Low Self-Mentalizing and Hypermentalizing Others as Core Features of Personality Pathology: A Person-Centered Analysis.

BACKGROUND Mentalizing is a multifaceted construct central to personality pathology, and a person-centered approach may clarify how imbalances between self-and other-mentalizing relate to its expression and severity.

METHODS Ninety-nine adults from clinical and community samples completed diagnostic interviews and validated measures of mentalizing, personality functioning, and maladaptive traits. Cluster analysis was applied to indices of self-and other-mentalizing.

RESULTS Three profiles emerged: (1) low self-mentalizing with hypermentalizing of others, (2) relatively preserved self-mentalizing with ineffective other-mentalizing, and (3) broadly effective mentalizing. Cluster 1 showed the highest severity of personality pathology and greater clinical burden reflected in higher rates of psychiatric hospitalization and treatment referral. Cluster 3 showed the lowest levels of pathology and clinical burden. No cluster differences were found in sociodemographic indicators.

CONCLUSIONS Distinct mentalizing profiles are differentially associated with personality pathology and clinical burden, highlighting the central role of impairments in self-mentalizing and hypermentalizing of others.