Newbury-Helps, J; (2011) Are difficulties in mentalizing associated with severity of Antisocial Personality Disorder? Doctoral thesis , UCL (University College London).

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Abstract

Part 1 of the thesis reviews the literature on the measurement of mentalization in adult clinical populations. As mentalization is a broad multi-faceted term, the search incorporates the related concepts of Theory of Mind (ToM) and Emotional Intelligence (EI) as these have been widely operationalised. The review presents a framework for different types of measures, including performance-based tasks and self-report questionnaires, and considers their relative psychometric strengths. It finds an absence of any one measure that covers the breadth of the mentalization construct, however, a set of recommendations are made for an optimal approach using currently available tools. Part 2 presents an empirical study of the relationship between mentalizing capability and severity of Antisocial Personality Disorder (ASPD) in an offender sample. The results show that some specific mentalizing measures were able to modestly predict severity of ASPD. These were the ability to take the perspective of another person, the ability to read mental states from the ‘eyes’ and a general inability to mentalize. These findings suggest that a greater understanding of mentalizing capacities in people with ASPD may support improved risk assessment and clinical treatments. The study’s limitations are considered and its implications for further research and practice. Part 3 presents a critical appraisal of the process of undertaking this research. It describes some of the challenges to joint working across the NHS and the Criminal Justice System. It considers how the use of psychometric assessment can be improved in an ASPD/offender population. It builds on the literature review to recommend how the operationalisation of mentalization can be further enhanced.

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