SynthesisPsychological medicine2025
The shadow of trauma: impaired mentalization in clinical populations - a systematic review.
Synthesis in Psychological medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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Who cites it
9 citing papers in PubMed.
- When Teachers Mentalize: A Mixed-Methods Analysis of Teacher Responses to Disruptive Classroom Behaviour.Children (Basel, Switzerland) · 2026Article
- Borderline personality symptom severity predicts reduced mentalization and affective empathy and altered responses to fairness in the Ultimatum Game.Borderline personality disorder and emotion dysregulation · 2026Article
- Mapping behavioural mechanisms linking childhood maltreatment, cognition, impulsivity, and suicidality in bipolar disorder: A network approach.Translational psychiatry · 2026Article
- Pathology of the self: a network analysis of personality functioning, narcissistic vulnerability, mentalizing, and epistemic trust across trauma profiles.Borderline personality disorder and emotion dysregulation · 2026Article
- Neural Correlates of Mentalizing Altered in Childhood Trauma and Cocaine Use Disorder.Research square · 2026Article
- Associations between childhood adverse experiences and medication adherence in asthma patients: a dual variable-centered and person-centered analysis of attachment security and mentalization.Frontiers in psychiatry · 2026Article
- Article
- Patient and therapist perspectives on impact, outcomes and change mechanisms in trauma-focused mentalization-based treatment: a qualitative interview study.Frontiers in psychiatry · 2026Article
- Article
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Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundMentalizing defines the set of social cognitive imaginative activities that enable interpretation of behaviors as arising from intentional mental states. Mentalization impairments have been related to childhood trauma (CT) and are widely present in people suffering from mental disorders. Nevertheless, the link between CT exposure, mentalization abilities, and related psychopathology remains unclear. This study aims to systematically review the evidence in this domain.
methodsA Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA)-compliant systematic review of literature published until December 2022 was conducted through an Ovid search (Medline, Embase, and PsycINFO). The review was registered in the Prospective Register of Systematic Reviews (PROSPERO) (CRD42023455602).
resultsTwenty-nine studies were included in the qualitative synthesis. Twenty studies (69%) showed a significant negative correlation between CT and mentalization. There was solid evidence for this association in patients with psychotic disorders, as almost half the studies focused on this population. The few studies focusing on unipolar depression, personality disorders, and opioid addiction also reported a negative impact of CT on mentalization. In contrast, evidence for post-traumatic stress disorder was inconsistent, and no evidence was found for bipolar disorder. When stratifying for subtypes of CT, there was solid evidence that neglect (physical and emotional) decreased mentalization capacity, while abuse (physical, emotional, or sexual) was not associated with mentalization impairments.
conclusionsAlthough causality cannot be established, there was substantial evidence that CT negatively affects mentalization across various psychiatric disorders, particularly psychotic disorders. These findings highlight the potential of targeting mentalization impairments in prevention and treatment strategies aiming to reduce the incidence and the social functioning burden of mental illness.
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