Doctor of Philosophy, University of Akron, 2021, Counseling Psychology

Prior research has consistently related borderline personality features (BPF) to internalized and externalized violence. Fortunately, development of treatment interventions to mitigate maladaptive behaviors associated with BPF has been a distinct aim within the extant literature. Mentalization-based therapy (MBT) has emerged as a promising intervention to improve adaptive functioning of persons with BPF by enhancing a form of social cognition to attend to mental states (Bateman & Fonagy, 2006). Further research is needed to bridge the gap between the theoretical mentalization literature (Fonagy & Bateman, 2007) and the randomized control trials demonstrating the efficacy of MBT (Bateman & Fonagy, 1999; 2001; 2008; 2009; Rossouw & Fonagy, 2012). Specifically, the present study examined the relationships among BPF, mentalization errors, deliberate self-harm, suicidal behaviors, aggression, and violence using Fonagy and Bateman's (2007) mentalization model. Furthermore, the present study considered the potential moderating influence of gender on the indirect effects of BPF on violence through mentalization errors. A sample of 215 adults recruited from social media community groups related to BPF completed self-report measures of BPF, mentalization errors, deliberate self-harm, suicidal behaviors, aggression, and violence. Additionally, a separate dimensional screener of mentalization errors was developed and piloted within the present study. Analyses included bivariate correlations, analyses of variance, and conditional process analyses of indirect effects. Results partially supported Fonagy and Bateman's (2007) mentalization model. Hypo- and hyper-mentalization errors mediated select relationships between BPF and internalized/externalized violence. Moreover, gender was found to moderate the indirect effect of BPF on violence in a manner that ran contrary to gender norms. Limitations of an existing mentalization measure are discussed. The alternative instrument (open full item for complete abstract)

Committee: Ingrid Weigold (Committee Chair); John Queener (Advisor); Heather Katafiasz (Committee Member); Andrea Snell (Committee Member); Charles Waehler (Committee Member) Subjects: Counseling Psychology

Psy. D., Antioch University, 2020, Antioch New England: Clinical Psychology

This dissertation is an innovative intervention design to improve mentalization in preadolescents. The intervention presented is conducted in a group format and using techniques drawn from drama-based therapy. I have provided a brief literature review on mentalization, and relevant topics in group treatment and drama therapy. I have outlined key concepts from mentalization theory including: (a) the development of the self, (b) its relationship to attachment, (c) psychic equivalence and pretend mode functioning, (d) marked-affect mirroring, (e) the various facets of mentalization, and (f) mentalization treatment with children. After outlining these concepts, I discuss psychodynamic group treatment, mentalization-based group therapy, and the mechanism of change in group treatment from a neurobiologically informed perspective. From there I discuss concepts from play and drama therapy relevant to work with preadolescents. The topics covered in the literature review are used as a basis for an mentalization-based intervention appropriate for preadolescents. The argument is made that drama therapy is an appropriate vehicle through which this age group can be engaged as they are often regarded as too old for the typical toys of play therapy, but not yet ready for an adult approach to group treatment. Following the literature review, an intervention design is proposed. The proposal offers guidance on the structure of the group intervention, approach taken by the therapist, and the format of a typical session. Finally, limitations, future directions, and reflections on conducting this research are discussed.

Committee: Theodore Ellenhorn PhD, ABPP (Committee Chair); Vincent Pignatiello PsyD (Committee Member); Megan Turchetti PsyD (Committee Member) Subjects: Clinical Psychology

Psy. D., Antioch University, 2018, Antioch New England: Clinical Psychology

The relationship between mentalization, affect regulation, and the quality of object relations among individuals with an autism spectrum disorder was explored. The findings could be used as conceptual support for the use of psychodynamic psychotherapy in the treatment of people on the autism spectrum. The study consisted of a retrospective analysis of neuropsychological assessment standard scores on three measures (Mutuality of Autonomy Scale, NEPSY-II Theory of Mind subtest, and the CBCL Dysregulated Profile). Forty-four subjects diagnosed with autism spectrum disorder —aged nine to sixteen—were compared with a matched non-autism clinical sample. The results supported the hypothesis that individuals with an autism spectrum disorder have less capacity for mentalization compared to the comparison subjects and the general population. The findings did not support more affect dysregulation among those with autism compared to the comparison group, and did not find heightened affect dysregulation in comparison to the general population. Additionally, the study did not confirm that as mentalization capacity decreases affect dysregulation increases. As was hypothesized, the absolute level of object relations was in the average range among individuals with autism.

Committee: Theodore Ellenhorn PhD, ABPP (Committee Chair); E. Porter Eagan PsyD (Committee Member); Gina Pasquale PsyD (Committee Member) Subjects: Clinical Psychology