Mentalizing in self vs. parent representations and working models of parents as risk and protective factors from distress and eating disorders

This study examined whether low developmental level of mentalization and symbolization, manifested as low ability to represent and reflect on mental states of the self and parents as well as malevolent working models of parents, may be risk factors in the genesis of eating disorders (EDs). We examined 71 female adolescent inpatients with ED and 45 controls without ED using the Object Representation Inventory and self-report measures assessing emotional distress and ED symptoms. The results indicated that the patients with ED presented with a significantly lower level of mentalization and symbolization and with more malevolent working models of their parents in comparison with the controls without ED. A more benevolent parental representation, specifically with the father, combined with better mentalization abilities, was found to indirectly predict lower ED symptoms, via the reduction of distress levels. These findings suggest that adequate mentalization and benevolent working models of parents may serve as a protective factor reducing the level of ED symptoms.