Mentalization in adult attachment narratives: Reflective functioning, mental states, and affect elaboration compared.

Relationships between three measures of mentalization (reflective function, mental states, and verbal elaboration of affect), attachment status, and the severity of axis I and axis II pathology were examined. Seventy-three adults, both ex-psychiatric patients and nonclinical volunteers were administered the Adult Attachment Interview (AAI). Comparisons between the three measures indicate that they share some aspect of a core mentalization process and that each illuminates a specific component. Reflective function was the only predictor of attachment status. The number of axis I diagnoses is partly explained by attachment insecurity, but the capacity to generate high-level defensive mental states as well as increments in verbal affect elaboration further contribute to the model. Finally, increments in affect elaboration, as well as augmentations in high-level defensive activity and reflective function are all associated with decreases in the number of axis II diagnoses, over and above the contribution of attachment status and axis I pathology.