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Abstract Background and Aims Multiple national guidelines stress the importance for clinicians to possess good therapeutic skills for working with patients with significant relational difficulties (who may receive a diagnosis of personality disorder). Training clinicians in mentalization‐based treatment skills (MBT‐S) is one approach to address this. The main outcome measure used in MBT‐S studies is the Knowledge and Application of MBT Questionnaire (KAMQ). However, an absence of research into the properties and validity of the KAMQ has limited the methodological quality of MBT‐S evaluations so far. The aim of this study was therefore to investigate the factor structure, internal consistency, reliability, and validity of the KAMQ. Methods Using an existing multiprofessional sample of 217 clinicians from 2014 to 2016, we undertook exploratory factor analysis to determine the factor structure and internal consistency of the KAMQ. Convergent validity of the measure with the Attitudes to Personality Disorder Questionnaire (APDQ) was assessed in a subset of this dataset where both questionnaires had been administered (n = 92). Additionally, by recruiting a new sample of 70 clinicians, we assessed the measure's test‐retest reliability. Results Factor analysis found three factors underlying 17 of the 20 KAMQ items, relating to therapeutic skills in mentalizing, beliefs about applying MBT in practice, and specific MBT knowledge. The KAMQ was revised following the factor analysis to form the KAMQ‐2 with 17 items. Internal consistency (α = .85, 95% confidence interval [CI] = 0.80‐0.89) and test‐retest reliability (ICC = 0.84, 95% CI = 0.73‐0.91) were good. In correlation analyses, the KAMQ‐2 showed convergent validity with the main factor from the APDQ (n = 48; rs = 0.39, P

Background and Aims: Multiple national guidelines stress the importance for clinicians to possess good therapeutic skills for working with patients with significant relational difficulties (who may receive a diagnosis of personality disorder). Training clinicians in mentalization‐based treatment skills (MBT‐S) is one approach to address this. The main outcome measure used in MBT‐S studies is the Knowledge and Application of MBT Questionnaire (KAMQ). However, an absence of research into the properties and validity of the KAMQ has limited the methodological quality of MBT‐S evaluations so far. The aim of this study was therefore to investigate the factor structure, internal consistency, reliability, and validity of the KAMQ. Methods: Using an existing multiprofessional sample of 217 clinicians from 2014 to 2016, we undertook exploratory factor analysis to determine the factor structure and internal consistency of the KAMQ. Convergent validity of the measure with the Attitudes to Personality Disorder Questionnaire (APDQ) was assessed in a subset of this dataset where both questionnaires had been administered (n = 92). Additionally, by recruiting a new sample of 70 clinicians, we assessed the measure's test‐retest reliability. Results: Factor analysis found three factors underlying 17 of the 20 KAMQ items, relating to therapeutic skills in mentalizing, beliefs about applying MBT in practice, and specific MBT knowledge. The KAMQ was revised following the factor analysis to form the KAMQ‐2 with 17 items. Internal consistency (α =.85, 95% confidence interval [CI] = 0.80‐0.89) and test‐retest reliability (ICC = 0.84, 95% CI = 0.73‐0.91) were good. In correlation analyses, the KAMQ‐2 showed convergent validity with the main factor from the APDQ (n = 48; rs = 0.39, P < .01). Conclusion: The KAMQ‐2 provides a short, reliable self‐report instrument which probes clinicians' knowledge about mentalizing skills, and beliefs about using these. There was preliminary evidence for validity. The properties of the KAMQ‐2 mean that more robust evaluation and development of MBT‐S is now possible. [ABSTRACT FROM AUTHOR]

Persons with autism spectrum disorder (ASD) have impaired mentalizing skills. In this study, a group of persons with ASD traits (high-AQ scores) initially received sham tDCS before completing a pre-test in two mentalizing tasks: false belief and self-other judgments. Over the next week, on four consecutive days, they received sessions of anodal electrical stimulation (a-tDCS) over the right temporo-parietal junction (rTPJ), a region frequently associated with the theory of mind. On the last day, after the stimulation session, they completed a new set of mentalizing tasks. A control group (with low-AQ scores) matched in age, education and intelligence received just sham stimulation and completed the same pre-test and post-test. The results showed that the high-AQ group improved their performance (faster responses), after a-tDCS, in the false belief and in the self-other judgments of mental features, whereas they did not change performance in the false photographs or the self-other judgments of physical features. These selective improvements cannot be attributed to increased familiarity with the tasks, because the performance of the low-AQ control group remained stable about one week later. Therefore, our study provides initial proof that tDCS could be used to improve mentalizing skills in persons with ASD traits.

Persons with autism spectrum disorder (ASD) have impaired mentalizing skills. In this study, a group of persons with ASD traits (high-AQ scores) initially received sham tDCS before completing a pre-test in two mentalizing tasks: false belief and self-other judgments. Over the next week, on four consecutive days, they received sessions of anodal electrical stimulation (a-tDCS) over the right temporo-parietal junction (rTPJ), a region frequently associated with the theory of mind. On the last day, after the stimulation session, they completed a new set of mentalizing tasks. A control group (with low-AQ scores) matched in age, education and intelligence received just sham stimulation and completed the same pre-test and post-test. The results showed that the high-AQ group improved their performance (faster responses), after a-tDCS, in the false belief and in the self-other judgments of mental features, whereas they did not change performance in the false photographs or the self-other judgments of physical features. These selective improvements cannot be attributed to increased familiarity with the tasks, because the performance of the low-AQ control group remained stable about one week later. Therefore, our study provides initial proof that tDCS could be used to improve mentalizing skills in persons with ASD traits. [ABSTRACT FROM AUTHOR]

Background and Aims: Negative attitudes in clinicians towards people with personality disorder are common and associated with poor care. National guidelines recommend developing interventions to improve attitudes. Mentalization-based treatment theory and techniques provide a plausible intervention. We therefore evaluated the effect of teaching mentalizing skills on clinicians' attitudes towards personality disorder., Methods: Pilot before-and-after study of trainee psychiatrists receiving four teaching sessions in mentalizing skills. Self-report questionnaires were completed at baseline and post teaching programme., Main Outcome Measure: Attitudes to Personality Disorder Questionnaire., Secondary Measure: Knowledge and Application of Mentalization-based treatment Questionnaire., Results: Sixteen doctors were recruited with no study drop-out. Mean Attitudes to Personality Disorder Questionnaire score was superior post teaching programme versus baseline (135.3 vs. 124.5, standardised mean difference = 0.72, 95% confidence interval = 0.01 to 1.44). Mean Knowledge and Application of Mentalization-based treatment Questionnaire score was superior post teaching programme versus baseline (112.5 vs. 97.1, standardised mean difference = 1.83, 95% confidence interval 0.98 to 2.67)., Conclusions: As expected from a pilot study, the estimate of effect is imprecise. Within this limitation, our findings suggest that teaching in mentalizing skills improved attitudes and mentalization-based treatment knowledge to a clinically relevant degree. This has important implications for patient outcomes and staff development. Our study paves the way for a full-scale study to provide more precise and robust evidence., (© The Author(s) 2015.)