title: Theory of mind and emotion regulation difficulties in adolescents with borderline traits.
abstract: OBJECTIVE
  Dysfunctions in both emotion regulation and social cognition (understanding behavior in mental state terms, theory of mind or mentalizing) have been proposed as explanations for disturbances of interpersonal behavior in borderline personality disorder (BPD). This study aimed to examine mentalizing in adolescents with emerging BPD from a dimensional and categorical point of view, controlling for gender, age, Axis I and Axis II symptoms, and to explore the mediating role of emotion regulation in the relation between theory of mind and borderline traits.
  
  
  METHODS
  The newly developed Movie for the Assessment of Social Cognition (MASC) was administered alongside self-report measures of emotion regulation and psychopathology to 111 adolescent inpatients between the ages of 12 to 17 (mean age = 15.5 years; SD = 1.44 years). For categorical analyses borderline diagnosis was determined through semi-structured clinical interview, which showed that 23% of the sample met criteria for BPD.
  
  
  RESULTS
  Findings suggest a relationship between borderline traits and "hypermentalizing" (excessive, inaccurate mentalizing) independent of age, gender, externalizing, internalizing and psychopathy symptoms. The relation between hypermentalizing and BPD traits was partially mediated by difficulties in emotion regulation, accounting for 43.5% of the hypermentalizing to BPD path.
  
  
  CONCLUSIONS
  Results suggest that in adolescents with borderline personality features the loss of mentalization is more apparent in the emergence of unusual alternative strategies (hypermentalizing) than in the loss of the capacity per se (no mentalizing or undermentalizing). Moreover, for the first time, empirical evidence is provided to support the notion that mentalizing exerts its influence on borderline traits through the mediating role of emotion dysregulation.
authors.affiliation: Department of Psychology, University of Houston, Houston, TX 77024, USA. csharp2@uh.edu
authors.forename: Carla
authors.initials: C
authors.lastname: Sharp
authors.forename: Heather
authors.initials: H
authors.lastname: Pane
authors.forename: Carolyn
authors.initials: C
authors.lastname: Ha
authors.forename: Amanda
authors.initials: A
authors.lastname: Venta
authors.forename: Amee B
authors.initials: AB
authors.lastname: Patel
authors.forename: Jennifer
authors.initials: J
authors.lastname: Sturek
authors.forename: Peter
authors.initials: P
authors.lastname: Fonagy
mesh_terms: D000293:Adolescent; D001883:Borderline Personality Disorder / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology; D015897:Comorbidity; D039721:Diagnostic and Statistical Manual of Mental Disorders; D056348:Emotional Intelligence; D005260:Female; D006801:Humans; D007389:Internal-External Control; D007406:Interview, Psychological; D008016:Life Change Events; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D010552:Personality Assessment; D010555:Personality Inventory / Q000706:statistics & numerical data; D011594:Psychometrics; D012114:Residential Treatment; D019966:Substance-Related Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D056345:Theory of Mind