Interplay of mentalization, emotion regulation and identity integration among adolescents

Mentalization, emotion regulation (ER) and identity integration are important transdiagnostic concepts contributing to mental health. Yet, their interconnections are relatively poorly understood. Adolescence is a critical period for developing these skills, as well as for risk of developing mental health problems. In this study, we used network analysis among adolescents with and without mental health problems to examine how mentalization, ER, and identity integration overlap and interplay with each other, and which aspects of them are the most central in mental health problems. A non-clinical (N = 360) and a clinical sample (N = 110) of Finnish adolescents filled out the Mentalization Questionnaire (MZQ), the short version of the Difficulties in Emotion Regulation Scale (DERS) and the Development and Identity Diffusion in Adolescence (AIDA) questionnaire. Network analyses were conducted on the two data sets. With non-clinical data, measures clustered more expectedly around themselves, whereas with clinical data, different measures overlapped and connected more with each other. Limited access to effective ER strategies (DERS) and Consistent self (AIDA) were more central subconstructs in the clinical sample than in the non-clinical sample, implying that they could have the most central impact on maintaining difficulties in mentalization, ER, and identity development in adolescents with psychiatric disorders. Differences between the networks might imply complexity and individuality of factors contributing to problems with them. This would highlight the importance of individual case formulation about factors contributing to and maintaining problems when considering treatment targets, as well as the need for more research on individual dynamics of psychological problems.