Is mentalising ability associated with mental health difficulties in adolescents? A systematic review: understanding the construct of mentalising in adolescence and its association with mental health, a structural equation model

Abstract

Mentalising is an “imaginative mental activity that enables us to perceive and interpret human behaviour in terms of internal mental states (e.g. needs, desires, feelings, beliefs, goals, purposes and reasons)” (Bateman & Fonagy, 2012; page 4). While this has been studied within an adult population, there has been a lack of research in understanding this construct in adolescence and its associations with mental health. This thesis aimed to systematically review the literature to establish if there was an association between mentalising difficulties and mental health disorders in adolescence. It further aimed to empirically investigate using a questionnaire-based study with adolescents, the constructs of mentalising and their associations with mental wellbeing. The review found a negative association, indicating that low mentalising skills were a risk factor for mental health difficulties. However, there was a lack of research in this area and methodological and conceptual concerns about the measurement of mentalising. The empirical study found that the theoretical model of mentalising did not fit for adolescents. This was discussed in relation to the need for further adolescent specific research to understand this developing construct. In addition, a refined model that was hypothesised to be ‘self-awareness’ was suggested that was found to predict the mental wellbeing outcomes, indicating a potential risk factor for mental health difficulties in adolescence.