27th National Clinical Education Symposium Presentation Abstracts

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28 APRIL 2025, MONDAY
14:00 - 15:15 ORAL PRESENTATION SESSION – 2

Examining the effect of mentalization on somatization in borderline personality disorder

Osman Demirci1, Bayram Mert Savrun2

1. Department of Psychiatry, Kafkas University, Faculty of Medicine, Kars, Türkiye
2. Department of Psychiatry, Istanbul University-Cerrahpasa, Cerrahpasa Faculty of Medicine, Istanbul, Türkiye

DOI: 10.5080/kes27.abs10 Page 30

BACKGROUND AND AIM:Somatization can be frequently observed in patients with borderline personality disorder(BPD). BPD also presents with disruptions in the self and other dimensions of mentalization capacity. The aim of this study was to examine the effect of self- and other-mentalizing on somatization tendency in BPD where attachment insecurity is high.
METHODS (Ethics Committee Approval must be obtained and the number should be specified.):164 individuals (82 BPD patients, 82 healthy controls) participated in our study between August 2023 and March 2024. Somatization Scale(SS), Experiences in Close Relationships-Revised, clarity of feelings subscale(CF) of Trait Meta-Mood Scale, Reading the Mind in the Eyes Test(RMET) were used to assess somatization, dimensions of attachment insecurity, self-mentalizing, and other-mentalizing, respectively. Model 15 in the PROCESS v4.2 macro added to the SPSS v26.0 was used in the moderated mediation analysis. The study was approved by the Istanbul University–Cerrahpasa Clinical Research Ethics Committee(No:743969).
RESULTS:The significant positive effect of attachment anxiety(AA) on SS (B=1.500, SE=0.603, t=2.487, 95% CI=[0.308, 2.692], p=0.014) disappears due to moderation of BPD (t=-.032, p=0.974). The significant negative relationship between CF and SS (B=-0.264, SE=0.079, t=-3.361, 95% CI=[-0.419, -0.109], p=0.001) is not moderated by BPD. The nonsignificant relationship between RMET and SS (t=0.609, p=0.543) becomes a significant negative relationship in moderation of BPD (B=-0.493, SE=0.200, t=-2.471, 95% CI[-0.887, -0.099], p=0.015). The indirect effect of AA on somatization through CF is independent of BPD and is not moderated (B=-0.102, SE=0.333, 95% CI=[-0.765, 0.568]). The indirect effect of AA on somatization through RMET becomes significant in moderation of BPD (B=0.253, SE=0.153, 95% CI=[0.013, 0.605]).
CONCLUSIONS:Our findings show that deficiencies in self- and other-mentalizing mediate increased somatization associated with attachment anxiety in BPD patients, whereas only self-mentalizing mediates this in healthy controls. Identity diffusion, impairments in self-other distinction and in the sense of self-agency/ownership, which are associated with disruptions in self- and other-mentalizing, may lead to increased somatization in BPD patients.