Hypermentalizing as a marker of borderline personality disorder in Italian adolescents: a cross-cultural replication of Sharp and colleagues’ (2011) findings

Background Extant literature indicates that Borderline Personality Disorder (BPD) may be reliably assessed in adolescence. Sharp and colleagues’ (2011) suggested that mentalization could be an important early target for intervention in BPD adolescents and showed that hypermentalizing may represent an important marker to distinguish emerging BPD from adolescent turmoil. We aimed at testing if both dimensionally-assessed and categorically-diagnosed BPD was selectively associated with hypermentalizing errors on the Movie for the Assessment of Social Cognition (MASC) task in Italian adolescent inpatients and community adolescents. Findings The sample was composed of 58 Italian adolescents who were consecutively admitted to an adolescent psychiatry unit in Rome, Italy. BPD was assessed using the Structured Clinical Interview for DSM-5 Personality Disorders (SCID-5-PD); the MASC task was used to assess mentalizing. Findings supported the hypothesis of a specific link between BPD features and hypermentalizing in adolescent inpatients. Both dimensionally-assessed and categorically-assessed BPD showed significant and non-negligible associations with hypermentalizing. The overall performance on the MASC task significantly discriminated BPD adolescents from Italian community-dwelling adolescents. Conclusions Our findings supported the hypothesis that specific deficits in mentalization–namely, hypermentalizing–may play a crucial role in the developmental pathway leading to emerging BPD in adolescence.