Alqadri, Yaman; (2022) Minding the Baby: Examining the impact of a reflective home-visiting programme in promoting maternal Mind-Mindedness. Doctoral thesis (D.Clin.Psy), UCL (University College London).

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Abstract

Background: The role of early maltreatment in the development of mentalization has been studied in various independent studies. Given the complexity of developmental pathways from childhood to adulthood, quantifying the association across multiple studies offers a higher precision of estimate and allows an objective integration of quantitative evidence pertaining to this association. This meta-analysis aims to estimate the strength of the association between the experience of neglect in childhood and mentalization measured in adulthood. Methods: The meta-analysis offers a synthesis of extant literature pertaining to the association between childhood maltreatment, especially experiences of neglect, and adult mentalization. In order to identify the relevant studies, systematic electronic searches were conducted in line with PRISMA guidelines. In total, 20 eligible studies (23 separate samples) with 34,802 participants were included for the study of the association between childhood neglect and mentalizing in adulthood. Additional 18 studies (19 separate sample) of 17,163 participants were independently analysed to examine the association between overall childhood maltreatment and adult mentalizing. The two effect sizes were compared to each other. A multivariate mixed-effects model was adopted to identify possible moderators of the relation between childhood neglect and mentalization. Results: In line with the expectations, childhood neglect was negatively associated with adults’ capacity to mentalize. The results showed a pooled correlation of r = 0.15 between experiences of childhood neglect and later mentalization. The highest value of association with mentalization was produced by emotional neglect (r = 0.17), followed by total neglect (r = 0.16), and finally physical neglect (r = 0.14), however, they did not statistically differ from each other. Meta-regression showed that younger age at the assessment of mentalization, and percentage of participants from ethnic minority backgrounds, were positively associated with higher impairment of mentalization. This suggests that samples including a higher proportion of minoritized ethnicities, and participants of younger age, produced stronger associations. Lastly, general maltreatment had a marginally stronger association with adult mentalizing (r = 0.17) but not statistically different from childhood neglect. Conclusion: Given the apparent lack of consensus on defining neglect, significant challenges in measuring neglect and its associated developmental outcomes are still present in the research literature. Findings from this meta-analysis could be utilised to inform future research efforts studying the long-term outcomes of early experiences of neglect.

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