Reflective functioning in anorexia nervosa: does it differ from healthy controls and what is its relation to...

Area of Science:

• Psychiatry
• Psychology
• Clinical Psychology

Background:

• Previous research indicates reduced mentalizing capacity, or reflective functioning (RF), in anorexia nervosa (AN) patients.
• Few studies have utilized validated interview procedures to assess RF in AN.
• This study aimed to evaluate RF in AN patients compared to healthy controls (HCs) using expert-rated and self-report measures.

Purpose of the Study:

• To assess and compare reflective functioning (RF) in female patients with anorexia nervosa (AN) and healthy controls (HCs).
• To explore the relationship between RF and various psychopathological aspects in AN.
• To compare expert-rated and self-report measures of RF in AN.

Main Methods:

• 30 female AN patients and 30 matched HCs were assessed.
• Reflective functioning (RF) was measured using the Brief Reflective Functioning Interview (BRFI) and the Mentalization Questionnaire (MZQ).
• Correlations were examined between RF and eating disorder psychopathology, body experience, general psychopathology, and personality functioning.

Main Results:

• AN patients showed significantly lower RF on the expert-rated RF-Scale (RF-BRFI) compared to HCs (p=0.011).
• Self-reported mentalizing (MZQ) was also significantly worse in the AN group compared to HCs (p<0.0001).
• RF measured by BRFI correlated only with 'weight concern', while MZQ RF correlated with various psychopathology aspects, excluding depressive symptoms and BMI.

Conclusions:

• The study confirms impaired mentalizing in AN patients.
• Enhancing mentalization abilities could be a significant therapeutic target for AN.
• The association between RF and psychopathology is dependent on the specific RF measurement tool used, necessitating further research into their distinct captured aspects.