“Eating Me Up from Inside”: A Pilot Study of Mentalization of Self and Others and Emotion Regulation Strategies among Young Women with Eating Disorders

Background: We examined the relationship between general ability of mentalization, the specific aspect of affective mentalizing of self and others, emotion regulation strategies, and eating disorder (ED) symptoms. Method: Twenty-five female adolescent and young adult inpatients with EDs, and 22 healthy subjects, were administered a semi-structured interview-the Reflective Function (RF) scale, self-rating scales assessing alexithymia, emotion regulation, depression and ED symptomatology, and a neurocognitive measure assessing Theory of Mind. Results: Participants with EDs presented lower levels of RF regarding the self and higher levels of alexithymia, using more emotional suppression and less cognitive reappraisal than controls. Elevated levels of general RF and self RF and attenuated alexithymia, along with elevated cognitive reappraisal and attenuated emotional suppression, were correlated with attenuated ED symptoms. Comorbidity with depressive symptoms predicted greater ED symptomatology. Conclusions: High mentalization may serve as a coping mechanism to attenuate ED symptoms.