personality organization in adolescence: the validity of a brief screening measure assessing severity and core domains of functioning
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Biberdzic, M., Grenyer, B. F., Normandin, L., Ensink, K., and Clarkin, J. F.
- Abstract
Additional file 1: Supplementary Figure 1. Receiver operating characteristic (ROC) curves for the IPO-A-SF’s specific factors (Aggression, Reality Testing, and Moral Functioning) in detecting borderline personality pathology as defined by the CI-BPD. AUCs: 0.54, 0.56, 0.76.
- Published
- 2022
- Full Text
- View/download PDF
11. Inventory of Personality Organization For Adolescents--Short Form
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Biberdzic, M., primary, Grenyer, B. F., additional, Normandin, L., additional, Ensink, K., additional, and Clarkin, J. F., additional
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- 2022
- Full Text
- View/download PDF
12. Development and validation of a self-report measure assessing failures in the mentalization of trauma and adverse relationships
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Berthelot, N., Savard, C., Lemieux, R., Garon-Bissonnette, J., Ensink, K., Godbout, N., Berthelot, N., Savard, C., Lemieux, R., Garon-Bissonnette, J., Ensink, K., and Godbout, N.
- Abstract
Background: The way people process trauma and adverse relationships may be more predictive of subsequent adaptation than trauma exposure in itself. However, there is currently no self-report instrument assessing failures in the mentalization of trauma and adverse relationships. Objective: We developed the Failure to Mentalize Trauma Questionnaire (FMTQ) and evaluated its psychometric properties. The FMTQ is a 29-item self-report instrument designed to assess different indications of failures in the mentalization of trauma and adverse relationships. Participants and setting A total of 975 participants (84 % women; 37 % exposed to child maltreatment) were recruited in the course of larger research protocols on parenting. Methods: Participants completed the FMTQ and measures of childhood maltreatment, psychopathology (post-traumatic stress symptoms, dissociative symptoms, level of personality dysfunction), general mentalization and intimate partner violence. Results: Exploratory factor analysis, supported by a confirmatory factor analysis, identified seven factors with good internal consistency that corresponded to different types of failures in the mentalization of trauma and adverse relationships and that loaded on a general factor. A dose-effect association was observed between the severity of childhood maltreatment, and the severity of failures in the mentalization of trauma and adverse relationships (rs = .49, p < .01). The FMTQ total score explained a significant proportion of variance in psychopathology and intimate partner violence, both in participants with histories of childhood maltreatment and participants without childhood maltreatment. Conclusion: The FMTQ is a promising, concise and efficient measure of failures in the mentalization of trauma and adverse relationships that may facilitate clinical screening and research with adults who experienced trauma.
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- 2021
13. Examining Ecological Constraints on the Intergenerational Transmission of Attachment Via Individual Participant Data Meta-analysis
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Verhage, M, Fearon, R, Schuengel, C, van IJzendoorn, M, Bakermans-Kranenburg, M, Madigan, S, Roisman, G, Oosterman, M, Behrens, K, Wong, M, Mangelsdorf, S, Priddis, L, Brisch, K, Arnott, B, Aviezer, O, Bailey, H, Behringer, J, Bernier, A, Cassibba, R, Cassidy, J, Coppola, G, Costantini, A, Cyr, C, Dozier, M, Ensink, K, Finger, B, Gojman, S, Harder, S, Hautamaki, A, Hazen, N, Ierardi, E, Jin, M, Jongenelen, I, Leerkes, E, Lionetti, F, Lyons-Ruth, K, Mcmahon, C, Meins, E, Pace, C, Raby, K, Riva Crugnola, C, Sagi-Schwartz, A, Schoppe-Sullivan, S, Steele, H, Steele, M, Tarabulsy, G, Væver, M, Brice, P, Castoro, G, Costantino, E, George, C, Gloger-Tippelt, G, Howes, C, Jacobvitz, D, Juffer, F, Kazui, M, Køppe, S, Millán, S, Murray, L, Pederson, D, Simonelli, A, Solomon, J, Speranza, A, Teti, D, van Londen-Barentsen, W, Ward, M, The Collaboration on Attachment Transmission, S, Verhage, Marije L., Fearon, R. M. Pasco, Schuengel, Carlo, van IJzendoorn, Marinus H., Bakermans-Kranenburg, Marian J., Madigan, Sheri, Roisman, Glenn I., Oosterman, Mirjam, Behrens, Kazuko Y., Wong, Maria S., Mangelsdorf, Sarah, Priddis, Lynn E., Brisch, Karl-Heinz, Arnott, B., Aviezer, O., Bailey, H., Behringer, J., Bernier, A., Cassibba, R., Cassidy, J., Coppola, G., Costantini, A., Cyr, C., Dozier, M., Ensink, K., Finger, B., Gojman, S., Harder, S., Hautamaki, A., Hazen, N. L., Ierardi, E., Jin, M. K., Jongenelen, I., Leerkes, E. M., Lionetti, F., Lyons-Ruth, K., McMahon, C., Meins, E., Pace, C. S., Priddis, L., Raby, K. L., Riva Crugnola, C., Sagi-Schwartz, A., Schoppe-Sullivan, S. J., Steele, H., Steele, M., Tarabulsy, G. M., Væver, M. S., Brice, P. J., Castoro, G., Costantino, E., George, C., Gloger-Tippelt, G., Howes, C., Jacobvitz, D., Juffer, F., Kazui, M., Køppe, S., Millán, S., Murray, L., Pederson, D. R., Simonelli, A., Solomon J., Speranza A. M., Teti, D. M., van Londen-Barentsen, W. M., Ward, M. J., The Collaboration on Attachment Transmission Synthesis, Verhage, M, Fearon, R, Schuengel, C, van IJzendoorn, M, Bakermans-Kranenburg, M, Madigan, S, Roisman, G, Oosterman, M, Behrens, K, Wong, M, Mangelsdorf, S, Priddis, L, Brisch, K, Arnott, B, Aviezer, O, Bailey, H, Behringer, J, Bernier, A, Cassibba, R, Cassidy, J, Coppola, G, Costantini, A, Cyr, C, Dozier, M, Ensink, K, Finger, B, Gojman, S, Harder, S, Hautamaki, A, Hazen, N, Ierardi, E, Jin, M, Jongenelen, I, Leerkes, E, Lionetti, F, Lyons-Ruth, K, Mcmahon, C, Meins, E, Pace, C, Raby, K, Riva Crugnola, C, Sagi-Schwartz, A, Schoppe-Sullivan, S, Steele, H, Steele, M, Tarabulsy, G, Væver, M, Brice, P, Castoro, G, Costantino, E, George, C, Gloger-Tippelt, G, Howes, C, Jacobvitz, D, Juffer, F, Kazui, M, Køppe, S, Millán, S, Murray, L, Pederson, D, Simonelli, A, Solomon, J, Speranza, A, Teti, D, van Londen-Barentsen, W, Ward, M, The Collaboration on Attachment Transmission, S, Verhage, Marije L., Fearon, R. M. Pasco, Schuengel, Carlo, van IJzendoorn, Marinus H., Bakermans-Kranenburg, Marian J., Madigan, Sheri, Roisman, Glenn I., Oosterman, Mirjam, Behrens, Kazuko Y., Wong, Maria S., Mangelsdorf, Sarah, Priddis, Lynn E., Brisch, Karl-Heinz, Arnott, B., Aviezer, O., Bailey, H., Behringer, J., Bernier, A., Cassibba, R., Cassidy, J., Coppola, G., Costantini, A., Cyr, C., Dozier, M., Ensink, K., Finger, B., Gojman, S., Harder, S., Hautamaki, A., Hazen, N. L., Ierardi, E., Jin, M. K., Jongenelen, I., Leerkes, E. M., Lionetti, F., Lyons-Ruth, K., McMahon, C., Meins, E., Pace, C. S., Priddis, L., Raby, K. L., Riva Crugnola, C., Sagi-Schwartz, A., Schoppe-Sullivan, S. J., Steele, H., Steele, M., Tarabulsy, G. M., Væver, M. S., Brice, P. J., Castoro, G., Costantino, E., George, C., Gloger-Tippelt, G., Howes, C., Jacobvitz, D., Juffer, F., Kazui, M., Køppe, S., Millán, S., Murray, L., Pederson, D. R., Simonelli, A., Solomon J., Speranza A. M., Teti, D. M., van Londen-Barentsen, W. M., Ward, M. J., and The Collaboration on Attachment Transmission Synthesis
- Abstract
Parents’ attachment representations and child–parent attachment have been shown to be associated, but these associations vary across populations (Verhage et al., 2016). The current study examined whether ecological factors may explain variability in the strength of intergenerational transmission of attachment, using individual participant data (IPD) meta-analysis. Analyses on 4,396 parent–child dyads (58 studies, child age 11–96 months) revealed a combined effect size of r =.29. IPD meta-analyses revealed that effect sizes for the transmission of autonomous-secure representations to secure attachments were weaker under risk conditions and weaker in adolescent parent–child dyads, whereas transmission was stronger for older children. Findings support the ecological constraints hypothesis on attachment transmission. Implications for attachment theory and the use of IPD meta-analysis are discussed.
- Published
- 2018
14. Examining Ecological Constraints on the Intergenerational Transmission of Attachment Via Individual Participant Data Meta-analysis
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Verhage, Marije L., Fearon, R. M. Pasco, Schuengel, Carlo, van IJzendoorn, Marinus H., Bakermans-Kranenburg, Marian J., Madigan, Sheri, Roisman, Glenn I., Oosterman, Mirjam, Behrens, Kazuko Y., Wong, Maria S., Mangelsdorf, Sarah, Priddis, Lynn E., Brisch, Karl-Heinz, Arnott, B., Aviezer, O., Bailey, H., Behringer, J., Bernier, A., Cassibba, R., Cassidy, J., Coppola, G., Costantini, A., Cyr, C., Dozier, M., Ensink, K., Finger, B., Gojman, S., Harder, S., Hautamaki, A., Hazen, N. L., Ierardi, E., Jin, M. K., Jongenelen, I., Leerkes, E. M., Lionetti, F., Lyons-Ruth, K., McMahon, C., Meins, E., Pace, C. S., Priddis, L., Raby, K. L., Riva Crugnola, C., Sagi-Schwartz, A., Schoppe-Sullivan, S. J., Steele, H., Steele, M., Tarabulsy, G. M., Væver, M. S., Brice, P. J., Castoro, G., Costantino, E., George, C., Gloger-Tippelt, G., Howes, C., Jacobvitz, D., Juffer, F., Kazui, M., Køppe, S., Millán, S., Murray, L., Pederson, D. R., Simonelli, A., Solomon J., Speranza A. M., Teti, D. M., van Londen-Barentsen, W. M., Ward, M. J., The Collaboration on Attachment Transmission Synthesis, Verhage, M, Fearon, R, Schuengel, C, van IJzendoorn, M, Bakermans-Kranenburg, M, Madigan, S, Roisman, G, Oosterman, M, Behrens, K, Wong, M, Mangelsdorf, S, Priddis, L, Brisch, K, Arnott, B, Aviezer, O, Bailey, H, Behringer, J, Bernier, A, Cassibba, R, Cassidy, J, Coppola, G, Costantini, A, Cyr, C, Dozier, M, Ensink, K, Finger, B, Gojman, S, Harder, S, Hautamaki, A, Hazen, N, Ierardi, E, Jin, M, Jongenelen, I, Leerkes, E, Lionetti, F, Lyons-Ruth, K, Mcmahon, C, Meins, E, Pace, C, Raby, K, Riva Crugnola, C, Sagi-Schwartz, A, Schoppe-Sullivan, S, Steele, H, Steele, M, Tarabulsy, G, Væver, M, Brice, P, Castoro, G, Costantino, E, George, C, Gloger-Tippelt, G, Howes, C, Jacobvitz, D, Juffer, F, Kazui, M, Køppe, S, Millán, S, Murray, L, Pederson, D, Simonelli, A, Solomon, J, Speranza, A, Teti, D, van Londen-Barentsen, W, Ward, M, The Collaboration on Attachment Transmission, S, Clinical Child and Family Studies, APH - Mental Health, LEARN! - Social cognition and learning, and LEARN! - Brain, learning and development
- Subjects
Male ,Parents ,Adolescent ,Child age ,Education ,03 medical and health sciences ,0302 clinical medicine ,Sex Factors ,Sex factors ,Developmental and Educational Psychology ,Attachment theory ,Humans ,0501 psychology and cognitive sciences ,030212 general & internal medicine ,Parent-Child Relations ,Child ,Object Attachment ,Intergenerational transmission ,Parenting ,Ecology ,Individual participant data ,05 social sciences ,Age Factors ,Intergenerational Transmission of Attachment ,Meta-analysis ,Child, Preschool ,Pediatrics, Perinatology and Child Health ,Educational Status ,Female ,Psychology ,050104 developmental & child psychology - Abstract
Parents' attachment representations and child-parent attachment have been shown to be associated, but these associations vary across populations (Verhage et al., 2016). The current study examined whether ecological factors may explain variability in the strength of intergenerational transmission of attachment, using individual participant data (IPD) meta-analysis. Analyses on 4,396 parent-child dyads (58 studies, child age 11-96 months) revealed a combined effect size of r = .29. IPD meta-analyses revealed that effect sizes for the transmission of autonomous-secure representations to secure attachments were weaker under risk conditions and weaker in adolescent parent-child dyads, whereas transmission was stronger for older children. Findings support the ecological constraints hypothesis on attachment transmission. Implications for attachment theory and the use of IPD meta-analysis are discussed.
- Published
- 2018
15. Attachment and mentalization in middle childhood and early adolescence: a comparison between clinical and non clinical groups
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Bizzi, Fabiola, Ensink, K., CHARPENTIER MORA, Simone, Bastianoni, Chiara, and Cavanna, Donatella
- Published
- 2018
16. Informed consent - a survey of doctors' practices in South Africa
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Henley, L., Benatar, S. R., Robertson, B. A., and Ensink, K.
- Abstract
Objective. To examine doctors' practices with regard to informed consent.Design. Cross-sectional, descriptive survey.Participants 'and setting. All full-time consultants and registrars in the Departments of Medicine, Obstetrics and Gynaecology, Paediatrics and Child Health, Paediatric Surgery and Surgery at the University of Cape Town were included. The overall response rate was 63% (160/254).Measurement. Data were collected by means of selfadministered, semi-structured questionnaires.Results. Most doctors (79%) felt it was their responsibility to ensure that patients and parents were fully informed about diagnostic and therapeutic interventions. Many (62%) supported a patient-centred standard for determining the type and amount of information to disclose. Doctors disclose most of the legally required information except for information about alternative forms of treatment and remote serious risks. They almost never provide information on medical costs. The most common reasons for not obtaining informed consent were the doctors' tendency to 'tell' patients! parents what they intend doing and their belief that patients/parents expect doctors to know what is medicallybest for them. Language, inadequate communication skills and lack of time were, surprisingly, seldom viewed as obstacles to the obtaining of informed consent. Findings were independent of discipline (medical or surgical) and doctors' status (consultant or registrar). Doctors who treat children were significantly less likely to obtain consent forcertain interventions.Conclusion. Doctors meet many, but not all, of the legal requirements for informed consent. The findings question whether informed consent as envisioned by the law existsin reality. Cross-cultural research is needed to clarify patients' and parents' expectations of informed consent
- Published
- 2016
17. Fact or fiction? A longitudinal study of play and the development of reflective functioning
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Tessier, V. P., primary, Normandin, L., additional, Ensink, K., additional, and Fonagy, P., additional
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- 2016
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18. Beyond the reflection – the role of the mirror paradigm
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Normandin, L., primary, Ensink, K., additional, and Berthelot, N., additional
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- 2012
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19. Transition to becoming a mother: Mental representations of attachment figures, partners and imagined infants of women suffering from eating disorders
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Achim, J., primary, Lafortune, D., additional, Laurier, C., additional, Ensink, K., additional, Jeammet, P., additional, and Corcos, M., additional
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- 2012
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20. Mother-Infant attachment, reflective functioning, and unresolved trauma in mothers with childhood histories of abuse and neglect: A prospective study
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Ensink, K., primary, Berthelot, N., additional, Bernazzani, O., additional, Normandin, L., additional, and Luyten, P., additional
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- 2012
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21. Prevalence And Detection Of Psychiatric Disorders Among Children And Adolescents Attending A Primary Health Care Clinic
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Robertson, B. A., primary, Ensink, K., additional, Parry, C. D.H., additional, and Chatton, D., additional
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- 2001
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22. THE EMPILWENI PROJECT
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Ensink, K., primary, Richardson, K. A., additional, and Robertson, B. A., additional
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- 1994
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23. THE PSYCHOSOCIAL IMPACT OF HUMAN IMMUNODEFICIENCY VIRUS INFECTIONS IN CHILDREN
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Robertson, B. A., primary and Ensink, K., additional
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- 1992
- Full Text
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24. The countertransference rating system (CRS): a tool to analyse contertransference in the treatment of severe personality disordersde [sic].
- Author
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Normandin L and Ensink K
- Abstract
Copyright of Sante Mentale au Quebec is the property of Revue Sante Mentale au Quebec and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
- Published
- 2007
25. Expression of schizophrenia in black Xhosa-speaking South Africans
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Ensink, K, Robertson, B A, Ben-Arie, 0, Hodson, P, and Tredoux, C
- Published
- 1998
26. Expression of schizophrenia in black Xhosa-speaking and white English-speaking South Africans
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Ensink, K., Robertson, B. A., Ben-Arie, O., Hodson, P., and Colin Tredoux
- Abstract
Objective. To inv:estigate whether schizophrenia manifests itself differently in Xhosa-speaking South Africans, compared with English-speaking white South Africans.Design. A comparative study ·of the presentation of schizophrenia in two groups of patients.Settings and subjects. A sample of 63 patients (43 Xhosaspeaking and 20 English-speaking) admitted to a large psychiatric hospital for the first time with a diagnosis of schizophrenia.Outcome measures. The Present State Examination (PSE) was used to confirm the clinical diagnosis of schizophrenia. The Relatives' Rating of Symptoms and Social Behaviour (KAS-R) was used to obtain information on the behavioural and emotional expression of schizophrenia.Results. A significantly higher prevalence of aggressive and disruptive behaviour was reported by relatives of Xhosaspeaking patients with schizophrenia of recent onset compared with English-speaking patients. The PSE elicited significantly more delusions of persecution, sexual and fantastic delusions, self-neglect and irritability in the Xhosaspeaking patients.Canclusion. Significant differences in the presentation of schizophrenia, but not its core symptoms, were identified in . Xhosa-speaking blacks and English-speaking whites.
27. Emerging personality in adolescence: developmental trajectories, internalizing and externalizing problems, and the role of mentalizing abilities
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Ilaria Maria Antonietta Benzi, Andrea Fontana, Lavinia Barone, Emanuele Preti, Laura Parolin, Karin Ensink, Benzi, I, Fontana, A, Barone, L, Preti, E, Parolin, L, and Ensink, K
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mentalization ,Psychiatry and Mental health ,Social Psychology ,Pediatrics, Perinatology and Child Health ,Developmental and Educational Psychology ,adolescence ,internalizing problem ,personality development ,externalizing problem - Abstract
Introduction: Identifying longitudinal trajectories of emerging personality (EP) is crucial to highlight developmental patterns that might foster personality pathology in adolescence and early adulthood. Research on the exacerbation of personality pathology in adolescence identifies the significant contribution of internalizing and externalizing problems and suggests the importance of considering aspects such as mentalization, while accounting for gender differences. Methods: In our study, we adopted a mixed-model approach to (1) explore longitudinally EP (Adolescent Personality Structure Questionnaire; APS-Q) over 12 months in a sample of adolescents (N = 178, 62% females, mAGE = 15.04, SD = 1.27), accounting for gender effects. Moreover, (2) we assessed the longitudinal effect of internalizing and externalizing problems (Youth Self-Report; YSR-112) on EP. Finally, (3) we addressed the moderating role of mentalization (Movie Assessment for Social Cognition; MASC) in this developmental pathway. Results: Results highlighted a two-way pattern of EP. No changes were found in the level of difficulties in Self-acceptance, Investments and Goals, and Relationships with family dimensions. However, significant changes were found in personality functioning in the dimensions of Sense of Self, Aggression, and Relationships with friends. More, changes in difficulties in Sexuality emerged only in females. Also, gender differences emerged in the level of severity of EP. In addition, Internalizing and Externalizing problems differentially predicted difficulties in personality dimensions. Finally, mentalizing features moderated the relationship between Internalizing problems and Sense of Self and Internalizing problems and Self-acceptance, respectively. Conclusions: Our contribution aligns with recent developmental models of personality pathology, suggesting that different personality dimensions develop at different paces. More, it highlights the predictive power of externalizing and internalizing problems on difficulties in personality dimensions. Finally, it advances the discussion on the contribution of mentalizing abilities to EP.
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- 2022
28. Adolescence in lockdown: The protective role of mentalizing and epistemic trust
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Francesca Locati, Alberto Milesi, Federica Conte, Chloe Campbell, Peter Fonagy, Karin Ensink, Laura Parolin, Locati, F, Milesi, A, Conte, F, Campbell, C, Fonagy, P, Ensink, K, and Parolin, L
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lockdown ,Clinical Psychology ,Arts and Humanities (miscellaneous) ,mentalizing ,COVID-19 ,adolescence ,epistemic trust - Abstract
Objective Mentalizing is the ability to interpret one's own and others' behavior as driven by intentional mental states. Epistemic trust (openness to interpersonally transmitted information) has been associated with mentalizing. Balanced mentalizing abilities allow people to cope with external and internal stressors. Studies show that social isolation imposed by the COVID-19 pandemic was highly stressful for most people, especially for adolescents. Here we examine whether mentalizing and epistemic trust were protective factors in relation to emotional distress during the lockdown. Method A total of 131 nonclinical adolescents, aged between 12 and 18 years, were evaluated during the lockdown using the Reflective Functioning Questionnaire for Youth, Inventory of Parent and Peer Attachment, Perceived Stress Scale, and Difficulties in Emotion Regulation Scale. Results Results from network analysis showed that epistemic trust and mentalizing were negatively associated with perceived stress and emotion dysregulation. Epistemic trust in fathers was associated with level of perceived stress, and epistemic trust in mothers with emotion dysregulation. Conclusion These findings suggest that epistemic trust and the capacity to mentalize were low in adolescents during lockdown, and this was associated with high levels of stress. However, robust levels of epistemic trust and mentalizing may have acted as protective factors that buffered individuals from the risk of emotional dysregulation during the lockdown.
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- 2022
29. Trauma-related symptoms in adolescents: the differential roles of sexual abuse and mentalizing.
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Wais M, Bégin M, Sharp C, and Ensink K
- Abstract
Introduction: 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., Method: 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)., Results: 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., Discussion: 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., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Wais, Bégin, Sharp and Ensink.)
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- 2024
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30. Unpacking the p-factor. Associations Between Maladaptive Personality Traits and General Psychopathology in Female and Male Adolescents.
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Benzi IMA, Fontana A, Di Pierro R, Parolin L, and Ensink K
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- Infant, Newborn, Adolescent, Male, Humans, Female, Young Adult, Adult, Cross-Sectional Studies, Psychopathology, Self Concept, Personality Disorders epidemiology, Personality
- Abstract
Adolescence is a period of rapid physical, psychological, and neural maturation that makes youth vulnerable to emerging psychopathology, highlighting the need for improved identification of psychopathology risk indicators. Recently, a higher-order latent psychopathology factor (p-factor) was identified that explains latent liability for psychopathology beyond internalizing and externalizing difficulties. However, recent proposals suggest reconceptualizing the p-factor model in terms of impairments in personality encompassing difficulties in both self-regulation (borderline features) and self-esteem (narcissistic features), but this remains untested. To address this, this study examined the p-factor structure and the contribution of borderline and narcissistic features using two cross-sectional data collections. In Study 1, 974 cisgender adolescents (63% assigned females at birth; age range: 13-19; Mage = 16.68, SD = 1.40) reported on internalizing and externalizing problems (YSR) to test via structural equation models (SEM) different theoretical models for adolescent psychopathology. In Study 2, 725 cisgender adolescents (64.5% assigned females at birth; age range: 13-19; Mage = 16.22, SD = 1.32) reported internalizing and externalizing problems (YSR), borderline personality features (BPFSC-11), and narcissistic personality traits (PNI), to explore, via SEM, the contribution of borderline and narcissistic traits to the p-factor and accounting for gender differences. Results confirmed the utility of a bi-factor model in adolescence. Furthermore, findings highlighted the contribution of borderline features and narcissistic vulnerability to general psychopathology. The study provides the first evidence supporting a p-factor model reconceptualized in terms of personality impairments encompassing difficulties in self-regulation and self-esteem in adolescents., (© 2023. The Author(s).)
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- 2024
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31. Dimensional model of adolescent personality pathology, reflective functioning, and emotional maltreatment.
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Ensink K, Deschênes M, Bégin M, Cimon L, Gosselin T, Wais M, Normandin L, and Fonagy P
- Abstract
Introduction: Childhood emotional abuse (CEA) is a recognized risk factor for adolescent mentalizing challenges. However, there's limited understanding about how CEA might influence personality development and elevate the risk of adolescent personality pathology. A deeper grasp of these pathways is crucial, given that adolescence is a pivotal developmental phase for identity integration, personality consolidation, and the emergence of personality disorders. As the emphasis shifts to dimensional perspectives on adolescent personality pathology, the spotlight is increasingly on adolescents' evolving personality organization (PO). Within this framework, personality disorder manifestations stem from inherent vulnerabilities in PO. A comprehensive understanding of how CEA leads to these inherent vulnerabilities in PO can inform enhanced interventions for at-risk adolescents. Nonetheless, our comprehension lacks insight into potential pathways to PO, especially those involving external factors like maltreatment and individual traits like mentalizing. This study sought to bridge these gaps by employing latent factor analysis and structural equation modeling to explore connections between emotional maltreatment, adolescent mentalizing, and PO., Methods: A community-based cohort of 193 adolescents (aged 12-17) took part in self-report assessments: the Childhood Experience of Care and Abuse Questionnaire (CECA.Q), the Reflective Functioning Questionnaire for Youth (RFQ-Y), and the Inventory for Personality Organization for Adolescents (IPO-A)., Results: The structural equation model revealed a significant direct influence of CEA on both RFQ-Confusion and PO, and a noteworthy direct effect of RFQ-Confusion on PO. Remarkably, the model accounted for 76.9% of the PO variance. CEA exhibited a significant indirect impact on PO through RFQ-Confusion, which was accountable for 52.3% of the CEA effect on PO, signifying a partial mediation by mentalizing., Discussion: These insights carry substantial clinical implications, especially for devising integrated, trauma-informed strategies for adolescents with personality pathologies. This is particularly relevant for enhancing mentalizing and bolstering personality consolidation among adolescent CEA survivors., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Ensink, Deschênes, Bégin, Cimon, Gosselin, Wais, Normandin and Fonagy.)
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- 2024
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32. Different epistemic stances for different traumatic experiences: implications for mentalization.
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Benzi IMA, Carone N, Parolin L, Martin-Gagnon G, Ensink K, and Fontana A
- Abstract
Traumatic experiences may impair reflective functioning (RF), making it difficult for individuals to understand their own and others' mental states. Epistemic trust (ET), which enables evaluating social information as reliable and relevant, may vary in association with RF. In this study, we explored the implications of different ET stances (i.e., trust, mistrust, and credulity) in the relation between different childhood traumatic experiences (i.e., emotional abuse, physical abuse, sexual abuse, emotional neglect, and physical neglect) and different types of RF impairments (uncertainty and certainty about mental states). A non-clinical community sample of 496 cisgender emerging adults (mage = 24.91, standard deviation = 2.66, 71.85% assigned female at birth, 63.63% heterosexual) reported on their childhood traumatic experiences, ET, and RF. We used structural equation models to examine direct and indirect associations. The results showed significant indirect effects between emotional abuse and uncertainty about mental states through credibility. We also observed significant indirect effects between emotional abuse and certainty about mental states through mistrust and credibility. The findings suggest that a lack of discrimination when evaluating knowledge from others (i.e., credulity) might promote increased uncertainty in RF when emerging adults have experienced emotional abuse in their childhood. Conversely, a tendency to view all information sources as unreliable or ill-intentioned (i.e., mistrust) may foster greater certainty in RF as a protective mechanism against an unreliable and potentially harmful world when combined with childhood emotional abuse. The implications for clinical practice and intervention are discussed.
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- 2023
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33. Measuring mentalizing in youth: further validation of the reflective functioning questionnaire for youth (RFQY-13).
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Martin-Gagnon G, Fonagy P, Bégin M, Normandin L, and Ensink K
- Abstract
Objective: This study investigated the psychometric properties, including the factor structure, validity, and reliability of the 13-item Reflective Function Questionnaire for Youth (RFQY-13), using a new scoring system., Method: A community sample of 414 adolescents and a clinical sample of 83 adolescents (aged 12-21) completed the RFQY, the Borderline Personality Features Scale for Children (BPFS-C), the Beck Youth Inventories (BYI), the Child Behavior Checklist-Youth Self Report (CBCL-YSR) and the Movie for the Assessment of Social Cognition (MASC)., Results: Using the new scoring system, our results demonstrated configural and metric invariance, as well as adequate reliability and validity across both samples for the two-factor structure of the RFQY. The Uncertainty subscale also showed strong associations with psychopathology., Discussion: The findings show that the RFQY-13, when used with the new coding system, has good psychometric properties and is a reliable measure of mentalizing for adolescents and young adults. We discuss clinical implications, limitations and future directions., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Martin-Gagnon, Fonagy, Bégin, Normandin and Ensink.)
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- 2023
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34. Trust in Therapeutic Work With Adolescents With and Without Personality Disorders: A Transference-Focused Therapy Perspective.
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Ensink K and Normandin L
- Subjects
- Humans, Adolescent, Personality Disorders therapy, Psychotherapy methods, Object Attachment, Trust, Borderline Personality Disorder therapy
- Abstract
Trust is central to successful therapeutic work with adolescents, but establishing trust can be challenging, especially with adolescents with personality disorders. We present our understanding of trust in working with adolescents with and without personality disorders. We draw on complementary and overlapping perspectives, namely the attachment model, Kernberg's object relations model, and Fonagy's mentalization model. In Kernberg's object relations conceptualization, difficulties in trust experienced by patients with borderline personality disorders result from paranoia associated with splitting and identity diffusion. In Fonagy's mentalization model, epistemic trust is rooted in early experiences of being responded to and understood. We outline how techniques used in transference-focused psychotherapy for adolescents promote the development of the adolescent's capacity to trust by facilitating identity integration, thus reducing paranoia. Finally, we use two clinical case illustrations to demonstrate how trust unfolds in working with adolescents with and without personality disorders.
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- 2023
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35. Adolescent mentalizing and childhood emotional abuse: implications for depression, anxiety, and borderline personality disorder features.
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Martin-Gagnon G, Normandin L, Fonagy P, and Ensink K
- Abstract
Background: There is preliminary evidence that childhood emotional abuse (CEA) is a risk factor for adolescent mentalizing difficulties (Uncertainty/Confusion about mental states) and borderline personality features and that Uncertainty/Confusion about mental states mediate the relationship between CEA and adolescent borderline personality features, but these findings need replication. Furthermore, no previous studies have examined the relationship between adolescent mentalizing deficits, anxiety, and depression in the context of CEA., Objectives: This study examined the associations between CEA, adolescent borderline personality features, depression and anxiety symptoms and tested a pathway model where Uncertainty/Confusion about mental states mediates the relationships between CEA and adolescent borderline personality features, depression and anxiety symptoms., Method: A clinical sample of 94 adolescents completed the Reflective Function Questionnaire for Youth (RFQY) to assess mentalizing, the Childhood Experiences of Care and Abuse Questionnaire (CECA-Q), the Borderline Personality Disorders Features Scale (BPFS-C), and the Beck Youth Inventories for Depression (BDI-Y) and Anxiety (BAI-Y)., Results: Uncertainty/Confusion about mental states partially mediated the relationship between CEA and borderline traits as well as anxiety. In addition, there was an indirect effect where CEA predicted Uncertainty/Confusion about mental states, which then predicted depression., Discussion: The findings are consistent with the mentalizing model of psychopathology and provide new evidence that Uncertainty/Confusion about mental states might be a critical mentalizing deficit that characterizes the associations between CEA and adolescent BPD features and depression and anxiety symptoms. Uncertainty/Confusion may be a transdiagnostic risk factor for adolescent psychological distress and dysfunction. We discuss the clinical implications., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Martin-Gagnon, Normandin, Fonagy and Ensink.)
- Published
- 2023
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36. Post-traumatic-stress in the context of childhood maltreatment: pathways from attachment through mentalizing during the transition to parenthood.
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Ensink K, Bégin M, Martin-Gagnon G, Biberdzic M, Berthelot N, Normandin L, Fonagy P, Bernazzani O, and Borelli JL
- Abstract
Introduction: This study aimed to clarify the role of mentalizing in pathways from attachment to Post Traumatic Stress Symptoms (PTSS) in survivors of childhood maltreatment (CM). We focused on the transition to parenting, a critical period for reworking parenting representations to reduce intergenerational maltreatment cycles., Method: Study participants included 100 pregnant CM survivors. We assessed PTSS with the SCID and attachment and mentalizing with the Adult Attachment Interview (AAI), which was rated for Attachment and Reflective Functioning (RF)., Results: Regarding Re-experiencing trauma symptoms, the results of the path analysis were consistent with mediation. CM survivors' mentalizing about their early relationships with their parents (RF-Other) directly impacted Re-experiencing trauma symptoms, and attachment had an effect on Re-experiencing trauma symptoms through mentalizing (RF-Other). Regarding Arousal/Reactivity symptoms, the results of the pathways analysis were consistent with partial mediation by mentalizing about early relationships with parents (RF-Other). In addition to the pathway from attachment via mentalizing (RF-Other) to Arousal/Reactivity, the pathway between attachment and Arousal/Reactivity also remained significant., Discussion: This study provides new evidence of a mentalizing and attachment model of PTSS in CM survivors. The findings indicate that increased mentalizing about early relationships with parents is an important process associated with lower PTSS. Finally, we discuss the implications of developing interventions for CM survivors to reduce PTSS. Scaffolding the development of mentalizing regarding attachment relationships in which CM occurred may help CM survivors reduce the intrusion of traumatic memories and decrease trauma-related arousal and reactivity symptoms. Interventions to help CM survivors mentalize regarding parents and attachment relationships in which trauma occurred may be particularly important during the transition to parenting when activation of representations of parenting can trigger PTSS., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Ensink, Bégin, Martin-Gagnon, Biberdzic, Berthelot, Normandin, Fonagy, Bernazzani and Borelli.)
- Published
- 2023
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37. Adolescence in lockdown: The protective role of mentalizing and epistemic trust.
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Locati F, Milesi A, Conte F, Campbell C, Fonagy P, Ensink K, and Parolin L
- Subjects
- Female, Humans, Adolescent, Child, Trust psychology, Pandemics, Communicable Disease Control, Mentalization, COVID-19
- Abstract
Objective: Mentalizing is the ability to interpret one's own and others' behavior as driven by intentional mental states. Epistemic trust (openness to interpersonally transmitted information) has been associated with mentalizing. Balanced mentalizing abilities allow people to cope with external and internal stressors. Studies show that social isolation imposed by the COVID-19 pandemic was highly stressful for most people, especially for adolescents. Here we examine whether mentalizing and epistemic trust were protective factors in relation to emotional distress during the lockdown., Method: A total of 131 nonclinical adolescents, aged between 12 and 18 years, were evaluated during the lockdown using the Reflective Functioning Questionnaire for Youth, Inventory of Parent and Peer Attachment, Perceived Stress Scale, and Difficulties in Emotion Regulation Scale., Results: Results from network analysis showed that epistemic trust and mentalizing were negatively associated with perceived stress and emotion dysregulation. Epistemic trust in fathers was associated with level of perceived stress, and epistemic trust in mothers with emotion dysregulation., Conclusion: These findings suggest that epistemic trust and the capacity to mentalize were low in adolescents during lockdown, and this was associated with high levels of stress. However, robust levels of epistemic trust and mentalizing may have acted as protective factors that buffered individuals from the risk of emotional dysregulation during the lockdown., (© 2022 The Authors. Journal of Clinical Psychology published by Wiley Periodicals LLC.)
- Published
- 2023
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38. Emerging personality in adolescence: developmental trajectories, internalizing and externalizing problems, and the role of mentalizing abilities.
- Author
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Benzi IMA, Fontana A, Barone L, Preti E, Parolin L, and Ensink K
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- Female, Humans, Adolescent, Adult, Male, Personality Disorders, Aggression, Personality, Surveys and Questionnaires, Longitudinal Studies, Mentalization
- Abstract
Introduction: Identifying longitudinal trajectories of emerging personality (EP) is crucial to highlight developmental patterns that might foster personality pathology in adolescence and early adulthood. Research on the exacerbation of personality pathology in adolescence identifies the significant contribution of internalizing and externalizing problems and suggests the importance of considering aspects such as mentalization, while accounting for gender differences., Methods: In our study, we adopted a mixed-model approach to (1) explore longitudinally EP (Adolescent Personality Structure Questionnaire; APS-Q) over 12 months in a sample of adolescents (N = 178, 62% females, mAGE = 15.04, SD = 1.27), accounting for gender effects. Moreover, (2) we assessed the longitudinal effect of internalizing and externalizing problems (Youth Self-Report; YSR-112) on EP. Finally, (3) we addressed the moderating role of mentalization (Movie Assessment for Social Cognition; MASC) in this developmental pathway., Results: Results highlighted a two-way pattern of EP. No changes were found in the level of difficulties in Self-acceptance, Investments and Goals, and Relationships with family dimensions. However, significant changes were found in personality functioning in the dimensions of Sense of Self, Aggression, and Relationships with friends. More, changes in difficulties in Sexuality emerged only in females. Also, gender differences emerged in the level of severity of EP. In addition, Internalizing and Externalizing problems differentially predicted difficulties in personality dimensions. Finally, mentalizing features moderated the relationship between Internalizing problems and Sense of Self and Internalizing problems and Self-acceptance, respectively., Conclusions: Our contribution aligns with recent developmental models of personality pathology, suggesting that different personality dimensions develop at different paces. More, it highlights the predictive power of externalizing and internalizing problems on difficulties in personality dimensions. Finally, it advances the discussion on the contribution of mentalizing abilities to EP., (© 2022 The Foundation for Professionals in Services for Adolescents.)
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- 2023
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39. Strength-based Video-feedback to improve maternal sensitivity in mother-infant dyads with maternal depressive symptoms: Study protocol for a randomized controlled feasibility trial.
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Olhaberry M, Leyton F, Morán-Kneer J, León MJ, Sieverson C, Muzard A, Honorato C, Ensink K, Malberg N, Luyten P, and Costa-Cordella S
- Subjects
- Female, Humans, Infant, Feasibility Studies, Feedback, Mental Health, Randomized Controlled Trials as Topic, Depression therapy, Mothers psychology
- Abstract
Introduction: Maternal sensitivity and mentalization are fundamental for children's mental health development. These skills have been negatively associated with maternal postpartum depressive symptomatology. Moreover, its prevalence increases in low socioeconomic and psychosocial risk contexts, where the access to treatment is scarce. Even though Attachment Based Interventios, such as Video-Feedback has been internationally recognized as an effective intervention. Its cost, as well as the need for language translation and cultural adaptation makes it difficult to implement in Latinamerican countries., Aim: The present study aims to assess the feasibility and acceptability of an online Video-Feedback intervention informed n mentalization aimed at mother-infant dyads with depressive symptomatology who attend Chilean public health centers., Method: This is a pilot randomized clinical trial with two groups of 60 mother-infant dyads between 4 and 12 months of age. Participants will be randomly assigned to control and experimental groups in a 1:1 ratio. Even though both groups will receive usual treatment, the experimental group will also receive the present video-intervention. At the end of the study, feasibility will be assessed based on focus groups aimed at interveners and quantitative outcomes such as recruitment rate, questionnaire completion rate and intervention completeness. Acceptability will be assessed from in-depth interviews with participants. In addition, effect sizes of primary and secondary outcomes will be calculated., Expected Results: Results are expected to generate parameters to design a larger-scale clinical trial and to preliminary assess the effect of the reported mentalization-informed intervention on maternal sensitivity. Additionally, it seeks to contribute with a mental health intervention for low-income mother-infant dyads, which can be implemented remotely, at a low cost, and that would be suitable for implementation at a mental health care system policy. The protocol of this trial's design was registered at Clinical Trials (NCT04748731)., Competing Interests: The authors declare that they have no conflicts of interest., (This work is licensed under a Creative Commons Attribution 4.0 International License.)
- Published
- 2022
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40. Development and validation of a self-report measure assessing failures in the mentalization of trauma and adverse relationships.
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Berthelot N, Savard C, Lemieux R, Garon-Bissonnette J, Ensink K, and Godbout N
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- Adult, Child, Female, Humans, Male, Parenting, Self Report, Child Abuse, Intimate Partner Violence, Mentalization, Surveys and Questionnaires
- Abstract
Background: The way people process trauma and adverse relationships may be more predictive of subsequent adaptation than trauma exposure in itself. However, there is currently no self-report instrument assessing failures in the mentalization of trauma and adverse relationships., Objective: We developed the Failure to Mentalize Trauma Questionnaire (FMTQ) and evaluated its psychometric properties. The FMTQ is a 29-item self-report instrument designed to assess different indications of failures in the mentalization of trauma and adverse relationships., Participants and Setting: A total of 975 participants (84 % women; 37 % exposed to child maltreatment) were recruited in the course of larger research protocols on parenting., Methods: Participants completed the FMTQ and measures of childhood maltreatment, psychopathology (post-traumatic stress symptoms, dissociative symptoms, level of personality dysfunction), general mentalization and intimate partner violence., Results: Exploratory factor analysis, supported by a confirmatory factor analysis, identified seven factors with good internal consistency that corresponded to different types of failures in the mentalization of trauma and adverse relationships and that loaded on a general factor. A dose-effect association was observed between the severity of childhood maltreatment, and the severity of failures in the mentalization of trauma and adverse relationships (r
s = .49, p < .01). The FMTQ total score explained a significant proportion of variance in psychopathology and intimate partner violence, both in participants with histories of childhood maltreatment and participants without childhood maltreatment., Conclusion: The FMTQ is a promising, concise and efficient measure of failures in the mentalization of trauma and adverse relationships that may facilitate clinical screening and research with adults who experienced trauma., (Copyright © 2021 The Authors. Published by Elsevier Ltd.. All rights reserved.)- Published
- 2022
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41. Introduction to CAN special issue: Attachment & mentalization.
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Miljkovitch R and Ensink K
- Subjects
- Humans, Object Attachment, Mentalization
- Published
- 2022
- Full Text
- View/download PDF
42. The latent structure of the adult attachment interview: Large sample evidence from the collaboration on attachment transmission synthesis.
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Raby KL, Verhage ML, Fearon RMP, Fraley RC, Roisman GI, van IJzendoorn MH, Schuengel C, Madigan S, Oosterman M, Bakermans-Kranenburg MJ, Bernier A, Ensink K, Hautamäki A, Mangelsdorf S, Priddis LE, and Wong MS
- Subjects
- Adult, Humans, Interview, Psychological, Individuality, Object Attachment
- Abstract
The Adult Attachment Interview (AAI) is a widely used measure in developmental science that assesses adults' current states of mind regarding early attachment-related experiences with their primary caregivers. The standard system for coding the AAI recommends classifying individuals categorically as having an autonomous, dismissing, preoccupied, or unresolved attachment state of mind. However, previous factor and taxometric analyses suggest that: (a) adults' attachment states of mind are captured by two weakly correlated factors reflecting adults' dismissing and preoccupied states of mind and (b) individual differences on these factors are continuously rather than categorically distributed. The current study revisited these suggestions about the latent structure of AAI scales by leveraging individual participant data from 40 studies (N = 3,218), with a particular focus on the controversial observation from prior factor analytic work that indicators of preoccupied states of mind and indicators of unresolved states of mind about loss and trauma loaded on a common factor. Confirmatory factor analyses indicated that: (a) a 2-factor model with weakly correlated dismissing and preoccupied factors and (b) a 3-factor model that further distinguished unresolved from preoccupied states of mind were both compatible with the data. The preoccupied and unresolved factors in the 3-factor model were highly correlated. Taxometric analyses suggested that individual differences in dismissing, preoccupied, and unresolved states of mind were more consistent with a continuous than a categorical model. The importance of additional tests of predictive validity of the various models is emphasized.
- Published
- 2022
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43. Risky Sexual Behavior Profiles in Youth: Associations With Borderline Personality Features.
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Bégin M, Ensink K, Bellavance K, Clarkin JF, and Normandin L
- Abstract
Adolescence and young adulthood are peak periods for risky sexual behaviors (RSB) and borderline personality disorder (BPD) features. RSB is a major public health concern and adolescents with BPD may be particularly vulnerable to RSB, but this is understudied. The aim of this study was to identify distinct RSB profiles in youth and determine whether a specific profile was associated with BPD features. Participants were 220 adolescents and young adults (age 14-21) recruited from the community. To identify groups of adolescents and young adults who engage in similar RSB, a latent profile analysis (LPA) was conducted on sexually active youth (57%). Next ANOVA was used to identify how profiles differed in terms RSB dimensions and BPD features. We identified three distinct RSB profiles: (1) a Low RSB profile that was manifested by the majority (77.7%) of youth; (2) an Unprotected Sex in Relationships profile (13.3%) and; (3) an Impulsive Sex Outside Relationships profile (12%) which was manifested by youth with significantly higher BPD features. The findings shed light on the difficulties youth with BPD manifest around integrating sexuality, intimacy, fidelity, and love. This contrasts with the majority of youth who are sexually active in the context of relationships and engage in little or no RSB. The findings have important clinical implications. Adolescent sexuality is frequently in the blind spot of clinicians. To address the elevated risk of RSB in adolescents with BPD, interventions are needed to help adolescents navigate this period and improve their understanding of the reasons for RSB while addressing difficulties in establishing sexual and attachment relationships., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Bégin, Ensink, Bellavance, Clarkin and Normandin.)
- Published
- 2022
- Full Text
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44. Mothers' Self-focused Reflective Functioning Interacts with Childhood Experiences of Rejection to Predict Current Romantic Relationship Quality and Parenting Behavior.
- Author
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Borelli JL, Ensink K, Gillespie ML, Falasiri E, Bernazzani O, Fonagy P, and Berthelot N
- Subjects
- Adult, Child, Female, Humans, Infant, Longitudinal Studies, Mother-Child Relations, Pregnancy, Retrospective Studies, Mothers, Parenting
- Abstract
Parents exposed to rejection in their childhood could experience bonding disturbances in their current relationships. Reflective functioning (RF), the capacity to understand one's own and others' behavior through the lens of underlying mental states (cognitions, emotions), has been identified as a potential protective process. The aim of this longitudinal study was to examine whether RF moderates the effect of parents' experiences of rejection in childhood on later relationship functioning with partners and infants. Pregnant women with experiences of abuse and neglect were recruited and completed the Adult Attachment Interview, which was coded for RF and experiences of childhood rejection. During two follow-up assessments, when their infants were 5 and 17 months old, the mothers in our sample who had partners reported on dyadic cohesion with these partners. Further, at 5 months postnatal, mothers completed interaction tasks with their infants, which were later assessed using observational measures (i.e., CARE-Index). Results of mothers with partners (N = 93) indicated that RF moderated the relationship between dyadic cohesion with partners at 17 months only. Additionally, results with all mothers in the sample (N = 108) indicated that RF moderated the relationship between retrospectively reported experiences of rejection and controlling and unresponsive behaviors with infants. Adequate-to-high RF was associated with lower unresponsiveness and higher relationship satisfaction in the context of rejection, while being associated with higher levels of control. These findings have important clinical implications, as RF is amenable to change and can therefore be more prominently implemented within various interventions., (© 2020 Family Process Institute.)
- Published
- 2021
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45. Post-traumatic Stress Disorder in Sexually Abused Children: Secure Attachment as a Protective Factor.
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Ensink K, Fonagy P, Normandin L, Rozenberg A, Marquez C, Godbout N, and Borelli JL
- Abstract
The aim of the present study was to examine the hypothesis that attachment and childhood sexual abuse (CSA) interacted such that school aged CSA survivors with insecure attachment to parents would be at an elevated risk of developing post-traumatic stress disorder (PTSD) and trauma symptoms. Participants ( n = 111, ages 7-12) comprised two groups, child CSA survivors ( n = 43) and a matched comparison group of children ( n = 68) recruited from the community. Children completed the Child Attachment Interview (CAI) as well as the Trauma Symptom Checklist for Children (TSCC). There was a significant interaction between sexual abuse history and attachment security, such that sexually abused children with insecure attachment representations had significantly more PTSD and trauma symptoms than sexually abused children with secure attachment to parents. The findings show that using a dual lens of attachment and CSA can facilitate the identification of children most at risk and has important implications for understanding risk and resilience processes., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Ensink, Fonagy, Normandin, Rozenberg, Marquez, Godbout and Borelli.)
- Published
- 2021
- Full Text
- View/download PDF
46. Transference-Focused Psychotherapy for Adolescents With Personality Disorders.
- Author
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Normandin L, Weiner A, and Ensink K
- Subjects
- Adolescent, Humans, Object Attachment, Psychotherapy, Transference, Psychology, Borderline Personality Disorder, Personality Disorders therapy
- Abstract
This article presents a conceptualization of personality disorders in adolescence and the adaptation of transference-focused psychotherapy (TFP) for personality disordered adolescents (TFP-A). The model of assessment and treatment presented is based on contemporary psychoanalytic object relations theory developed by Otto F. Kernberg and supported by findings from current evidence-based outcome research. We present a method of assessing personality disorders in adolescents that addresses the variability of personality disorder symptoms and traits among adolescents and their instability over time. We then present the goal of TFP-A and its major phases of implementation. A major focus is therapist interventions.
- Published
- 2021
- Full Text
- View/download PDF
47. Reflective Function and Borderline Traits in Adolescents.
- Author
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Sharp C, Penner F, and Ensink K
- Subjects
- Adolescent, Child, Humans, Psychopathology, Borderline Personality Disorder diagnosis
- Abstract
Despite the developmental roots of the relation between attachment-based reflective function (RF) and borderline pathology, there is a lack of empirical studies examining this link in youth. We examined this link taking into account potential relations between RF and internalizing and externalizing pathology. A total of 421 clinical adolescents between the ages of 12 and 17 completed the Child Attachment Interview (CAI; Shmueli-Goetz, Target, Fonagy, & Datta, 2008), which was coded using the Child and Adolescent Reflective Functioning Scale (CARFS; Ensink, Target, & Oandasan, 2013), alongside a self-report measure of borderline pathology and parent-reported measures of internalizing and externalizing pathology. Exploratory analyses revealed no direct relation between RF and borderline features or internalizing psychopathology but a negative relation with externalizing pathology. Moderation analyses showed that externalizing pathology moderated the relation between RF and borderline pathology. Implications for understanding the various ways in which impaired RF may present in adolescents with BPD are discussed.
- Published
- 2020
- Full Text
- View/download PDF
48. Childhood sexual abuse and attachment insecurity: Associations with child psychological difficulties.
- Author
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Ensink K, Borelli JL, Normandin L, Target M, and Fonagy P
- Subjects
- Child, Female, Humans, Male, Risk Factors, Behavioral Symptoms psychology, Child Abuse, Sexual psychology, Child Behavior psychology, Object Attachment
- Abstract
Childhood sexual abuse (CSA) is considered an important public health concern that can derail the developmental course of children. Given that children rely upon their attachment figures when they experience upsetting events, attachment organization may play a critical role in predicting victims' adaptation to CSA. To date, no studies have delineated the unique and interactive contributions of these two risk factors in the prediction of psychopathology. The aims of this study were to examine attachment in CSA victims and a comparison group and to assess the contributions of each risk factor to child psychological difficulties. Participants included 111 children aged 7-13, of whom 43 were CSA victims. Children completed an attachment interview and reported on their depressive symptoms. Their mothers reported on children's externalizing symptoms, internalizing symptoms, dissociation, and sexualized behavior. Our key findings showed that child victims of CSA were more likely to be classified as having insecure and disorganized attachment. Further, insecure attachment was the primary factor associated with higher self-reported depressive symptoms in all children and that CSA was associated with more parent-reported child externalizing problems, sexualizing problems, and dissociation. (PsycINFO Database Record (c) 2020 APA, all rights reserved).
- Published
- 2020
- Full Text
- View/download PDF
49. Emotional understanding, aggression, and social functioning among preschoolers.
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Laurent G, Hecht HK, Ensink K, and Borelli JL
- Subjects
- Child, Preschool, Female, Humans, Male, Psychological Distance, Aggression physiology, Child Behavior physiology, Comprehension physiology, Emotions physiology, Interpersonal Relations, Social Behavior
- Abstract
Evidence suggests that emotional understanding (EU) assists in the regulation of aggression, which in turn, predicts better social functioning. Although the links among EU, aggression, and social functioning have been preliminarily explored, significant gaps remain in our comprehension of the factors that could qualify these links (e.g., impact of developmental stage, type of aggression, type of social functioning, and different dimensions of EU). Here we conduct a multidimensional assessment of EU, aggression, and social functioning within a sample of aggressive preschoolers (n = 24) and a matched comparison group (n = 26; N = 50, 26 girls; Mage = 53.83 months, SDage = 3.73). We assessed EU using a behavioral assessment and social functioning via teacher-report. We conducted all analyses through the use of two measures of children's aggression-first, we compared children identified as aggressive by preschool teachers to those in the nonaggressive comparison group. Second, we used teacher-reported continuous measures of children's physical and relational aggression. Relative to the comparison group, the aggressive group demonstrated lower expressive EU, higher receptive EU, lower peer acceptance, and lower prosocial behavior. Analyses of continuous measures revealed a more complicated pattern of associations among aggression, EU, and social functioning. Higher physical aggression predicted greater peer victimization among females, and expressive EU was only associated with higher peer acceptance among the aggressive group. (PsycINFO Database Record (c) 2020 APA, all rights reserved).
- Published
- 2020
- Full Text
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50. Maternal and Child Sexual Abuse History: An Intergenerational Exploration of Children's Adjustment and Maternal Trauma-Reflective Functioning.
- Author
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Borelli JL, Cohen C, Pettit C, Normandin L, Target M, Fonagy P, and Ensink K
- Abstract
Objective: The aim of the current study was to investigate associations, unique and interactive, between mothers' and children's histories of childhood sexual abuse (CSA) and children's psychiatric outcomes using an intergenerational perspective. Further, we were particularly interested in examining whether maternal reflective functioning about their own trauma (T-RF) was associated with a lower likelihood of children's abuse exposure (among children of CSA-exposed mothers). Methods: One hundred and eleven children ( M
age = 9.53 years; 43 sexual abuse victims) and their mothers ( Mage = 37.99; 63 sexual abuse victims) participated in this study. Mothers completed the Parent Development Interview (PDI), which yielded assessments of RF regarding their own experiences of abuse, and also reported on their children's internalizing and externalizing symptoms. Results: Children of CSA-exposed mothers were more likely to have experienced CSA. A key result was that among CSA-exposed mothers, higher maternal T-RF regarding their own abuse was associated with lower likelihood of child CSA-exposure. Mothers' and children's CSA histories predicted children's internalizing and externalizing symptoms, such that CSA exposure for mother or child was associated with greater symptomatology in children. Conclusion: The findings show that the presence of either maternal or child CSA is associated with more child psychological difficulties. Importantly in terms of identifying potential protective factors, maternal T-RF is associated with lower likelihood of CSA exposure in children of CSA-exposed mothers. We discuss these findings in the context of the need for treatments focusing on increasing T-RF in mothers and children in the context of abuse to facilitate adaptation and reduce the intergenerational risk.- Published
- 2019
- Full Text
- View/download PDF
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