Exploring Personal Recovery in Schizophrenia: The Role of Mentalization
Abstract
:1. Introduction
1.1. Personal Recovery
1.2. Factors Influencing Personal Recovery
2. Materials and Methods
- The Recovery Assessment Scale (RAS) was used to define patients’ perceived recovery. It is a 41-item self-administered tool structured as a Likert scale from 1 (completely disagree) to 5 (completely agree), designed to assess perceived recovery in psychiatric patients. Five factors of recovery can be depicted as Personal Trust and Hope, Willingness to Ask for Help, Goal and Success Orientation, Dependence on Others, and Not being Dominated by Symptoms [4,35].
- The Multidimensional Mentalizing Questionnaire (MMQ) measures the mentalizing processes. It is a 33-item self-rated tool covering different core aspects of mentalization that embraces a multidimensional construct with 4 dimensions: automatic-controlled mentalizing, self/other-oriented mentalization, internal-external mentalizing, and cognitive/affective mentalization. The response format is on a five-point Likert scale from 1 = “Not at all” to 5 = “A great deal”. It can be possible to define scores on positive (reflexivity, ego-strength, and relational attunement) and negative (relational discomfort, distrust, and emotional dyscontrol) subscales as well as an overall MMQ score by summing all the items after having reversed those included in the negative subscales [36].
- The brief version of the WHO Disability Assessment Schedule (WHO-DAS) 2.0 is a 12-item self-rated scale used to measure disability levels in clinical practice [37,38]. All the questions refer to the prior thirty days, asking for the level of difficulty in doing daily activities, ranging from “No difficulty”, equal to 1, to “Extreme or cannot do”, equal to 5. The sum of the items is proportional to the functional impairment. The following six “life areas” can be evaluated: Cognition, Mobility, Self-care, Getting along, Life activities, and Participation.
- The EuroQoL-5 dimensions-5 levels (EQ-5D-5L) was administered to assess quality of life [39]. It is a self-report screening tool consisting of two sections. The first part contains five Likert-level questions regarding movement capacity, self-care, common activities, pain, and anxiety/depression; the second part is a visual analog scale (VAS) in which patients indicate their perceived health ranging from 0 to 100, where higher is better.
- The Insight Orientation Scale (IOS) is a 7-item self-report scale designed to measure a person’s orientation and tendency toward insight, which refers to the understanding or awareness of one’s thoughts, emotions, and behaviors. Each item is rated on a Likert scale ranging from 1 (not at all) to 5 (a great deal), focused on seven core aspects of the construct: level of consciousness, problem solving, restructuring (behavior change), awareness, complexity (abstraction, depth), surprise, and self-reflectiveness (thoughtfulness) [40].
- The Glasgow Antipsychotic Side Effect Scale (GASS) is a 22-item self-rated questionnaire used to assess AP-induced SE. For each item, it is possible to indicate the frequency of the reported SE (Never, Once, A few times, and Every day, scored as 0, 1, 2, and 3, respectively) and then the level of distress that the SE determines (scored from 1 to 10). The first twenty questions refer to the prior week, while the last two questions (on changes in menstrual periods and weight gain) refer to the previous 3 months. The total scale score is given by the sum of the item frequency [41].
Statistical Analyses
3. Results
4. Discussion
4.1. Findings from the Study
4.2. Correlation between Mentalization Abilities and Other Variables
4.3. Limitations
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
- Slade, M.; Leamy, M.; Bacon, F.; Janosik, M.; Le Boutillier, C.; Williams, J.; Bird, V. International differences in understanding recovery: Systematic review. Epidemiol. Psychiatr. Sci. 2012, 21, 353–364. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Law, H.; Morrison, A.P. Recovery in psychosis: A Delphi study with experts by experience. Schizophr. Bull. 2014, 40, 1347–1355. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Cavelti, M.; Kvrgic, S.; Beck, E.M.; Kossowsky, J.; Vauth, R. Assessing recovery from schizophrenia as an individual process. A review of self-report instruments. Eur. Psychiatry 2012, 27, 19–32. [Google Scholar] [CrossRef] [PubMed]
- Salzer, M.S.; Brusilovskiy, E. Advancing recovery science: Reliability and validity properties of the Recovery Assessment Scale. Psychiatr. Serv. 2014, 65, 442–453. [Google Scholar] [CrossRef] [PubMed]
- Skar-Fröding, R.; Clausen, H.K.; Šaltytė Benth, J.; Ruud, T.; Slade, M.; Sverdvik Heiervang, K. The Importance of Personal Recovery and Perceived Recovery Support among Service Users with Psychosis. Psychiatr. Serv. 2021, 72, 661–668. [Google Scholar] [CrossRef]
- Davidson, L.; Roe, D. Recovery from versus recovery in serious mental illness: One strategy for lessening confusion plaguing recovery. J. Ment. Health 2007, 16, 459–470. [Google Scholar] [CrossRef]
- Van Eck, R.M.; Burger, T.J.; Vellinga, A.; Schirmbeck, F.; de Haan, L. The Relationship Between Clinical and Personal Recovery in Patients With Schizophrenia Spectrum Disorders: A Systematic Review and Meta-analysis. Schizophr. Bull. 2018, 44, 631–642. [Google Scholar] [CrossRef] [Green Version]
- Leamy, M.; Bird, V.; Le Boutillier, C.; Williams, J.; Slade, M. Conceptual framework for personal recovery in mental health: Systematic review and narrative synthesis. Br. J. Psychiatry 2011, 199, 445–452. [Google Scholar] [CrossRef] [Green Version]
- Corrigan, P.W.; Salzer, M.; Ralph, R.O.; Sangster, Y.; Keck, L. Examining the factor structure of the recovery assessment scale. Schizophr. Bull. 2004, 30, 1035–1041. [Google Scholar] [CrossRef] [Green Version]
- Shanks, V.; Williams, J.; Leamy, M.; Bird, V.J.; Le Boutillier, C.; Slade, M. Measures of personal recovery: A systematic review. Psychiatr. Serv. 2013, 64, 974–980. [Google Scholar] [CrossRef]
- Gorwood, P.; Bouju, S.; Deal, C.; Gary, C.; Delva, C.; Lancrenon, S.; Llorca, P.M. Predictive factors of functional remission in patients with early to mid-stage schizophrenia treated by long acting antipsychotics and the specific role of clinical remission. Psychiatry Res. 2019, 281, 112560. [Google Scholar] [CrossRef]
- Carpiniello, B.; Pinna, F.; Manchia, M.; Tusconi, M.; Cavallaro, R.; Bosia, M. Sustained symptomatic remission in schizophrenia: Course and predictors from a two-year prospective study. Schizophr. Res. 2022, 239, 34–41. [Google Scholar] [CrossRef] [PubMed]
- Lambert, M.; Karow, A.; Leucht, S.; Schimmelmann, B.G.; Naber, D. Remission in schizophrenia: Validity, frequency, predictors, and patients’ perspective 5 years later. Dialogues Clin. Neurosci. 2010, 12, 393–407. [Google Scholar] [CrossRef] [PubMed]
- Liberman, R.P.; Kopelowicz, A.; Ventura, J.; Gutkind, D. Operational criteria and factors related to recovery from schizophrenia. Int. Rev. Psychiatry 2002, 14, 256–272. [Google Scholar] [CrossRef]
- Yu, Y.; Xiao, X.; Yang, M.; Ge, X.P.; Li, T.X.; Cao, G.; Liao, Y.J. Personal Recovery and Its Determinants Among People Living with Schizophrenia in China. Front. Psychiatry 2020, 11, 602524. [Google Scholar] [CrossRef]
- Torgalsbøen, A.K. Sustaining full recovery in schizophrenia after 15 years: Does resilience matter? Clin. Schizophr. Relat. Psychoses 2012, 5, 193–200. [Google Scholar] [CrossRef]
- Li, K.Y.; Wu, Y.H.; Chen, H.Y. Predictors of personal recovery for individuals with schizophrenia spectrum disorders living in the community. Clin. Psychol. Psychother. 2023, 30, 179–187. [Google Scholar] [CrossRef]
- Chang, Y.C.; Heller, T.; Pickett, S.; Chen, M.D. Recovery of people with psychiatric disabilities living in the community and associated factors. Psychiatr. Rehabil. J. 2013, 36, 80–85. [Google Scholar] [CrossRef] [Green Version]
- Song, L.Y. Predictors of personal recovery for persons with psychiatric disabilities: An examination of the Unity Model of Recovery. Psychiatry Res. 2017, 250, 185–192. [Google Scholar] [CrossRef]
- Wood, L.; Irons, C. Experienced stigma and its impacts in psychosis: The role of social rank and external shame. Psychol. Psychother. 2017, 90, 419–431. [Google Scholar] [CrossRef]
- Best, M.W.; Law, H.; Pyle, M.; Morrison, A.P. Relationships between psychiatric symptoms, functioning and personal recovery in psychosis. Schizophr. Res. 2020, 223, 112–118. [Google Scholar] [CrossRef] [PubMed]
- Tse, S.; Davidson, L.; Chung, K.F.; Ng, K.L.; Yu, C.H. Differences and similarities between functional and personal recovery in an Asian population: A cluster analytic approach. Psychiatry 2014, 77, 41–56. [Google Scholar] [CrossRef] [PubMed]
- Van Aken, B.; Wierdsma, A.; Voskes, Y.; Pijnenborg, G.; van Weeghel, J.; Mulder, C. The association between executive functioning and personal recovery in people with psychotic disorders. Schizophr. Bull. Open 2022, 3, sgac023. [Google Scholar] [CrossRef]
- Giusti, L.; Ussorio, D.; Tosone, A.; Di Venanzio, C.; Bianchini, V.; Necozione, S.; Casacchia, M.; Roncone, R. Is personal recovery in schizophrenia predicted by low cognitive insight? Community Ment. Health J. 2015, 51, 30–37. [Google Scholar] [CrossRef]
- Leendertse, J.C.P.; Wierdsma, A.I.; van den Berg, D.; Ruissen, A.M.; Slade, M.; Castelein, S.; Mulder, C.L. Personal Recovery in People with a Psychotic Disorder: A Systematic Review and Meta-Analysis of Associated Factors. Front. Psychiatry 2021, 12, 622628. [Google Scholar] [CrossRef]
- Fonagy, P.; Bateman, A.W. Adversity, attachment, and mentalizing. Compr. Psychiatry 2016, 64, 59–66. [Google Scholar] [CrossRef]
- Choi-Kain, L.W.; Gunderson, J.G. Mentalization: Ontogeny, assessment, and application in the treatment of borderline personality disorder. Am. J. Psychiatry 2008, 165, 1127–1135. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Lysaker, P.H.; Cheli, S.; Dimaggio, G.; Buck, B.; Bonfils, K.A.; Huling, K.; Wiesepape, C.; Lysaker, J.T. Metacognition, social cognition, and mentalizing in psychosis: Are these distinct constructs when it comes to subjective experience or are we just splitting hairs? BMC Psychiatry 2021, 21, 329. [Google Scholar] [CrossRef]
- Vucurovic, K.; Caillies, S.; Kaladjian, A. Neural Correlates of Mentalizing in Individuals With Clinical High Risk for Schizophrenia: ALE Meta-Analysis. Front. Psychiatry 2021, 12, 634015. [Google Scholar] [CrossRef]
- Papadea, D.; Dalla, C.; Tata, D.A. Exploring a Possible Interplay between Schizophrenia, Oxytocin, and Estrogens: A Narrative Review. Brain Sci. 2023, 13, 461. [Google Scholar] [CrossRef]
- Fusar-Poli, L.; Rodolico, A.; Sturiale, S.; Carotenuto, B.; Natale, A.; Arillotta, D.; Siafis, S.; Signorelli, M.S.; Aguglia, E. Second-to-Fourth Digit Ratio (2D:4D) in Psychiatric Disorders: A Systematic Review of Case-control Studies. Clin. Psychopharmacol. Neurosci. 2021, 19, 26–45. [Google Scholar] [CrossRef] [PubMed]
- Weijers, J.; Ten Kate, C.; Debbané, M.; Bateman, A.; de Jong, S.; Selten, J.-P.C.; Eurelings-Bontekoe, E. Mentalization and psychosis: A rationale for the use of mentalization theory to understand and treat non-affective psychotic disorder. J. Contemp. Psychother. 2020, 50, 223–232. [Google Scholar] [CrossRef] [Green Version]
- Fett, A.K.; Viechtbauer, W.; Dominguez, M.D.; Penn, D.L.; van Os, J.; Krabbendam, L. The relationship between neurocognition and social cognition with functional outcomes in schizophrenia: A meta-analysis. Neurosci. Biobehav. Rev. 2011, 35, 573–588. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Velthorst, E.; Fett, A.J.; Reichenberg, A.; Perlman, G.; van Os, J.; Bromet, E.J.; Kotov, R. The 20-Year Longitudinal Trajectories of Social Functioning in Individuals With Psychotic Disorders. Am. J. Psychiatry 2017, 174, 1075–1085. [Google Scholar] [CrossRef]
- Boggian, I.; Lamonaca, D.; Ghisi, M.; Bottesi, G.; Svettini, A.; Basso, L.; Bernardelli, K.; Merlin, S.; Liberman, R.P. “The Italian Study on Recovery 2” Phase 1: Psychometric Properties of the Recovery Assessment Scale (RAS), Italian Validation of the Recovery Assessment Scale. Front. Psychiatry 2019, 10, 1000. [Google Scholar] [CrossRef]
- Gori, A.; Arcioni, A.; Topino, E.; Craparo, G.; Lauro Grotto, R. Development of a New Measure for Assessing Mentalizing: The Multidimensional Mentalizing Questionnaire (MMQ). J. Pers. Med. 2021, 11, 305. [Google Scholar] [CrossRef]
- Holmberg, C.; Gremyr, A.; Torgerson, J.; Mehlig, K. Clinical validity of the 12-item WHODAS-2.0 in a naturalistic sample of outpatients with psychotic disorders. BMC Psychiatry 2021, 21, 147. [Google Scholar] [CrossRef]
- Ustün, T.B.; Chatterji, S.; Kostanjsek, N.; Rehm, J.; Kennedy, C.; Epping-Jordan, J.; Saxena, S.; von Korff, M.; Pull, C. Developing the World Health Organization Disability Assessment Schedule 2.0. Bull. World Health Organ. 2010, 88, 815–823. [Google Scholar] [CrossRef]
- Konig, H.H.; Roick, C.; Angermeyer, M.C. Validity of the EQ-5D in assessing and valuing health status in patients with schizophrenic, schizotypal or delusional disorders. Eur. Psychiatry 2007, 22, 177–187. [Google Scholar] [CrossRef]
- Gori, A.; Craparo, G.; Giannini, M.; Loscalzo, Y.; Caretti, V.; La Barbera, D.; Manzoni, G.M.; Castelnuovo, G.; Tani, F.; Ponti, L.; et al. Development of a new measure for assessing insight: Psychometric properties of the insight orientation scale (IOS). Schizophr. Res. 2015, 169, 298–302. [Google Scholar] [CrossRef]
- Rodolico, A.; Concerto, C.; Ciancio, A.; Siafis, S.; Fusar-Poli, L.; Romano, C.B.; Scavo, E.V.; Petralia, A.; Salomone, S.; Signorelli, M.S.; et al. Validation of the Glasgow Antipsychotic Side-Effect Scale (GASS) in an Italian Sample of Patients with Stable Schizophrenia and Bipolar Spectrum Disorders. Brain Sci. 2022, 12, 891. [Google Scholar] [CrossRef] [PubMed]
- Debbané, M.; Salaminios, G.; Luyten, P.; Badoud, D.; Armando, M.; Solida Tozzi, A.; Fonagy, P.; Brent, B.K. Attachment, Neurobiology, and Mentalizing along the Psychosis Continuum. Front. Hum. Neurosci. 2016, 10, 406. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Thibaudeau, É.; Cellard, C.; Turcotte, M.; Achim, A.M. Functional Impairments and Theory of Mind Deficits in Schizophrenia: A Meta-analysis of the Associations. Schizophr. Bull. 2021, 47, 695–711. [Google Scholar] [CrossRef]
- Dimopoulou, T.; Tarazi, F.I.; Tsapakis, E.M. Clinical and therapeutic role of mentalization in schizophrenia-a review. CNS Spectr. 2017, 22, 450–462. [Google Scholar] [CrossRef]
- Mazza, M.; Di Michele, V.; Pollice, R.; Casacchia, M.; Roncone, R. Pragmatic language and theory of mind deficits in people with schizophrenia and their relatives. Psychopathology 2008, 41, 254–263. [Google Scholar] [CrossRef] [PubMed]
- Greig, T.C.; Bryson, G.J.; Bell, M.D. Theory of mind performance in schizophrenia: Diagnostic, symptom, and neuropsychological correlates. J. Nerv. Ment. Dis. 2004, 192, 12–18. [Google Scholar] [CrossRef] [PubMed]
- Achim, A.M.; Thibaudeau, É.; Huot, A.; Cellard, C.; Roy, M.A. What areas of everyday functioning are affected by theory of mind deficits in recent-onset schizophrenia spectrum disorders? Early Interv. Psychiatry 2023, 17, 57–64. [Google Scholar] [CrossRef]
- Gori, A.; Topino, E. Exploring and Deepening the Facets of Mentalizing: The Integration of Network and Factorial Analysis Approaches to Verify the Psychometric Properties of the Multidimensional Mentalizing Questionnaire (MMQ). Int. J. Environ. Res. Public Health 2023, 20, 4744. [Google Scholar] [CrossRef]
- Swenson, C.R.; Choi-Kain, L.W. Mentalization and Dialectical Behavior Therapy. Am. J. Psychother. 2015, 69, 199–217. [Google Scholar] [CrossRef] [Green Version]
- Bateman, A.W.; Fonagy, P.E. Handbook of Mentalizing in Mental Health Practice; American Psychiatric Publishing, Inc.: Washington, DC, USA, 2012. [Google Scholar]
- Achim, A.M.; Ouellet, R.; Roy, M.A.; Jackson, P.L. Mentalizing in first-episode psychosis. Psychiatry Res. 2012, 196, 207–213. [Google Scholar] [CrossRef]
- Lysaker, P.H.; Pattison, M.L.; Leonhardt, B.L.; Phelps, S.; Vohs, J.L. Insight in schizophrenia spectrum disorders: Relationship with behavior, mood and perceived quality of life, underlying causes and emerging treatments. World Psychiatry 2018, 17, 12–23. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Ballespí, S.; Vives, J.; Sharp, C.; Chanes, L.; Barrantes-Vidal, N. Self and Other Mentalizing Polarities and Dimensions of Mental Health: Association With Types of Symptoms, Functioning and Well-Being. Front. Psychol. 2021, 12, 566254. [Google Scholar] [CrossRef] [PubMed]
- Bighelli, I.; Wallis, S.; Reitmeir, C.; Schwermann, F.; Salahuddin, N.H.; Leucht, S. Effects of psychological treatments on functioning in people with Schizophrenia: A systematic review and meta-analysis of randomized controlled trials. Eur. Arch. Psychiatry Clin. Neurosci. 2022, 273, 779–810. [Google Scholar] [CrossRef] [PubMed]
- Lysaker, P.; Yanos, P.T.; Roe, D. The role of insight in the process of recovery from schizophrenia: A review of three views. Psychosis 2009, 1, 113–121. [Google Scholar] [CrossRef]
- Law, H.; Shryane, N.; Bentall, R.P.; Morrison, A.P. Longitudinal predictors of subjective recovery in psychosis. Br. J. Psychiatry 2016, 209, 48–53. [Google Scholar] [CrossRef] [Green Version]
- Wood, L.; Alsawy, S. Recovery in Psychosis from a Service User Perspective: A Systematic Review and Thematic Synthesis of Current Qualitative Evidence. Community Ment. Health J. 2018, 54, 793–804. [Google Scholar] [CrossRef] [Green Version]
- Werner, S. Subjective well-being, hope, and needs of individuals with serious mental illness. Psychiatry Res. 2012, 196, 214–219. [Google Scholar] [CrossRef]
- Ponce-Correa, F.; Caqueo-Urízar, A.; Berrios, R.; Escobar-Soler, C. Defining recovery in schizophrenia: A review of outcome studies. Psychiatry Res. 2023, 322, 115134. [Google Scholar] [CrossRef]
Variables | Mean | Standard Deviation | Median | Inferior IQ | Superior IQ |
---|---|---|---|---|---|
Illness Duration Years * | 13.80 | 9.68 | 6 | 12 | 20 |
Hospitalizations * | 2.43 | 3.84 | 0 | 1 | 3 |
WHODAS Cognition * | 3.88 | 2.15 | 2 | 3 | 5 |
WHODAS Mobility * | 3.99 | 2.26 | 2 | 3 | 6 |
WHODAS Selfcare * | 2.91 | 1.78 | 2 | 2 | 3 |
WHODAS Getting Along * | 3.74 | 2.12 | 2 | 3 | 5 |
WHODAS Life Activities * | 3.89 | 2.10 | 2 | 3 | 5 |
WHODAS Participation * | 4.30 | 1.85 | 3 | 4 | 6 |
WHODAS Total * | 22.70 | 9.52 | 15 | 20 | 28 |
EQ-5D-5L-VAS | 68.62 | 24.14 | 50 | 75 | 85 |
RAS Self Trust * | 31.53 | 7.93 | 28 | 33 | 37 |
RAS Help * | 11.65 | 2.86 | 10 | 12 | 14 |
RAS Success * | 18.74 | 4.81 | 16 | 20 | 22 |
RAS Other Trust * | 14.72 | 3.73 | 13 | 15 | 17 |
RAS Not Overwhelmed * | 9.22 | 3.31 | 7 | 9 | 12 |
RAS Total * | 146.69 | 31.44 | 135 | 150 | 166 |
IOS Total | 21.25 | 6.39 | - | - | - |
MMQ Reflexivity | 27.69 | 8.51 | - | - | - |
MMQ Ego-strength | 15.91 | 5.83 | - | - | - |
MMQ Relational attunement | 12.84 | 4.29 | - | - | - |
MMQ Relational discomfort * | 19.64 | 4.61 | 18 | 21 | 23 |
MMQ Distrust * | 14.01 | 3.82 | 12 | 15 | 17 |
MMQ Emotional dyscontrol * | 15.17 | 3.95 | 13 | 16 | 18 |
MMQ Total | 105.27 | 17.18 | - | - | - |
GASS Total * | 15.07 | 10.55 | 6 | 13 | 21 |
1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 | 9 | 10 | 11 | 12 | 13 | 14 | 15 | 16 | 17 | 18 | 19 | 20 | 21 | 22 | 23 | 24 | 25 | ||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Age | 1 | - | ||||||||||||||||||||||||
Illness Duration Years | 2 | 0.558 | - | |||||||||||||||||||||||
WHODAS Cognition | 3 | 0.026 | −0.059 | - | ||||||||||||||||||||||
WHODAS Mobility | 4 | −0.032 | 0.040 | 0.548 | - | |||||||||||||||||||||
WHODAS Selfcare | 5 | 0.119 | 0.123 | 0.422 | 0.419 | - | ||||||||||||||||||||
WHODAS Getting Along | 6 | −0.027 | −0.050 | 0.64 | 0.477 | 0.438 | - | |||||||||||||||||||
WHODAS Life Activities | 7 | 0.053 | −0.025 | 0.725 | 0.483 | 0.401 | 0.604 | - | ||||||||||||||||||
WHODAS Participation | 8 | −0.110 | −0.135 | 0.514 | 0.477 | 0.278 | 0.573 | 0.542 | - | |||||||||||||||||
WHODAS Total | 9 | 0.007 | 0.011 | 0.816 | 0.74 | 0.555 | 0.797 | 0.823 | 0.77 | - | ||||||||||||||||
EQ-5D-5L-VAS | 10 | 0.013 | −0.147 | −0.229 | −0.356 | −0.159 | −0.322 | −0.29 | −0.352 | −0.378 | - | |||||||||||||||
RAS Self Trust | 11 | −0.033 | −0.214 | −0.150 | −0.204 | −0.363 | −0.324 | −0.215 | −0.348 | −0.343 | 0.57 | - | ||||||||||||||
RAS Help | 12 | −0.210 | −0.171 | −0.164 | −0.083 | −0.287 | −0.158 | −0.069 | −0.089 | −0.151 | 0.305 | 0.585 | - | |||||||||||||
RAS Success | 13 | 0.028 | −0.055 | −0.045 | −0.109 | −0.149 | −0.173 | −0.044 | −0.186 | −0.159 | 0.287 | 0.672 | 0.564 | - | ||||||||||||
RAS Other Trust | 14 | 0.052 | −0.065 | 0.160 | 0.083 | 0.017 | 0.069 | 0.197 | 0.075 | 0.135 | 0.194 | 0.467 | 0.43 | 0.488 | - | |||||||||||
RAS Not Overwhelmed | 15 | 0.016 | −0.175 | 0.035 | −0.139 | −0.28 | −0.027 | −0.034 | −0.161 | −0.133 | 0.160 | 0.52 | 0.222 | 0.323 | 0.349 | - | ||||||||||
RAS Total | 16 | −0.005 | −0.175 | −0.045 | −0.179 | −0.263 | −0.198 | −0.107 | −0.276 | −0.236 | 0.468 | 0.904 | 0.661 | 0.771 | 0.644 | 0.625 | - | |||||||||
IOS Total | 17 | −0.029 | −0.051 | −0.125 | −0.103 | −0.255 | −0.224 | −0.110 | −0.039 | −0.148 | 0.297 | 0.607 | 0.503 | 0.501 | 0.376 | 0.348 | 0.65 | - | ||||||||
MMQ Reflexivity | 18 | −0.039 | −0.084 | 0.085 | 0.077 | −0.063 | 0.054 | 0.070 | 0.117 | 0.077 | 0.101 | 0.5 | 0.474 | 0.502 | 0.478 | 0.387 | 0.621 | 0.714 | - | |||||||
MMQ Ego-strength | 19 | −0.099 | −0.140 | −0.165 | −0.23 | −0.374 | −0.242 | −0.256 | −0.215 | −0.307 | 0.423 | 0.684 | 0.302 | 0.473 | 0.242 | 0.513 | 0.642 | 0.69 | 0.566 | - | ||||||
MMQ Relational attunement | 20 | 0.051 | −0.016 | −0.011 | 0.083 | −0.102 | 0.030 | 0.009 | 0.006 | 0.027 | 0.099 | 0.365 | 0.291 | 0.422 | 0.356 | 0.392 | 0.464 | 0.629 | 0.696 | 0.535 | - | |||||
MMQ Relational discomfort | 21 | 0.087 | 0.019 | −0.423 | −0.252 | −0.210 | −0.413 | −0.321 | −0.369 | −0.385 | 0.257 | 0.142 | 0.036 | 0.061 | −0.161 | −0.104 | 0.008 | −0.007 | −0.277 | −0.039 | −0.189 | - | ||||
MMQ Distrust | 22 | 0.073 | −0.019 | −0.233 | −0.195 | −0.085 | −0.171 | −0.186 | −0.263 | −0.231 | 0.157 | 0.004 | −0.020 | 0.073 | −0.139 | −0.195 | −0.027 | −0.080 | −0.255 | −0.120 | −0.101 | 0.657 | - | |||
MMQ Emotional dyscontrol | 23 | 0.131 | −0.053 | −0.4 | −0.382 | −0.293 | −0.433 | −0.334 | −0.427 | −0.46 | 0.382 | 0.096 | −0.066 | −0.083 | −0.165 | 0.070 | −0.031 | −0.111 | −0.331 | 0.054 | −0.196 | 0.577 | 0.381 | - | ||
MMQ Total | 24 | 0.080 | −0.054 | −0.278 | −0.153 | −0.324 | −0.269 | −0.248 | −0.224 | −0.286 | 0.343 | 0.602 | 0.425 | 0.527 | 0.316 | 0.379 | 0.611 | 0.729 | 0.696 | 0.732 | 0.695 | 0.28 | 0.241 | 0.234 | - | |
GASS Total | 25 | −0.096 | 0.040 | 0.413 | 0.456 | 0.222 | 0.425 | 0.438 | 0.562 | 0.578 | −0.398 | −0.291 | −0.025 | −0.081 | 0.086 | −0.079 | −0.203 | −0.036 | 0.154 | −0.152 | 0.078 | −0.395 | −0.315 | −0.393 | −0.182 | - |
RAS Self Trust | RAS Help | RAS Success | RAS Other Trust | RAS Not Overwhelmed | RAS Total | |||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
Model Adjusted-R2 | 0.482 | 0.209 | 0.281 | 0.146 | 0.167 | 0.447 | ||||||
Model ANOVA p-value | >0.001 | 0.005 | >0.001 | 0.029 | 0.017 | <0.001 | ||||||
β | t | β | t | β | t | β | t | β | t | β | t | |
(Constant) | 0.851 | 2.137 | 0.336 | 0.175 | 0.317 | 0.943 | ||||||
Age | 0.108 | 0.937 | −0.097 | −0.68 | −0.034 | −0.251 | 0.12 | 0.812 | 0.2 | 1.372 | 0.11 | 0.928 |
Gender | 0.164 | 1.947 | 0.169 | 1.625 | −0.018 | −0.179 | 0.191 | 1.763 | 0.195 | 1.823 | 0.143 | 1.642 |
Education | −0.049 | −0.524 | 0.084 | 0.727 | 0.155 | 1.399 | 0.044 | 0.362 | −0.121 | −1.015 | 0.038 | 0.393 |
Marital Status | −0.134 | −1.404 | −0.162 | −1.372 | 0.002 | 0.02 | −0.007 | −0.059 | −0.032 | −0.267 | −0.09 | −0.918 |
Children | −0.002 | −0.017 | 0.117 | 0.946 | 0.125 | 1.055 | 0.001 | 0.011 | −0.024 | −0.187 | 0.064 | 0.616 |
Work | 0.123 | 1.325 | 0.163 | 1.414 | 0.13 | 1.185 | 0.136 | 1.137 | 0.179 | 1.517 | 0.176 | 1.829 |
Illness Duration | −0.241 | −2.21 | −0.034 | −0.249 | −0.02 | −0.158 | −0.082 | −0.586 | −0.316 | −2.284 | −0.193 | −1.708 |
Hospitalizations | 0.146 | 1.598 | 0.074 | 0.651 | 0.181 | 1.681 | 0.118 | 1.007 | 0.058 | 0.496 | 0.154 | 1.627 |
WHODAS Total | 0.007 | 0.065 | −0.035 | −0.274 | 0.027 | 0.222 | 0.286 | 2.149 | −0.018 | −0.141 | 0.076 | 0.713 |
EQ-5D-5L-VAS | 0.156 | 1.493 | 0.058 | 0.448 | 0.026 | 0.215 | 0.016 | 0.116 | −0.164 | −1.235 | 0.051 | 0.469 |
IOS Total | 0.286 | 2.232 | 0.397 | 2.512 | 0.151 | 1.005 | 0.255 | 1.552 | 0.17 | 1.046 | 0.35 | 2.646 |
MMQ Total | 0.307 | 2.157 | 0.063 | 0.357 | 0.395 | 2.359 | 0.18 | 0.987 | 0.317 | 1.757 | 0.305 | 2.074 |
GASS Total | −0.058 | −0.554 | 0.12 | 0.931 | −0.001 | −0.008 | 0.008 | 0.063 | 0.019 | 0.142 | −0.019 | −0.176 |
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Concerto, C.; Rodolico, A.; Mineo, L.; Ciancio, A.; Marano, L.; Romano, C.B.; Scavo, E.V.; Spigarelli, R.; Fusar-Poli, L.; Furnari, R.; et al. Exploring Personal Recovery in Schizophrenia: The Role of Mentalization. J. Clin. Med. 2023, 12, 4090. https://doi.org/10.3390/jcm12124090
Concerto C, Rodolico A, Mineo L, Ciancio A, Marano L, Romano CB, Scavo EV, Spigarelli R, Fusar-Poli L, Furnari R, et al. Exploring Personal Recovery in Schizophrenia: The Role of Mentalization. Journal of Clinical Medicine. 2023; 12(12):4090. https://doi.org/10.3390/jcm12124090
Chicago/Turabian StyleConcerto, Carmen, Alessandro Rodolico, Ludovico Mineo, Alessia Ciancio, Leonardo Marano, Carla Benedicta Romano, Elisa Vita Scavo, Riccardo Spigarelli, Laura Fusar-Poli, Rosaria Furnari, and et al. 2023. "Exploring Personal Recovery in Schizophrenia: The Role of Mentalization" Journal of Clinical Medicine 12, no. 12: 4090. https://doi.org/10.3390/jcm12124090