Mentalization and psychosis

Citation for published version (APA):

Weijers, J. (2020). Mentalization and psychosis: trying to understand the un-understandable. Ridderprint. https://doi.org/10.26481/dis.20201208jw

Document status and date: Published: 01/01/2020

DOI: 10.26481/dis.20201208jw

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Download date: 02 Oct. 2021

Mentalization and psychosis  Trying to understand the “un-understandable”

Jonas Gijs Weijers

  

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                   Mentalization and Psychosis: trying to understand the “un-understandable”

‘ƒ• ‹Œ•‡‹Œ‡”• Š‹••‡”–ƒ–‹‘



ͻ͹ͺǦͻͶǦ͸Ͷͳ͸ǦʹͳͷǦͺ

 ̹‘’›”‹‰Š– ‘ƒ• ‹Œ•‡‹Œ‡”•ǡʹͲʹͲǡ–Š‡‡–Š‡”Žƒ†• ŽŽ”‹‰Š–•”‡•‡”˜‡†Ǥ‘’ƒ”–‘ˆ–Š‹•–Š‡•‹•ƒ›„‡”‡’”‘†— ‡†‘”–”ƒ•‹––‡†‹ƒ›ˆ‘”‘”„›ƒ› ‡ƒ•ǡ™‹–Š‘—––Š‡™”‹––‡’‡”‹••‹‘‘ˆ–Š‡ƒ—–Š‘”Ǥ ‘˜‡”†‡•‹‰„›Œ‘‡”†‡–‹‰ Š‘–‘‰”ƒ’Š›„› ‡”‘‡‡”‡†• ”‹–ǣ‹††‡”’”‹–ȁ™™™Ǥ”‹††‡”’”‹–ǤŽ

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Mentalization and psychosis Trying to understand the “un-understandable”

        –‡”˜‡””‹Œ‰‹‰˜ƒ†‡‰”ƒƒ†˜ƒ†‘ –‘”ƒƒ†‡‹˜‡”•‹–‡‹–ƒƒ•–”‹ Š–ǡ ‘’‰‡œƒ‰˜ƒ†‡‡ –‘”ƒ‰‹ˆ‹ —•ǡ”‘ˆǤ†”Ǥ‹ƒ‡Ǥ‡–• Š‡”– ˜‘Ž‰‡•Š‡–„‡•Ž—‹–˜ƒŠ‡–‘ŽŽ‡‰‡˜ƒ‡ ƒ‡ǡ ‹Š‡–‘’‡„ƒƒ”–‡˜‡”†‡†‹‰‡ ‘’†‹•†ƒ‰ͺ†‡ ‡„‡”ʹͲʹͲ‘ͳͲǤͲͲ——”  †‘‘”  ‘ƒ• ‹Œ•‡‹Œ‡”• ‡„‘”‡‘’ͺƒ’”‹Žͳͻͺ͸–‡‹Œ‡‰‡ 

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Promotores

”‘ˆǤ”Ǥ ǤǦǤǤ Ǥ‡Ž–‡ ”‘ˆǤ”ǤǤ ǤǤ—”‡Ž‹‰•Ǧ‘–‡‘‡ȋ‹˜‡”•‹–‡‹–‡‹†‡Ȍ Copromotor  ”ǤǤǤ‹‡ Š–„ƒ—‡”  Beoordelingscommissie

 ”‘ˆǤ†”ǤǤǤ Ǥ—––‡ȋ‘‘”œ‹––‡”Ȍ ”ǤǤǤǤ ‡“—‡– ”‘ˆǤ†”ǤǤǤ Ǥ‹†‡ ”‘ˆǤ†”ǤǤ—›–‡ȋƒ–Š‘Ž‹‡‡‹˜‡”•‹–‡‹–‡—˜‡ǡ‡Ž‰‹´Ȍ ”‘ˆǤ†”ǤǤǤ—Ž†‡”ȋ”ƒ•—•‹˜‡”•‹–‡‹–‘––‡”†ƒȌ                  Š‡”‡•‡ƒ” Š’”‡•‡–‡†‹–Š‹•–Š‡•‹•™ƒ• ‘†— –‡†ƒ––Š‡ Š‘‘Ž‘ˆ‡–ƒŽ ‡ƒŽ–Šƒ† ‡—”‘• ‹‡ ‡ȋ ‡Ȍǡ‡’ƒ”–‡–‘ˆ•› Š‹ƒ–”›ƒ†‡—”‘’•› Š‘Ž‘‰›‘ˆƒƒ•–”‹ Š–‹˜‡”•‹–›ǡ ‹˜‹‡”†—‹‡ •–‹–—–‡ˆ‘”‡–ƒŽ ‡ƒŽ–Šƒ”‡ƒ†Ž–”‡ Š– •–‹–—–‡ˆ‘”‡–ƒŽ ‡ƒŽ–Šƒ”‡Ǥ

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Table of contents

 PART I Theoretical outline 7

Šƒ’–‡”‡ ‡‡”ƒŽ –”‘†— –‹‘ ͻ Šƒ’–‡”™‘ ‡–ƒŽ‹œƒ–‹‘ƒ†’•› Š‘•‹•ǣƒ”ƒ–‹‘ƒŽ‡ˆ‘”–Š‡—•‡‘ˆ‡–ƒŽ‹œƒ–‹‘ ʹͷ PART II –Š‡‘”›–‘—†‡”•–ƒ†ƒ†–”‡ƒ–‘Childhood abuse and psychosis Ǧƒˆˆ‡ –‹˜‡’•› Š‘–‹ †‹•‘”†‡” 47  Šƒ’–‡”Š”‡‡ ‡’‘”–‡† Š‹Ž†Š‘‘†ƒ„—•‡ƒ†•–”‡••”‡ƒ –‹˜‹–›‹’•› Š‘•‹•ǣƒ Ͷͻ ‘ ‡’–—ƒŽ”‡’Ž‹ ƒ–‹‘ƒ†ƒ‡š’Ž‘”ƒ–‹‘‘ˆ•–ƒ–‹•–‹ ƒŽƒ’’”‘ƒ Š‡• Šƒ’–‡” ‘—” Š‡”‡Žƒ–‹‘•Š‹’„‡–™‡‡ Š‹Ž†Š‘‘†ƒ„—•‡ƒ†•‡˜‡”‹–›‘ˆ’•› Š‘•‹• ͸ͻ ‹•‡†‹ƒ–‡†„›Ž‘‡Ž‹‡••ǣƒ‡š’‡”‹‡ ‡•ƒ’Ž‹‰•–—†› Šƒ’–‡” ‹˜‡ ‡–ƒŽ‹œ‹‰‹’ƒ‹”‡–ƒ•ƒ‡†‹ƒ–‘”„‡–™‡‡”‡’‘”–‡† Š‹Ž†Š‘‘† ͺ͹ PART III ƒ„—•‡ƒ†‘—– ‘‡‹‘ƒˆˆ‡ –‹˜‡’•› Š‘–‹ †‹•‘”†‡”Mentalization based treatment for psychotic disorder 107  Šƒ’–‡”•‹š ‡–ƒŽ‹œƒ–‹‘Ǧ„ƒ•‡†–”‡ƒ–‡–ˆ‘”’•› Š‘–‹ †‹•‘”†‡”ǣ’”‘–‘ ‘Ž‘ˆƒ ͳͲͻ ”ƒ†‘‹œ‡† ‘–”‘ŽŽ‡†–”‹ƒŽ Šƒ’–‡”•‡˜‡ ‡–ƒŽ‹œƒ–‹‘„ƒ•‡†–”‡ƒ–‡–ˆ‘”’•› Š‘–‹ †‹•‘”†‡”ǣƒ”ƒ–‡” Ǧ ͳ͵͵ PART IV „Ž‹†‡†ǡ—Ž–‹Conclusion Ǧ ‡–‡”ǡ”ƒ†‘‹œ‡† ‘–”‘ŽŽ‡†–”‹ƒŽǤ 157  Šƒ’–‡”‹‰Š– —ƒ”›ƒ†Addendum ‰‡‡”ƒŽ†‹• —••‹‘ ͳͷͻ185   —ƒ”›‹—– Š ͳͺ͸  ƒŽ‘”‹œƒ–‹‘ ʹͳʹ  ‹•–‘ˆ’—„Ž‹ ƒ–‹‘•ƒ†‹˜‹–‡†Ž‡ –—”‡• ʹͳ͸   ‘™Ž‡†‰‡‡–• ʹͳͺ —””‹ —Ž—‹–ƒ‡ ʹʹ͵ 

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PART I:

Š‡‘”‡–‹ ƒŽ‘—–Ž‹‡ THEORETICAL

OUTLINE

Part I Part

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Chapter One:

‡‡”ƒŽ‹–”‘†— –‹‘ GENERAL INTRODUCTION

1

J.G. Weijers

Chapter Chapter

146807_JonasWeijers_BNW_def.indd 9 28-10-2020 15:08 Chapter One

Psychosis and non-affective psychotic disorder

Š‹•†‹••‡”–ƒ–‹‘‹•–Š‡”‡•—Ž–‘ˆƒ•‹šǦ›‡ƒ”Ž‘‰‡’‹”‹ ƒŽŒ‘—”‡›‡š’Ž‘”‹‰–Š‡’‘–‡–‹ƒŽ ‘–”‹„—–‹‘‘ˆ‡–ƒŽ‹œƒ–‹‘–Š‡‘”›–‘–Š‡Mentalization and—†‡”•–ƒ†‹‰ƒ†–”‡ƒ–‡–‘ˆ‘ psychosis: trying to understand the Ǧ“unˆˆ‡ –‹˜‡•› Š‘–‹ - ‹•‘”†‡”ȋunderstandable” ȌǤ –•–‹–Ž‡– –”ƒ–Š‡” Š‡‡‹Ž›”‡ˆ‡”•–‘–Š‹•Œ‘—”‡›ǡƒ•„‘–Š’•› Š‘•‹•ƒ†‡–ƒŽ‹œƒ–‹‘ƒ”‡ ‘’Ž‡š ‘ ‡’–•–Šƒ– ƒ„‡†‹ˆˆ‹ —Ž––‘‰”ƒ•’Ǥ . •› Š‘•‹•‹•ƒ•–ƒ–‡‘ˆ‹† Šƒ”ƒ –‡”‹œ‡†„›ƒŽ‘••‘ˆ ‘–ƒ –™‹–Š”‡ƒŽ‹–› ƒŽŽƒ”•‘ˆ ’•› Š‘•‹•ƒ”‡ –Š‡’”‡•‡ ‡‘ˆ‹†‹‘•› ”ƒ–‹ ǡ•‘‡–‹‡•†‡‘•–”ƒ„Ž›ˆƒŽ•‡‹–‡”’”‡–ƒ–‹‘•‘ˆ ”‡ƒŽ‹–›ǡ‹Ǥ‡Ǥ†‡Ž—•‹‘•ǡƒ†–Š‡’‡” ‡’–‹‘‘ˆ–Š‹‰•–Šƒ–ƒ”‡‘–”‡ƒŽŽ›’”‡•‡–ǡ‹Ǥ‡ǤŠƒŽŽ— ‹ƒ–‹‘•ǤŠ‡ term ‘unǦunderstandability’ was first introduced in 1910 by psychiatrist and philosopher Karl ƒ•’‡”•ƒ•ƒ™ƒ›–‘†‹ˆˆ‡”‡–‹ƒ–‡†‡Ž—•‹‘ǦŽ‹‡‹†‡ƒ•–Šƒ–ƒ”‡ ‘‘–‘ƒ›’•› Š‹ƒ–”‹ †‹•‘”†‡”• ˆ”‘–”—Ž›’•› Š‘–‹ †‡Ž—•‹‘•Ǥ ‘”†‹‰–‘ ƒ•’‡”•ǡ†‡Ž—•‹‘ǦŽ‹‡‹†‡ƒ• ƒ„‡—†‡”•–‘‘†„› others “rationally or emotionally as arising from the situation of the patient and due to the situation and his emotions” (Fish Ƭ ƒ‹Ž–‘ǡͳͻͺͶȌǤ–Š‡‘–Š‡”Šƒ†ǡ–”—‡†‡Ž—•‹‘•ƒ”‹•‡ˆ”‘’”‹ƒ”› †‡Ž—•‹‘ƒŽ‡š’‡”‹‡ ‡ȋ ‹•ŠƬ ƒ‹Ž–‘ǡͳͻͺͶȌǦwhat today would be referred to as ‘aberrant experience’ –‹™Š‹ Šƒ„‘”ƒŽ•‹‰‹ˆ‹ ƒ ‡‹•ƒ––”‹„—–‡†–‘‘”ƒŽ’‡” ‡’–‹‘ǤŠ‡”‡ˆ‘”‡ ƒ ‘”†‹‰–‘ ƒ•’‡”•ǡƒ––Š‡‹” ‘”‡ǡ’•› Š‘–‹ †‡Ž—•‹‘•”‡ƒ‹‹ ‘’”‡Š‡•‹„Ž‡‹–‡”•‘ˆƒ ‘”ƒŽ‡–ƒŽ’”‘ ‡••Ǥ „‘—–͸Ψ‘ˆ–Š‡‰‡‡”ƒŽ’‘’—Žƒ–‹‘Šƒ•’•› Š‘–‹ ǦŽ‹‡‡š’‡”‹‡ ‡•ƒ–•‘‡’‘‹–‹–Š‡‹” Ž‹˜‡•ǡƒŽ–Š‘—‰Š–Š‡•‡†‘‘–‡ ‡••ƒ”‹Ž›†‹•”—’–Ž‹ˆ‡•‡˜‡”‡Ž›Ǥ ‘™‡˜‡”ǡƒ’•› Š‘–‹ †‹•‘”†‡”ǡ™Š‹ Š ‹•„›†‡ˆ‹‹–‹‘’ƒ–Š‘Ž‘‰‹ ƒŽǡ–‡†•–‘•‡˜‡”‡Ž›‹˜ƒŽ‹†ƒ–‡–Š‡’ƒ–‹‡–Ǥ•› Š‘–‹ †‹•‘”†‡”• ‘’”‹•‡ ƒ ‘„‹ƒ–‹‘‘ˆˆ‹˜‡ˆ‡ƒ–—”‡•ƒ ‘”†‹‰–‘–Š‡Ǧͷȋ‡”‹ ƒ•› Š‹ƒ–”‹ ••‘ ‹ƒ–‹‘ǡʹͲͳ͵Ȍǡ ‹ Ž—†‹‰ǣ†‡Ž—•‹‘•ǡŠƒŽŽ— ‹ƒ–‹‘•ǡ†‹•‘”‰ƒ‹œ‡†–Š‹‹‰ƒ†•’‡‡ Šȋ–Š‡•‡ƒ”‡‘ˆ–‡”‡ˆ‡””‡†–‘ as ‘positive symptoms’), grossly disorganized or abnormal motor behavior, and negative symptoms, •— Šƒ•ƒ˜‘Ž‹–‹‘‘”ˆŽƒ––‡‡†ƒˆˆ‡ –‹˜‡‡š’”‡••‹‘Ǥ‹–Š‹–Š‡•’‡ –”—‘ˆ’•› Š‘–‹ †‹•‘”†‡”•ǡ Ž‹‹ ‹ƒ•–‡†–‘†‹ˆˆ‡”‡–‹ƒ–‡„‡–™‡‡ƒˆˆ‡ –‹˜‡’•› Š‘•‡•ǡ™Š‹ Š•‘Ž‡Ž›‘ —”‹–Š‡ ‘–‡š–‘ˆ manic or depressive episodes, and the so called ‘nonǦaffective psychotic disorders’ (Ȍǡ–Šƒ–†‘ ‘–‡ ‡••ƒ”‹Ž› ‘Ǧ‘ —”™‹–Š‡’‹•‘†‡•‘ˆƒˆˆ‡ –‹˜‡†›•”‡‰—Žƒ–‹‘ǤŠ‡—„”‡ŽŽƒ–‡”‹ Ž—†‡• –Š‡Ǧͷ ƒ–‡‰‘”‹‡•• Š‹œ‘’Š”‡‹ƒǡ• Š‹œ‘ƒˆˆ‡ –‹˜‡†‹•‘”†‡”ǡ„”‹‡ˆ’•› Š‘–‹ †‹•‘”†‡”ǡ†‡Ž—•‹‘ƒŽ †‹•‘”†‡”ǡ• Š‹œ‘’Š”‡‹ˆ‘”†‹•‘”†‡”ǡƒ†—•’‡ ‹ˆ‹‡†• Š‹œ‘’Š”‡‹ƒ•’‡ –”—ƒ†‘–Š‡”’•› Š‘–‹  †‹•‘”†‡”ǤŠ‹•–Š‡•‹••‘Ž‡Ž›ˆ‘ —•‡•‘Ǥ 

10

146807_JonasWeijers_BNW_def.indd 10 28-10-2020 15:08 General Introduction

Social functioning and social cognition in NAPD

‡š––‘–Š‡ Ž‹‹ ƒŽ•›’–‘•†‡• ”‹„‡†ƒ„‘˜‡ǡ–‡†•–‘‹˜‘Ž˜‡ƒ•‹‰‹ˆ‹ ƒ–†‡ Ž‹‡‹•‘ ‹ƒŽ ˆ— –‹‘‹‰ǡ™Š‹ Š‹ Ž—†‡•†‹ˆˆ‹ —Ž–‹‡•‹•‡ŽˆǦ ƒ”‡ǡ‹†‡’‡†‡–Ž‹˜‹‰ǡƒ†–Š‡ƒ‹–‡ƒ ‡‘ˆ ”‡Žƒ–‹‘•Š‹’•ƒ†‡’Ž‘›‡–Ǥƒ†Ž›ǡ™Š‡”‡ƒ•–Š‡’ƒ•– ‡–—”›Šƒ••‡‡–Š‡†‡˜‡Ž‘’‡–‘ˆ ‡ˆˆ‡ –‹˜‡‡†‹ ƒ–‹‘–‘–”‡ƒ––Š‡’‘•‹–‹˜‡•›’–‘•‘ˆ’•› Š‘–‹ †‹•‘”†‡”•ǡ–Š‡”‡Šƒ•„‡‡ ”‡ƒ”ƒ„Ž›Ž‹––Ž‡‹’”‘˜‡‡–‹–Š‡–”‡ƒ–‡–‘ˆ‘˜‡”ƒŽŽ•‘ ‹ƒŽˆ— –‹‘‹‰‘ˆ’ƒ–‹‡–•™‹–Š 1 ’•› Š‘–‹ †‹•‘”†‡”ȋ ”‡‡ǡ ‘”ƒƬ‡‡ǡʹͲͳͷȌǤ Š‡ ƒ—•‡•‘ˆ’‘‘”•‘ ‹ƒŽˆ— –‹‘‹‰ƒ”‡‹ ‘’Ž‡–‡Ž›—†‡”•–‘‘†ǡ„—–•‘ ‹ƒŽ ‘‰‹–‹˜‡ †‡ˆ‹ ‹–•Šƒ˜‡„‡‡‹†‡–‹ˆ‹‡†ƒ•ƒ‹’‘”–ƒ– ‘–”‹„—–‘”ȋ ‡––ǡ‹‡ Š–„ƒ—‡”ǡ‡ǡ˜ƒ•ǡƬ ”ƒ„„‡†ƒǡ2011). Social cognition is the multifaceted domain of “the mental processes —†‡”Ž›‹‰•‘ ‹ƒŽ‹–‡”ƒ –‹‘ns” (Fett et al., 2011). It entails the capacity to perceive, interpret, and ƒ†‡“—ƒ–‡Ž›”‡ƒ ––‘•‘ ‹ƒŽ‹–‡”ƒ –‹‘•ȋ‹ƒ‰‰‹‘Ƭ›•ƒ‡”ǡʹͲͳͶȌǤŽƒ”‰‡„‘†›‘ˆ‡˜‹†‡ ‡‘™ •Š‘™•–Šƒ–‹• Šƒ”ƒ –‡”‹œ‡†„›ƒ”ƒ‰‡‘ˆ•‘ ‹ƒŽ ‘‰‹–‹˜‡†‡ˆ‹ ‹–•Ǥ•ƒ”‡•—Ž–ǡ‹–‡”‡•–‹–Š‡ ‡Šƒ ‡‡–‘ˆ•‘ ‹ƒŽ ‘‰‹–‹‘ƒ•ƒ–”‡ƒ–‡––ƒ”‰‡–Šƒ•‹ ”‡ƒ•‡†ǡƒ†–Š‡’ƒ•–†‡ ƒ†‡Šƒ••‡‡ –Š‡†‡˜‡Ž‘’‡–‘ˆ•‡˜‡”ƒŽ–”‡ƒ–‡–•–ƒ”‰‡–‹‰•‘ ‹ƒŽ ‘‰‹–‹‘ȋ‡‡ƒƒǡ‘Žƒ‹ –‘”Ƭƒ”–‹Ǧ ‘ƒ›ǡʹͲͳ͹ˆ‘”ƒ‘˜‡”˜‹‡™ȌǤ ‘™‡˜‡”ǡ‹••—‡•”‡ƒ‹”‡‰ƒ”†‹‰•‘ ‹ƒŽ ‘‰‹–‹‘ƒ†‹–••–ƒ–—•ƒ•ƒ–”‡ƒ–‡––ƒ”‰‡–Ǥ ‘ ‹ƒŽ ‘‰‹–‹‘ƒ•ƒ ‘•–”— –Žƒ ••’‡ ‹ˆ‹ ‹–›ǡ„‘–Šˆ‘” Ž‹‹ ƒŽƒ†ƒ ƒ†‡‹ ’—”’‘•‡•Ǥ ††‹–‹‘ƒŽŽ›ǡ–Š‡”‡‹•‘‰‡‡”ƒŽ ‘•‡•—•‘Š‘™–‘„‡•–‡ƒ•—”‡–Š‡˜ƒ”‹‘—•ƒ•’‡ –•‘ˆ•‘ ‹ƒŽ ‘‰‹–‹‘Ǥ‡Ž‘™™‡™‹ŽŽ†‹• —••Š‘™‡–ƒŽ‹œƒ–‹‘–Š‡‘”› ‘‡•–‘†‡ˆ‹‡•‘ ‹ƒŽ ‘‰‹–‹‘ƒ†™‹ŽŽ Š‹‰ŠŽ‹‰Š––Š‡”‘Ž‡‘ˆ Š‹Ž†Š‘‘†ƒ„—•‡‹‡–ƒŽ‹œ‹‰ƒ†’•› Š‘•‹•Ǥ —”–Š‡”‘”‡ǡ™‡™‹ŽŽ†‹• —•• Š‘™‡–ƒŽ‹œƒ–‹‘‹•‘’‡”ƒ–‹‘ƒŽ‹œ‡†ˆ‘”‡ƒ•—”‡‡–ƒ†™‹ŽŽ’”‘˜‹†‡ƒ•Š‘”–‹–”‘†— –‹‘‘ˆ ‡–ƒŽ‹œƒ–‹‘„ƒ•‡†–”‡ƒ–‡–Ǥ Social cognition according to mentalization theory

–Š‡Žƒ•––Š”‡‡†‡ ƒ†‡•ǡ‡–‡” ‘ƒ‰›ƒ† ‘ŽŽ‡ƒ‰—‡•Šƒ˜‡’‘’—Žƒ”‹œ‡†‡–ƒŽ‹œƒ–‹‘–Š‡‘”›ƒ•ƒ ˆ”ƒ‡™‘”–‘—†‡”•–ƒ†Š‘™Š—ƒ•ƒ‡•‡•‡‘ˆ–Š‡•‡Ž˜‡•ƒ†‘–Š‡”•Ǥ‡–ƒŽ‹œ‹‰”‡ˆ‡”•–‘ –Š‡‹ƒ‰‹ƒ–‹˜‡’”‘ ‡••–Š”‘—‰Š™Š‹ Šƒ‹†‹˜‹†—ƒŽ‹–‡”’”‡–•„‡Šƒ˜‹‘”‘ˆŠ‹•‡Žˆƒ†‘–Š‡”•‹ –‡”•‘ˆ‹–‡–‹‘ƒŽ‡–ƒŽ•–ƒ–‡••— Šƒ•†‡•‹”‡•ǡ‡‡†•ǡˆ‡‡Ž‹‰•ǡƒ†„‡Ž‹‡ˆ•Ǥ‡–ƒŽ‹œ‹‰ƒŽŽ‘™•—• to “put ourselves in another situation and feel ourselves into another’s shoes” (Fish Ƭ ƒ‹Ž–‘ǡ ͳͻͺͶȌǤ Š‡ ‘•–”— –‘ˆ‡–ƒŽ‹œƒ–‹‘‹‹–• —””‡–—•ƒ‰‡™ƒ•–Š‡”‡•—Ž–‘ˆƒ ‘„‹ƒ–‹‘‘ˆ–Š‡mentalisation French psychoanalytic term ‘ ’ and the empirical term ‘theory of mind’, which relates to

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146807_JonasWeijers_BNW_def.indd 11 28-10-2020 15:08 Chapter One

–Š‡ƒ„‹Ž‹–›–‘‹ˆ‡”–Š‡‡–ƒŽ•–ƒ–‡•‘ˆ‘–Š‡”•ȋ•‡‡‹ƒ‰‰‹‘Ƭ›•ƒ‡”ǡʹͲͳͶȌǤ‘–‡’‘”ƒ”›•‘ ‹ƒŽ ‘‰‹–‹˜‡”‡•‡ƒ” Š–‡†•–‘ ‘ˆŽƒ–‡–Š‡•‡–‡”•ǡ„—–•— Š ‘ˆŽƒ–‹‘”‡˜‡ƒŽ•ƒŽƒ ‘ˆ—†‡”•–ƒ†‹‰ of the concept’s theoretical underpinnings,mentalisation while also diminishing its conceptual depth and clinical —•‡ˆ—Ž‡••ǤŠ‡ ”‡ Š–‡” ‹‹–‹ƒŽŽ›‡š Ž—•‹˜‡Ž›”‡ˆ‡””‡†–‘–Š‡ ƒ’ƒ ‹–›–‘–”ƒ•ˆ‘” •‡•‘”›Ǧƒˆˆ‡ –‹˜‡‡š’‡”‹‡ ‡‹–‘‘”‰ƒ‹œ‡†‹†‡ƒ•–Šƒ– ‘—Ž†„‡ƒ†ƒ’–‡†ǡ”‡ˆŽ‡ –‡†—’‘ǡƒ†mentalisation ‘—‹ ƒ–‡†Ǥ ‘–Š‡”™‘”†•ǡ used to mean ‘to make mental’ or ‘to sym„‘Ž‹œ‡’ (see ‡ ‘—”•Ƭ‘— Šƒ”†ǡͳͻͻ͹). As such, “understandability” also applies to the activity of mentalizing, meaning ‘to understandmentalisation that which has not yet been understood’. ‘™‡˜‡”ǡ ‘ƒ‰›ȋͳͻͻͳȌ‰ƒ˜‡ƒ •‡ ‘†ƒ”›‡ƒ‹‰–‘ „›ƒ”‰—‹‰–Šƒ––Š‡’”‘ ‡••–Š”‘—‰Š™Š‹ Š™‡ ‘‡–‘ —†‡”•–ƒ†‘—”‘™‡–ƒŽ•–ƒ–‡•ǡ‹••‹‹Žƒ”–‘–Š‡’”‘ ‡••–Š”‘—‰Š™Š‹ Š™‡ ‘‡–‘—†‡”•–ƒ† –Š‡‡–ƒŽ•–ƒ–‡•‘ˆ‘–Š‡”•Ǥ ‡ƒ”‰—‡†–Šƒ––Š”‘—‰Š•›„‘Ž‹œƒ–‹‘‘ˆ‘—”‘™•‡•‘”›Ǧƒˆˆ‡ –‹˜‡ ‡š’‡”‹‡ ‡™‡†‡˜‡Ž‘’ƒ‹ ”‡ƒ•‹‰Ž› ‘’Ž‡šǡ ‘• ‹‘—•Ž›ƒ ‡••‹„Ž‡‘†‡Ž‘ˆ‘—”‘™‡–ƒŽ •–ƒ–‡•–ƒ–Š‡‘”›‘ˆ‹†–™Š‹ Š–Š‡ ƒ„‡ƒ’’Ž‹‡†–‘‘–Š‡”•ƒ•™‡ŽŽǤ for ‡ƒŽ•‘ƒ”‰—‡†–Šƒ–ǡ‡•’‡ ‹ƒŽŽ›‹ Š‹Ž†Š‘‘†ǡ•›„‘Ž‹œƒ–‹‘‹•†‘‡ —•Ǥ‡–”ƒŽ–‘ ‡–ƒŽ‹œƒ–‹‘–Š‡‘”›‹•–Š‡‘–‹‘–Šƒ–‡–ƒŽ‹œƒ–‹‘‹•ƒ†‡˜‡Ž‘’‡–ƒŽƒ Š‹‡˜‡‡–ǡ„‡•– ‡•–ƒ„Ž‹•Š‡†‹ƒ•‡ —”‡ƒ––ƒ Š‡–”‡Žƒ–‹‘•Š‹’–‘ ƒ”‡‰‹˜‡”•Ǥ ‹ˆƒ ›ǡ™Š‡–Š‡ ƒ’ƒ ‹–›–‘ ‡–ƒŽ‹œ‡‹••–‹ŽŽƒ„•‡–ǡ™‡”‡Ž›‘‘—” ƒ”‡‰‹˜‡”•–‘’”‘˜‹†‡‡ƒ‹‰–‘‘—”›‡––‘„‡—†‡”•–‘‘†ǡ ˜‹• ‡”ƒŽ‡š’‡”‹‡ ‡•Ǥ •‡ —”‡”‡Žƒ–‹‘•Š‹’•ǡ ƒ”‡‰‹˜‡”•–‡†–‘’”‘˜‹†‡•— Š‡ƒ‹‰–Š”‘—‰Š responsive, sensitive and slightly exaggerated or ‘marked’ feedback to the infant’s sensoryǦƒˆˆ‡ –‹˜‡ ‡š’‡”‹‡ ‡•ǡ•‘‡–‹‡•”‡ˆ‡””‡†–‘ƒ•‘motherese’ (see chapter 2). Providing feedback that accurately reflects the child’s sensoryǦƒˆˆ‡ –‹˜‡‡š’‡”‹‡ ‡ǡƒŽŽ‘™•–Š‡ Š‹Ž†–‘‹†‡–‹ˆ›‹–•ˆ‡‡Ž‹‰•Ǥ ††‹–‹‘ƒŽŽ›ǡ™Š‡–Š‡ˆ‡‡†„ƒ ‹•ƒ”‡†ǡ–Š‡ Š‹Ž† ƒ ‘‡–‘—†‡”•–ƒ†–Šƒ––Š‡†‡• ”‹’–‹‘• —•‡†„›–Š‡ ƒ”‡‰‹˜‡”•†‘‘–ƒ’’Ž›–‘–Š‡‹”ˆ‡‡Ž‹‰•–ƒ–‡•ǡ„—–”ƒ–Š‡”–‘‹–•‘™ˆ‡‡Ž‹‰•–ƒ–‡•ǤŠ‹• allows the child to come into contact with another’s view of its inner experiences, which constitutes –Š‡ ‘”‡”•–‘‡‘ˆ‡–ƒŽ‹œ‹‰Ǥ —”–Š‡”‘”‡ǡ•‡ —”‹–›‹‡ƒ”Ž›ƒ––ƒ Š‡–”‡Žƒ–‹‘•Š‹’•‹•–Š‘—‰Š––‘ ‘–”‹„—–‡–‘ ‡–ƒŽ‹œ‹‰ǡƒ•‹–’”‘‘–‡•–Š‡ƒ„‹Ž‹–›–‘ ‘Ǧ”‡‰—Žƒ–‡‡‘–‹‘•ȋ›‘•Ǧ—–Šǡ‡ŽŽ‹ǡ‡Ž‹ ǡƬ –™‘‘†ǡʹͲͲ͵ȌǤƒ•‡†‘–Š‡“—ƒŽ‹–›‘ˆ‡ƒ”Ž›ƒ––ƒ Š‡–‹–‡”ƒ –‹‘•ǡ Š‹Ž†”‡ ‘‡–‘†‡˜‡Ž‘’ ‡š’‡ –ƒ–‹‘•‘ˆ”‡Žƒ–‹‘•Š‹’•Ǣ™Š‡–Š‡”‘”‘–‘–Š‡”• ƒ„‡–”—•–‡†–‘Š‡Ž’ ‘Ǧ”‡‰—Žƒ–‡ƒˆˆ‡ –ǡ‹Ǥ‡Ǥ–‘ ‘ˆˆ‡” ‘•‘Žƒ–‹‘ǡƒ†™Š‡–Š‡”‘”‘––Š‡•‡Žˆ‹•™‘”–Š›‘ˆ•— Š ‘•‘Žƒ–‹‘Ǥ— Š‡š’‡ –ƒ–‹‘•‹ –—”ƒ”‡–Š‘—‰Š––‘†‡–‡”‹‡Š‘™‡‘–‹‘•ƒ”‡”‡‰—Žƒ–‡†ƒ†–Š‡“—ƒŽ‹–›‘ˆ•— Š”‡‰—Žƒ–‹‘ǡˆ‘” ‡šƒ’Ž‡„›•‡‡‹‰‘—– ‘•‘Žƒ–‹‘‘”•‘Ž‹–—†‡ȋ‡Ǥ‰Ǥǡ‡””›ǡƒ””‘™ Ž‘—‰ŠƬ‡ƒ”†‡ǡʹͲͲ͹ȌǤ

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146807_JonasWeijers_BNW_def.indd 12 28-10-2020 15:08 General Introduction

‘–‹‘”‡‰—Žƒ–‹‘‹–—”‹•‡›–‘ƒ†‡“—ƒ–‡‡–ƒŽ‹œ‹‰ǡƒ•–Š‡ƒ„‹Ž‹–›–‘‡–ƒŽ‹œ‡†‡–‡”‹‘”ƒ–‡• ™Š‡‡‘–‹‘ƒŽƒ” ‘—•ƒŽ„‡ ‘‡•–‘‘Š‹‰Šȋ ‘ƒ‰›Ƭƒ–‡ƒǡʹͲͲ͸Ǣ‘Ž–‡‡–ƒŽǤǡʹͲͳ͵ȌǤ Childhood abuse, mentalizing and psychosis

Š‹Ž†Š‘‘†ƒ„—•‡ǡ†‡ˆ‹‡†ƒ•–Š‡’Š›•‹ ƒŽǡ•‡š—ƒŽǡ‘”’•› Š‘Ž‘‰‹ ƒŽƒŽ–”‡ƒ–‡–‘”‡‰Ž‡ –‘ˆƒ Š‹Ž†ǡ‹•˜‹‡™‡†–‘„‡ƒ–‹–Š‡–‹ ƒŽ–‘–Š‡‡•–ƒ„Ž‹•Š‡–‘ˆƒ•‡ —”‡ƒ––ƒ Š‡–”‡Žƒ–‹‘•Š‹’ƒ† 1 –Š‡”‡ˆ‘”‡–Š‡†‡˜‡Ž‘’‡–‘ˆ‡–ƒŽ‹œ‹‰Ǥ –‘ˆ–‡‹˜‘Ž˜‡•Š‘•–‹Ž‡ǡ— ƒ”‹‰‘”‰”‘••Ž› inappropriate responses to a child’s affective states, which may communicate that such states are ‘–ƒ ‡’–ƒ„Ž‡‘”’‡”‹••‹„Ž‡Ǥ  •”‡Žƒ–‹˜‡Ž›™‡ŽŽˆ— –‹‘‹‰ƒ†—Ž–•‹–ƒ›„‡†‹ˆˆ‹ —Ž––‘—†‡”•–ƒ†–Šƒ–ƒ›‘‡™‘—Ž† ™ƒ––‘’‡”’‡–”ƒ–‡Šƒ”‘ Š‹Ž†”‡Ǥ –Š‹••‡•‡ǡ“unǦunderstandability” ‹•ƒŽ•‘ƒ’’Ž‹ ƒ„Ž‡–‘–Š‡ –‘’‹ ‘ˆ Š‹Ž†Š‘‘†ƒ„—•‡Ǥ‡–ǡ‡’‹”‹ ƒŽ”‡•‡ƒ” Š•—‰‰‡•–•–Šƒ–ƒŠ‹•–‘”›‘ˆ Š‹Ž†Š‘‘†ƒ„—•‡‹• ‘‘ƒ‘‰’ƒ–‹‡–•™‹–Šǡ™‹–Š‡•–‹ƒ–‡•”ƒ‰‹‰„‡–™‡‡Ͷ͹ǤͷΨȋŽ˜ƒ”‡œ‡–ƒŽǤǡʹͲͳͳȌ ƒ†ͺͷΨȋ—Š‹‰‡–ƒŽǤǡʹͲͳͷǢƒ”••‘‡–ƒŽǤǡʹͲͳ͵Ȍǡ‡š ‡‡†‹‰’”‡˜ƒŽ‡ ‡”ƒ–‡•‹–Š‡‰‡‡”ƒŽ ’‘’—Žƒ–‹‘ȋ‡Ǥ‰Ǥ’”‹‰‡”ǡŠ‡”‹†ƒǡ—‘Ƭƒ”‡•ǡʹͲͲ͹Ǣƒ ‹ŽŽƒǡƒƒƒǡ——ǡƒ‹ŽŽƒ ‘—”–ǡƬ ‘›Ž‡ǡʹͲͳ͵ȌǤ  Š‹Ž†Š‘‘†ƒ„—•‡‹•‹ ”‡ƒ•‹‰Ž›”‡ ‘‰‹œ‡†ƒ•ƒ‹’‘”–ƒ– ‘–”‹„—–‹‰ˆƒ –‘”–‘’•› Š‘•‹• ȋƒ”‡•‡‡–ƒŽǤǡʹͲͳʹȌǤŽ–Š‘—‰Š–Š‡˜‡”ƒ ‹–›‘ˆ•‡ŽˆǦ”‡’‘”–‡†ƒ ‘—–•‘ˆ Š‹Ž†Š‘‘†ƒ„—•‡„› ’•› Š‘–‹ ’ƒ–‹‡–•Šƒ•„‡‡“—‡•–‹‘‡†ȋ—••‡”Ƭ‹†‘ǡʹͲͳʹȌǡ•‡˜‡”ƒŽ’”‘•’‡ –‹˜‡•–—†‹‡•Šƒ˜‡ ‘˜‹ ‹‰Ž›•Š‘™–Šƒ– Š‹Ž†”‡™Š‘™‡”‡ƒ„—•‡†ǡ™‡”‡ƒ–‰”‡ƒ–‡””‹•‘ˆ†‡˜‡Ž‘’‹‰’•› Š‘•‹• Žƒ–‡”‹Ž‹ˆ‡ȋ—–ƒŒƒ”‡–ƒŽǤǡʹͲͳͲǢ‡ Š†‘Žˆ‡–ƒŽǤǡʹͲͳͲǡ”•‡‡ƒ—Ž–‡–ƒŽǤǡʹͲͳͳǢ‡ŽŽ‡Š‡”‡–ƒŽǤǡʹͲͳ͵ȌǤ ††‹–‹‘ƒŽŽ› Š‹Ž†Š‘‘†ƒ„—•‡Šƒ•„‡‡•Š‘™–‘ ‘–”‹„—–‡–‘ƒƒ†˜‡”•‡‘—– ‘‡‘ˆǡ ’”‡†‹ –‹‰–Š‡•‡˜‡”‹–›‘ˆ’‘•‹–‹˜‡•›’–‘•ǡ‡‰ƒ–‹˜‡•›’–‘•ȋ‘‰†‡ǡƒ’•‘ǡǡƬ‡ƒ†ǡ ʹͲͳͷǢ Š‡‡Žǡ’ƒ—Ž†‹‰ǡ‹‹ŽŽ‘ǡ‹Ž˜‡”•–‡‹ǡȋʹͲͲͷȌǢ’ƒ—™‡ǡ”ƒ„„‡†ƒǡ‹‡„ǡ‹–– Š‡Ƭ ƒ•ǡʹͲͲ͸Ǣ˜ƒƒ‡–ƒŽǤǡʹͲͳͷȌƒ†•‘ ‹ƒŽ†›•ˆ— –‹‘‹ƒ†—Ž–Š‘‘†ȋŽƒ‡†ƒ‡–ƒŽǤǡʹͲͳͷǢ–ƒ‹ ‡–ƒŽǤǡʹͲͳ͵ȌǤŠ‡”‡‹• —””‡–Ž›ƒ™‹†‡ ‘•‡•—•–Šƒ– Š‹Ž†Š‘‘†ƒ„—•‡’Žƒ›••‘‡’ƒ”–‹’•› Š‘•‹• ȋ‡ƒ†ǡ˜ƒ•ǡ‘””‹•‘ǡƬ‘••ǡʹͲͲͷǢ ‘™‡•Ƭ—””ƒ›ǡʹͲͳͶȌǡƒŽ–Š‘—‰Š— Š”‡ƒ‹•— Ž‡ƒ” ƒ„‘—––Š‡™ƒ›‹™Š‹ Š‹– ‘–”‹„—–‡•–‘†‡˜‡Ž‘’‡–ƒ† ‘—”•‡‘ˆǤ  ‡Žƒ–‹˜‡Ž›ˆ‡™•–—†‹‡•Šƒ˜‡‡šƒ‹‡†–Š‡—†‡”Ž›‹‰‡ Šƒ‹••‘ˆ–Š‹•”‡Žƒ–‹‘•Š‹’ǡ„—– •‡˜‡”ƒŽŠ›’‘–Š‡•‡•Šƒ˜‡„‡‡’”‘’‘•‡†–Šƒ–•‡‡–‘ ‘˜‡”‰‡™‹–Š‡–ƒŽ‹œƒ–‹‘–Š‡‘”›Ǥ Š‹Ž†Š‘‘†ƒ„—•‡ƒ› ƒ—•‡ƒ•‡•‹–‹œƒ–‹‘‘ˆ”‡ƒ –‹˜‹–›–‘•–”‡••ˆ—Ž•‹–—ƒ–‹‘•ǡ‹Ǥ‡Ǥ’‘‘”‡‘–‹‘ ”‡‰—Žƒ–‹‘ǡ–Šƒ–ƒ› ‘–”‹„—–‡–‘’•›• Š‘•‹•ȋ•‡‡ Šƒ’–‡”͵ȌǤ• Š‹Ž†Š‘‘†ƒ„—•‡‹•–‹ŽŽ•‡‰ƒ–‹˜‡ expectations of others’ abilities to help coǦ”‡‰—Žƒ–‡‡‘–‹‘ǡ–Š‹•ƒ›ƒŽ•‘”‡•—Ž–‹–Š‡•Š—‹‰‘ˆ

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146807_JonasWeijers_BNW_def.indd 13 28-10-2020 15:08 Chapter One

ƒ––ƒ Š‡–”‡Žƒ–‹‘•Š‹’•ƒŽ–‘‰‡–Š‡”Ǥ–‡†‡ ›ˆ‘”Ž‘‡Ž‹‡••ƒ›–Š‡”‡ˆ‘”‡ˆ—”–Š‡” ‘’Ž‹ ƒ–‡ –Š‡ ‘Ǧ”‡‰—Žƒ–‹‘‘ˆ‡‘–‹‘•ǡ–Š‡”‡„› ‘–”‹„—–‹‰–‘–Š‡†‡˜‡Ž‘’‡–‘ˆ’•› Š‘•‹•ȋ•‡‡ Šƒ’–‡” ͶȌǤƒ•–Ž›ǡ Š‹Ž†Š‘‘†ƒ„—•‡ƒ› ‘–”‹„—–‡–‘’•› Š‘•‹•‹ƒ†—Ž–Š‘‘†–Š”‘—‰Šƒ‹’ƒ‹”‡† †‡˜‡Ž‘’‡–‘ˆ‡–ƒŽ‹œ‹‰ȋ•‡‡ Šƒ’–‡”ͷȌǤŠ‹Ž†Š‘‘†ƒ„—•‡‹•–Š‘—‰Š––‘•—’’”‡••–Š‡ƒ–—”ƒŽŽ› —”‹‘—•ǡ‘Œ—†‰‡–ƒŽƒ––‹–—†‡‡‡†‡†ˆ‘”‡–ƒŽ‹œ‹‰Ǥ —”–Š‡”‘”‡ǡ–Š‹‹‰ƒ„‘—–ƒŠ‘•–‹Ž‡‘” uncaring caregiver’s mind may be so overwhelmingly painful for a child, that it instills ƒ’Š‘„‹  ƒ˜‘‹†ƒ ‡‘ˆ‡–ƒŽ‹œ‹‰ȋ•‡‡ Šƒ’–‡”ͷˆ‘”‘”‡‡Žƒ„‘”ƒ–‹‘ȌǤ  Operationalization of mentalization

Š‡ ‘•–”— –‘ˆ‡–ƒŽ‹œƒ–‹‘Šƒ•‘–„‡‡™‹–Š‘—– ”‹–‹ ‹•Ǥ‘‡Šƒ˜‡”‡ˆ‡””‡†–‘–Š‡ ‘ ‡’–ƒ• “ungainly” and “allǦencompassing” (ChoiǦƒ‹Ƭ —†‡”•‘ǡʹͲͲͺȌƒ†‹– ƒ„‡ƒ”‰—‡†–‘„‡ †‹ˆˆ‹ —Ž––‘‘’‡”ƒ–‹‘ƒŽ‹œ‡ˆ‘”‡’‹”‹ ƒŽ•–—†›Ǥ ‘ƒ‰›ƒ†—›–‡ȋʹͲͲͻȌ–Š‡”‡ˆ‘”‡’”‘’‘•‡†–‘ †‡ ‘•–”— –‡–ƒŽ‹œ‹‰‹–‘ˆ‘—”‹–‡””‡Žƒ–‡†’‘Žƒ”‹–‹‡•ǣ‹’Ž‹ ‹–˜•‡š’Ž‹ ‹–ǡ ‘‰‹–‹˜‡˜•ƒˆˆ‡ –‹˜‡ǡ ‹–‡”ƒŽ˜•‡š–‡”ƒŽǡƒ†•‡Žˆ˜•‘–Š‡”Ǥƒ•–Ž›ǡ‹– ‘—Ž†„‡ƒ”‰—‡†–Šƒ–—›–‡ǡ˜ƒ ‘—†‡Š‘˜‡ǡ ‡ƒǡƒ”‰‡–ǡƬ ‘ƒ‰›(2012a) introduced a fifth polarity by introducing the term ‘embodied mentalizing’.  ’Ž‹ ‹–‘”ƒ—–‘ƒ–‹ ‡–ƒŽ‹œƒ–‹‘”‡ˆ‡”•–‘–Š‡‘Ǧ ‘• ‹‘—•Ž›†‹”‡ –‡†’”‘ ‡••‘ˆ mentalizing. Implicit mentalizing involves reflexive and intuitive ‘snap’ judgments about internal or ‡š–‡”ƒŽ‡˜‡–•Ǥ  ‘–”ƒ•–ǡ‡š’Ž‹ ‹–‡–ƒŽ‹œƒ–‹‘‹˜‘Ž˜‡•–Š‡•Ž‘™ƒ††‡Ž‹„‡”ƒ–‡Ž›‰—‹†‡† process of reflection on one’s own and someone else’s mental states (Fonagy Ƭ—›–‡ǡʹͲͲͻȌǤ  ‘‰‹–‹˜‡˜‡”•—•ƒˆˆ‡ –‹˜‡‡–ƒŽ‹œƒ–‹‘”‡ˆ‡”•–‘–Š‡†‹ˆˆ‡”‡–™ƒ›•’‡‘’Ž‡’”‘ ‡•• ‹ˆ‘”ƒ–‹‘ǡƒ•™‡ŽŽƒ•–Š‡†‹ˆˆ‡”‡––›’‡•‘ˆ‹ˆ‘”ƒ–‹‘–Šƒ–ƒ”‡’”‘ ‡••‡†Ǥ ‘”†‹‰–‘ ‡–ƒŽ‹œƒ–‹‘–Š‡‘”›ǡ•‘ ‹ƒŽ ‘‰‹–‹‘‹˜‘Ž˜‡•„‘–Š–Š‡ ƒ’ƒ„‹Ž‹–›–‘”‡ƒ•‘ƒ„‘—–„‡Ž‹‡ˆ•ƒ†–Š‡ capacity to detect and process signals on an affective basis, i.e. ‘to feel for someone’.   Š‡•‡ŽˆǦƒ†Ǧ‘–Š‡”†‹•–‹ –‹‘”‡ˆ‡”•–‘–Š‡‘„Œ‡ –‘ˆ‡–ƒŽ‹œ‹‰Ǣ–Šƒ–‹•–‘™Šƒ–‡š–‡– people are able to reflect on their own or others’ mental states. Here the two must not be seen as discrete polarities but as dynamically interacting domains. Reflecting on one’s own feelings can ’”‘˜‹†‡‹ˆ‘”ƒ–‹‘ƒ„‘—–Š‘™‘‡ˆ‡‡Ž•ƒ„‘—–•‘‡‘‡‡Ž•‡ǡ™Š‡”‡ƒ•–Š‡”‡ƒ –‹‘‘ˆ‘–Š‡”•–‘ ‘‡•‡Žˆ’”‘˜‹†‡•‹ˆ‘”ƒ–‹‘ƒ„‘—–‘—”•‡Ž˜‡•ƒ•™‡ŽŽǤ‡ ‘†ƒ”‹Ž›‹–ƒŽ•‘‹˜‘Ž˜‡•–Š‡ƒ„‹Ž‹–›–‘ clearly distinguish between one’s own mental state and those of others.   Š‡‹–‡”ƒŽȀ‡š–‡”ƒŽ†‹•–‹ –‹‘”‡ˆ‡”•–‘–Š‡ƒ–‡”‹ƒŽ™‹–Š™Š‹ Š‘‡‡–ƒŽ‹œ‡•Ǥ „ƒŽƒ ‡•‘–Š‹•’‘Žƒ”‹–›†‡–‡”‹‡™Š‡–Š‡”‘‡ˆ‘ —•‡•‡š Ž—•‹˜‡Ž›‘‹‡”‡š’‡”‹‡ ‡•‘”‘ ‡š–‡”ƒŽˆ‡ƒ–—”‡•ǡ•— Šƒ•Ž‘‘•‘”„‡Šƒ˜‹‘”Ǥ

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146807_JonasWeijers_BNW_def.indd 14 28-10-2020 15:08 General Introduction

 ƒ•–Ž›ǡ—›–‡ƒ† ‘ŽŽ‡ƒ‰—‡•ȋʹͲͳʹƒȌ‹–”‘†— ‡†–Š‡–‡”‡„‘†‹‡†‡–ƒŽ‹œ‹‰–‘•‹‰‹ˆ› “the ability to experience the body as the seat of emotions’’. Specifically, embodied mentalizing pertains to the degree of certainty that is attributed to one’s cognitive beliefs or one’s sensoryǦ ƒˆˆ‡ –‹˜‡•‹‰ƒŽ•ƒ•ƒ —”ƒ–‡”‡’”‡ •‡–ƒ–‹‘•‘ˆ–Š‡™‘”Ž†ȋ•‡‡ Šƒ’–‡”ʹˆ‘”‘”‡‡Žƒ„‘”ƒ–‹‘ȌǤ Measurement of mentalization 1 ‡ƒ•—”‹‰‡–ƒŽ‹œ‹‰ ƒ’ƒ ‹–› ƒ„‡ ‘•‹†‡”‡†–‘„‡‹‹–•‹ˆƒ ›Ǥ‘‡ƒ•—”‡‡–ƒŽ‹œ‹‰‘ –Š‡„ƒ•‹•‘ˆ•‡ŽˆǦ”‡’‘”–‹•–”—‡–•‹•†‹ˆˆ‹ —Ž–ǡƒ•‹–”‡“—‹”‡••‘‡‡–ƒŽ‹œ‹‰ ƒ’ƒ ‹–›–‘ understand one’s mentalizing deficits. Furthermore, the field of•‘ ‹ƒŽ ‘‰‹–‹‘”‡•‡ƒ” ŠŽƒ •ƒ ‰‡‡”ƒŽ ‘•‡•—•‘™Šƒ–‡ƒ•—”‡•„‡•– ƒ’–—”‡‡–ƒŽ‹œ‹‰ ƒ’ƒ ‹–›Ǥ‘‘Ž›—•‡†‘Ǧ•‡ŽˆǦ ”‡’‘”––‡•–•ƒ”‡Š‡–‡”‘‰‡‡‘—•ǡ–‡†–‘Šƒ˜‡’‘‘”’•› Š‘‡–”‹ ’”‘’‡”–‹‡•ƒ†Žƒ ‡ ‘Ž‘‰‹ ƒŽ ˜ƒŽ‹†‹–›ȋ ”‡‡‡–ƒŽǡʹͲͲͺǢ ‘”ƒƬ ”‡‡ǡʹͲͳͻȌǤ••— Šǡ–Š‡‡ƒ•—”‡‡–‹•–”—‡–•‘ˆ ‡–ƒŽ‹œ‹‰—•‡†‹–Š‹•–Š‡•‹•†‡•‡”˜‡•‘‡ƒ––‡–‹‘Ǥ ”‡ ‡–Žƒ”‰‡Ǧ• ƒŽ‡•–—†›‘ˆ–Š‡’•› Š‘‡–”‹ ’”‘’‡”–‹‡•‘ˆ™‹†‡Ž›—•‡†•‘ ‹ƒŽ ‘‰‹–‹˜‡Hinting Task ‡ƒ•—”‡••Š‘™‡†–Šƒ––Š‡ ȋ Ȍ™ƒ•‘‡‘ˆ–Š‡ˆ‡™‹•–”—‡–• ‘•‹†‡”‡†–‘„‡‰‘‘† ‡‘—‰Šˆ‘”—•‡‹ Ž‹‹ ƒŽ–”‹ƒŽ•ȋ‹Šƒ‡–ƒŽǤǡʹͲͳ͵ȌǤŠ‡ ‡ƒ•—”‡•–Š‡ƒ„‹Ž‹–›–‘‹ˆ‡” another’s wishes from indirect speech, i.e. the cognitive, otherǦ‘”‹‡–‡†ƒ•’‡ –‘ˆ‡–ƒŽ‹œ‹‰‘” ‘theory of mind’. –ˆ‡ƒ–—”‡•–‡•Š‘”–’ƒ••ƒ‰‡•ǡ™‹–Š‡ƒ Š’ƒ••ƒ‰‡’”‡•‡–‹‰ƒ‹–‡”ƒ –‹‘ „‡–™‡‡–™‘ Šƒ”ƒ –‡”•–Šƒ–—•–„‡‹–‡”’”‡–‡†„›–Š‡”‡•’‘†‡–Ǥ‘’”‘˜‹†‡ ‘””‡ –ƒ•™‡”•ǡ ”‡•’‘†‡–•—•–’Žƒ ‡–Š‡•‡Ž˜‡•‹–Š‡•Š‘‡•‘ˆ–Š‡ Šƒ”ƒ –‡”•‹‘”†‡”–‘‹ˆ‡”™Šƒ––Š‡‘–Š‡” Šƒ”ƒ –‡”•ƒ”‡‹’Ž›‹‰ǤŠ‡ •Š‘™‡†ƒ†‡“—ƒ–‡–‡•–Ǧ”‡–‡•–”‡Ž‹ƒ„‹Ž‹–›ǡ‘Ž›•ƒŽŽ’”ƒ –‹ ‡‡ˆˆ‡ –•ǡ ƒ•–”‘‰”‡Žƒ–‹‘–‘•‘ ‹ƒŽˆ— –‹‘‹‰ƒ†ƒŽ•‘‡‘—‰Š•‡•‹–‹˜‹–›–‘†‹•–‹‰—‹•Š’ƒ–‹‡– ’‡”ˆ‘”ƒ ‡ˆ”‘ ‘–”‘Ž•Ǥ —”–Š‡”‘”‡ǡ‹–‹•™‡ŽŽ–‘Ž‡”ƒ–‡†„›’ƒ–‹‡–•ǡƒ† ƒ„‡ƒ†‹‹•–‡”‡† ”‡Žƒ–‹˜‡Ž›“—‹ Ž›ȋ‹Šƒ‡–ƒŽǤǡʹͲͳ͵ȌǤ–‹ŽŽ‘–‡•–‹•’‡”ˆ‡ –Ǣ–Š‡ Šƒ•„‡‡ ”‹–‹ ‹œ‡†ˆ‘”„‡‹‰ ‘˜‡”Ž›•‹’Ž‹•–‹ ƒ†Šƒ˜‹‰ƒ–‡†‡ ›ˆ‘” ‡‹Ž‹‰‡ˆˆ‡ –•ȋ‡Ǥ‰Ǥǡ‘„‡”–•Ƭ‡ǡʹͲͲͻȌǤ Š‡•‡ ‘†‹•–”—‡–ˆ‘”‡ƒ•—”‹‰‡–ƒŽ‹œ‹‰—•‡†‹–Š‹•–Š‡•‹•‹•–Š‡‘ ‹ƒŽ‘‰‹–‹‘ ƒ†„Œ‡ –Ǧ‡Žƒ–‹‘• ƒŽ‡• ‘”‡†‘ƒ””ƒ–‹˜‡•‘–Š‡Š‡ƒ–‹ ’’‡” ‡’–‹‘‡•–ȋǢ—””ƒ›ǡ ͳͻͶ͵ȌǤ –‹•Ž‡•• ‘‘Ž›—•‡†„‡ ƒ—•‡‘ˆ‹–•–‹‡ ‘•—‹‰ƒ†’”‘Œ‡ –‹˜‡ƒ–—”‡Ǥ –‹•–Š‡”‡ˆ‘”‡ ‘ˆ–‡‘‹––‡†ˆ”‘”‡˜‹‡™•‘ˆ‡ƒ•—”‡‡–‹•–”—‡–•ȋ‹Šƒ‡–ƒŽǤǡʹͲͳ͵Ǣ ‘”ƒǡƬ ”‡‡ ʹͲͳͻȌǤŠ‹•‹•—ˆ‘”–—ƒ–‡ǡ„‡ ƒ—•‡‹–Šƒ•ƒ†‡“—ƒ–‡ƒ†™‡ŽŽǦ•–—†‹‡†’•› Š‘‡–”‹ ’”‘’‡”–‹‡•ǤŠ‡  ‘•‹•–•‘ˆ„Žƒ Ǧƒ†Ǧ™Š‹–‡’‹ –—”‡•‘ˆƒ„‹‰—‘—••‘ ‹ƒŽ•‹–—ƒ–‹‘•–‘‡Ž‹ ‹–•’‘–ƒ‡‘—• ”‡•’‘•‡•ˆ”‘’ƒ”–‹ ‹’ƒ–•Ǥ‘‰‘–Š‡”–Š‹‰•ǡ’ƒ”–‹ ‹’ƒ–•ƒ”‡ƒ•‡†–‘†‡• ”‹„‡™Šƒ–‹•‰‘‹‰ ‘‹–Š‡’‹ –—”‡ƒ†™Šƒ–‹•‰‘‹‰–Š”‘—‰Š–Š‡‹†•‘ˆ–Š‡ Šƒ”ƒ –‡”•‹–Š‡’‹ –—”‡Ǥ –Š‡ —””‡–

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146807_JonasWeijers_BNW_def.indd 15 28-10-2020 15:08 Chapter One

–Š‡•‹•ǡ”‡•’‘•‡•™‡”‡–”ƒ• ”‹„‡†˜‡”„ƒ–‹ƒ†ƒƒŽ›œ‡†—•‹‰–Š‡‘ ‹ƒŽ‘‰‹–‹‘ƒ†„Œ‡ – ‡Žƒ–‹‘•›•–‡ȋǢ‡•–‡ǡͳͻͻͳȌǡƒ• ‘”‹‰•›•–‡–‘‡˜ƒŽ—ƒ–‡ƒ””ƒ–‹˜‡•ǤŠ‡ ƒ••‡••‡•ˆ‘—”†‹‡•‹‘•‘ˆ•‘ ‹ƒŽ ‘‰‹–‹‘ǣ ‘’Ž‡š‹–›‘ˆ”‡’”‡•‡–ƒ–‹‘•‘ˆ’‡‘’Ž‡ǡ‡ƒ•—”‹‰ the respondents’ ability to differentiate between their own and another’s point of view; understanding of social causality, representing respondents’ ability to give a logical and ’•› Š‘Ž‘‰‹ ƒŽŽ›Ǧminded explanation for another’s beŠƒ˜‹‘”Ǣƒˆˆ‡ –Ǧ–‘‡‘ˆ”‡Žƒ–‹‘•Š‹’•ǡ™Š‹ Š ”‡’”‡•‡–•–Š‡†‡‰”‡‡–‘™Š‹ Š‘–Š‡”•ƒ”‡‡š’‡ –‡†–‘„‡„‡‹‰‘”ƒŽ‹‰Ǣƒ†–Š‡ ƒ’ƒ ‹–›ˆ‘” ‡‘–‹‘ƒŽ‹˜‡•–‡–ǡ™Š‹ Š”‡’”‡•‡–•–Š‡‡š–‡––‘™Š‹ Š”‡Žƒ–‹‘•Š‹’•™‹–Š‘–Š‡”•ƒ”‡ ‡š’‡”‹‡ ‡†ƒ•‹Š‡”‡–Ž›‡ƒ‹‰ˆ—Ž‘”Œ—•–ƒ•ƒ‡ƒ•–‘ƒ‡†Ǥ ’‘”–ƒ–Ž›ǡƒ ‘”†‹‰–‘—›–‡ƒ† ‘ŽŽ‡ƒ‰—‡•ȋʹͲͳʹ„Ȍǡ–Š‡‹•‘‡‘ˆ–Š‡ˆ‡™–‡•–• –Šƒ––ƒ‡•ƒŽ‘•–ƒŽŽƒ•’‡ –•‘ˆ‡–ƒŽ‹œƒ–‹‘‹–‘ƒ ‘—–ǡ‹ Ž—†‹‰ ‘‰‹–‹˜‡‡–ƒŽ‹œ‹‰ ȋ‡ƒ•—”‡†„›–Š‡†‹‡•‹‘• ‘’Ž‡š‹–›ƒ†—†‡”•–ƒ†‹‰‘ˆ•‘ ‹ƒŽ ƒ—•ƒŽ‹–›Ȍƒ†ƒˆˆ‡ –‹˜‡ ‡–ƒŽ‹œ‹‰ȋ‡ƒ•—”‡†„›–Š‡†‹‡•‹‘•ƒˆˆ‡ ––‘‡ƒ†‡‘–‹‘ƒŽ‹˜‡•–‡–ȌǤ —”–Š‡”‘”‡ǡ–Š‡ ǡŠƒ•„‡‡•Š‘™–‘„‡ƒ˜ƒŽ‹†ƒ†”‡Ž‹ƒ„Ž‡‹•–”—‡–‘ˆ•‘ ‹ƒŽ ‘‰‹–‹‘ȋ‡›‡”ǡʹͲͲͶȌǡ™‹–Š ‰‘‘†‹–‡”ƒŽ ‘•‹•–‡ ›„‡–™‡‡’‹ –—”‡•ȋ ‹„„ƒ”†ǡ‹– Š‡ŽŽƬ‘” ‡”‡ŽŽ‹ǡʹͲͲͳȌƒ†‰‘‘† ȋ ‹„„ƒ”†‡–ƒŽǤǡʹͲͲͳȌ–‘‡š ‡ŽŽ‡–ȋ‡›‡”ǡʹͲͲͶȌ‹–‡” Ǧ”ƒ–‡””‡Ž‹ƒ„‹Ž‹–›Ǥ Mentalization based treatment

Š‡†‡˜‡Ž‘’‡–‘ˆ‡–ƒŽ‹œƒ–‹‘„ƒ•‡†–”‡ƒ–‡–™ƒ•‹•’‹”‡†„›–Š‡Š›’‘–Š‡•‹•–Šƒ–‡’‹”‹ ƒŽŽ› •—’’‘”–‡†’•› Š‘–Š‡”ƒ’‹‡•‘ˆ†‹ˆˆ‡”‡–’•› Š‘Ž‘‰‹ ƒŽ• Š‘‘Ž•–‡†–‘„‡‡“—ƒŽŽ›‡ˆˆ‡ –‹˜‡ǡ™Š‹ Š ™ƒ•Žƒ–‡” ‘””‘„‘”ƒ–‡†„› ‘–”‘ŽŽ‡†–”‹ƒŽ•ȋ‡Ǥ‰Ǥ‡••‡”Ƭƒ’‘Ž†ǡʹͲͲʹȌǤŠ‹•ˆ‹†‹‰Šƒ• ‘‡ to be known as the ‘dodo effect’ of psychotherapy, in which ‘every therapy wins’. Bateman and ‘ƒ‰›ƒ”‰—‡†–Šƒ––Š‹•†‘†‘‡ˆˆ‡ –‹•”‡Žƒ–‡†–‘‘Ǧ•’‡ ‹ˆ‹ ˆƒ –‘”•‘ˆ–Š‡”ƒ’›ǡ‹Ǥ‡Ǥˆƒ –‘”•–Šƒ–ƒ”‡ common to all forms of psychotherapeutic approaches. They argued that ‘bonafide’ ’•› Š‘–Š‡”ƒ’‹‡•–‡†–‘„‡‡ˆˆ‡ –‹˜‡„‡ ƒ—•‡–Š‡›ƒŽŽ‘ˆˆ‡”ƒ•–”— –—”‡†˜‹‡™‘ˆ–Š‡Š—ƒ‹†ǡ ™‹–Š™Š‹ Š’ƒ–‹‡–• ƒ‘”‰ƒ‹œ‡ƒ†ƒ‡•‡•‡‘ˆ–Š‡‹”’•› Š‘Ž‘‰‹ ƒŽ’”‘„Ž‡•ǤŠ‡›ƒŽ•‘ƒ”‰—‡† –Šƒ–ǡ–‘†‹ˆˆ‡”‹‰†‡‰”‡‡•ǡƒŽŽˆ‘”•‘ˆ’•› Š‘–Š‡”ƒ’›‡‰ƒ‰e the patient’s ability to reflect on and ˜‡”„ƒŽ‹œ‡•‡•‘”›Ǧƒˆˆ‡ –‹˜‡‡š’‡”‹‡ ‡ǡ‹Ǥ‡Ǥ–‘‡–ƒŽ‹œ‡ǤŠ‹‰ŠŽ‹‰Š–•‡–ƒŽ‹œ‹‰ƒ•ƒ™ƒ›–‘ ‹’”‘˜‡’•› Š‘’ƒ–Š‘Ž‘‰›ƒ†•‘ ‹ƒŽˆ— –‹‘‹‰ǤŠƒ’–‡”ʹ‡Žƒ„‘”ƒ–‡•‘Š‘™‡–ƒŽ‹œ‹‰‹• –ƒ”‰‡–‡†‹–”‡ƒ–‡–Ǥ ™ƒ•ˆ‘—†–‘„‡ƒ‡ˆˆ‡ –‹˜‡–”‡ƒ–‡–ˆ‘”„‘”†‡”Ž‹‡’‡”•‘ƒŽ‹–›†‹•‘”†‡”ȋƒ–‡ƒƬ ‘ƒ‰›ǡͳͻͻͻǢʹͲͲͳǢʹͲͲͺȌ„—–ƒ•ƒ–”ƒ•†‹ƒ‰‘•–‹ –Š‡‘”›‘ˆ’•› Š‘’ƒ–Š‘Ž‘‰›ƒ†•‘ ‹ƒŽ ‘‰‹–‹‘ǡ ‡–ƒŽ‹œƒ–‹‘–Š‡‘”›Šƒ• ‘‡–‘‹ˆ‘”—†‡”•–ƒ†‹‰ƒ†–”‡ƒ–‡–‘ˆ•‡˜‡”ƒŽ’•› Š‹ƒ–”‹ 

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146807_JonasWeijers_BNW_def.indd 16 28-10-2020 15:08 General Introduction

†‹•‘”†‡”•ǡ‹ Ž—†‹‰‡ƒ–‹‰†‹•‘”†‡”•ȋ‘„‹•‘‡–ƒŽǤǡʹͲͳ͵Ȍǡƒ–‹•‘ ‹ƒŽ’‡”•‘ƒŽ‹–›†‹•‘”†‡” ȋƒ–‡ƒ‡–ƒŽǤǡʹͲͳ͵Ȍǡƒ†‘Ž‡• ‡–•™Š‘•‡ŽˆǦŠƒ”ȋ‘••‘—™Ƭ ‘ƒ‰›ǡʹͲͳʹȌǡˆ— –‹‘ƒŽ•‘ƒ–‹  †‹•‘”†‡”ȋ—›–‡ǡ˜ƒ ‘—†‡Š‘˜‡ǡ‡ƒǡƒ”‰‡–ǡƬ ‘ƒ‰›ǡʹͲͳʹƒȌǡȋ”‡–ǡ ‘Ž–ǡƬ ‡•Šƒ˜ƒǡʹͲͳͶǢ‡‹Œ‡”•ǡ‡–ƒŽǤǡʹͲͳ͸Ȍƒ†–Š‡’”‘†”‘ƒŽ•–ƒ–‡•‘ˆȋ‡„„ƒ±‡–ƒŽǤǡʹͲͳ͸ȌǤ ‘™‡˜‡”ǡ‡’‹”‹ ƒŽ‡šƒ‹ƒ–‹‘‹•”‡“—‹”‡†–‘†‡–‡”‹‡‹–•‡ˆˆ‡ –‹˜‡‡••ˆ‘”ƒ›‘ˆ–Š‡•‡ †‹•‘”†‡”•ȋMalda‐Castillo, Browne, & Perez‐AlgortaǡʹͲͳͺȌǤŠƒ’–‡”•‡˜‡”‡’‘”–•–Š‡”‡•—Ž–•‘ˆƒ 1 ”ƒ†‘‹œ‡† ‘–”‘ŽŽ‡†–”‹ƒŽˆ‘ —•‹‰‘–Š‡‡ˆˆ‡ –‹˜‡‡••‘ˆ‡–ƒŽ‹œƒ–‹‘„ƒ•‡†–”‡ƒ–‡–ˆ‘” ’•› Š‘–‹ †‹•‘”†‡”Ǥ Aims and outline of this thesis

AIM I: To outline how mentalization theory may contribute to understanding and treatment of NAPD.   Šƒ’–‡”–™‘†‡• ”‹„‡•ƒ–Š‡‘”‡–‹ ƒŽˆ”ƒ‡™‘”‘ˆ„ƒ•‡†‘‡–ƒŽ‹œƒ–‹‘–Š‡‘”›Ǥ – †‡• ”‹„‡•Š‘™ Š‹Ž†Š‘‘†ƒ„—•‡ǡ‹•‡ —”‡ƒ––ƒ Š‡–ǡ•‘ ‹ƒŽ†›•ˆ— –‹‘ǡ’‘‘”‡‘–‹‘”‡‰—Žƒ–‹‘ǡ ‡’‹•–‡‹ ‹•–”—•–ƒ†‹’ƒ‹”‡†‡–ƒŽ‹œ‹‰ƒ”‡‹–‡””‡Žƒ–‡†ƒ†Š‘™–Š‡•‡ƒ› ‘–”‹„—–‡–‘ ’•› Š‘•‹•Ǥ††‹–‹‘ƒŽŽ›ǡ‹–†‹• —••‡•Š‘™‡–ƒŽ‹œƒ–‹‘„ƒ•‡†–”‡ƒ–‡–ƒ›„‡—•‡†–‘–”‡ƒ–Ǥ AIM II:  o test several hypotheses which have been proposed to explain the relationship between childhood abuse and the severity of symptoms in adult patients with NAPD.

Šƒ’–‡”•–Š”‡‡ǡˆ‘—”ǡƒ†ˆ‹˜‡‡šƒ‹‡–‘™Šƒ–‡š–‡–ƒ„—•‡‹ Š‹Ž†Š‘‘† ‘–”‹„—–‡•–‘ •‡˜‡”‹–›‘ˆ•›’–‘•‹ƒ†—Ž–’ƒ–‹‡–•™‹–Šƒ†‡š’Ž‘”‡•‡ Šƒ‹•• ‡–”ƒŽ–‘ ‡–ƒŽ‹œƒ–‹‘–Š‡‘”›–Šƒ–ƒ›ƒ ‘—–ˆ‘”–Š‹•”‡Žƒ–‹‘•Š‹’ǡƒ‡Ž›ǣ’‘‘”‡‘–‹‘”‡‰—Žƒ–‹‘ǡ Ž‘‡Ž‹‡••ƒ†‹’ƒ‹”‡†‡–ƒŽ‹œ‹‰Ǥ‘”‡•’‡ ‹ˆ‹ ƒŽŽ›ǡ Šƒ’–‡”–Š”‡‡‡šƒ‹‡•™Š‡–Š‡” Š‹Ž†Š‘‘† ƒ„—•‡‹•”‡Žƒ–‡†–‘ƒ‹ ”‡ƒ•‡†‡‘–‹‘ƒŽƒ†’•› Š‘–‹ ”‡ƒ –‹˜‹–›–‘•–”‡••ǡ™Š‹Ž‡ƒŽ•‘‡š’Ž‘”‹‰ •–ƒ–‹•–‹ ƒŽ‹••—‡•”‡Žƒ–‹‰–‘•‡™‡††ƒ–ƒǤŠƒ’–‡”ˆ‘—”‡šƒ‹‡•™Š‡–Š‡”Ž‘‡Ž‹‡••ƒ ‘—–•ˆ‘” –Š‡”‡Žƒ–‹‘•Š‹’„‡–™‡‡ Š‹Ž†Š‘‘†ƒ„—•‡ƒ†’•› Š‘–‹ •›’–‘•‹†ƒ‹Ž›Ž‹ˆ‡ƒ†™Š‡–Š‡”–Š‡ ”‡Žƒ–‹‘„‡–™‡‡Ž‘‡Ž‹‡••ƒ†’•› Š‘–‹ •›’–‘•‹–—” ƒ„‡ƒ ‘—–‡†ˆ‘”„›ƒš‹‘—•ƒ† †‡’”‡••‹˜‡ˆ‡‡Ž‹‰•ǤŠƒ’–‡”ˆ‹˜‡‡šƒ‹‡•™Š‡–Š‡”‹’ƒ‹”‡†‡–ƒŽ‹œ‹‰ƒ ‘—–•ˆ‘”–Š‡ ”‡Žƒ–‹‘•Š‹’„‡–™‡‡ Š‹Ž†Š‘‘†ƒ„—•‡ƒ†ˆ— –‹‘ƒŽƒ† Ž‹‹ ƒŽ‘—– ‘‡‹ Ǥ AIM III: To test whether mentalization based treatment for psychotic disorder (MBTp) is an effective

addition to treatment as usual regarding social dysfunction and impaired mentalizing.

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146807_JonasWeijers_BNW_def.indd 17 28-10-2020 15:08 Chapter One

’‡ ‹ˆ‹ ƒŽŽ›ǡ Šƒ’–‡”•‹š‘—–Ž‹‡•–Š‡Š›’‘–Š‡•‡•ƒ†‡–Š‘†•‹ƒ’”‡Ǧ’—„Ž‹•Š‡†”‡•‡ƒ” Š ’”‘–‘ ‘Ž‘ˆ‘—””ƒ†‘‹œ‡† ‘–”‘ŽŽ‡†–”‹ƒŽǤŠƒ’–‡”•‡˜‡†‡• ”‹„‡•–Š‡”‡•—Ž–•‘ˆ–Š‹•–”‹ƒŽǤ‡™‹ŽŽ ‘ Ž—†‡–Š‹•–Š‡•‹•™‹–Šƒ‰‡‡”ƒŽ†‹• —••‹‘‘ˆ–Š‡ ‘„‹‡†ˆ‹†‹‰•ƒ•™‡ŽŽƒ•†‹”‡ –‹‘•ˆ‘” ˆ—–—”‡”‡•‡ƒ” Šȋ Šƒ’–‡”‡‹‰Š–Ȍƒ†–Š‡˜ƒŽ‘”‹œƒ–‹‘‘ˆ‘—” —””‡–”‡•‡ƒ” Šȋ ƒ††‡†—ȌǤ References

Žƒ‡†ƒǡǤǡ ‡””ƒ”‹ǡǤǡƒ—ƒǡǤǤǡ Š‘ŽƒǦ‡œƒ‡‡ǡǤǡ‘ǡǤǤǡƬ‘—•ǡǤȋʹͲͳͷȌǤŠ‹Ž†Š‘‘† •‡š—ƒŽƒ†’Š›•‹ ƒŽƒ„—•‡ǣƒ‰‡ƒ–‡š’‘•—”‡‘†—Žƒ–‡•‹’ƒ –‘ˆ— –‹‘ƒŽ‘—– ‘‡‹‡ƒ”Ž›Psychological medicine, 45 ’•› Š‘•‹•’ƒ–‹‡–•Ǥ ȋͳ͵Ȍǡʹ͹ʹ͹Ǧʹ͹͵͸Ǥ Ž˜ƒ”‡œǡǤ Ǥǡ‘—”ƒǡǤǡ•±•ǡǤǡ ‘‰—‡–ǡǤǡ‘Žƒǡ ǤǡƬ””—ˆƒ–ǡ ǤǤȋʹͲͳͳȌǤ”‡˜ƒŽ‡ ‡ƒ† Ž‹‹ ƒŽThe Journal of nervous ‹’ƒ –‘ˆ Š‹Ž†Š‘‘†–”ƒ—ƒ‹’ƒ–‹‡–•™‹–Š•‡˜‡”‡‡–ƒŽ†‹•‘”†‡”•Ǥand mental disease 199  ǡ ȋ͵Ȍǡͳͷ͸Ǧͳ͸ͳǤDiagnostic and statistical manual of mental disorders ‡”‹ ƒ•› Š‹ƒ–”‹ ••‘ ‹ƒ–‹‘ǤȋʹͲͳ͵ȌǤ(DSM-5®) Ǥ‡”‹ ƒ•› Š‹ƒ–”‹ —„Ǥ ”•‡‡ƒ—Ž–ǡǤǡƒ‘ǡǤǡ ‹•Š‡”ǡ ǤǤǡ‘Žƒ œ›ǡ Ǥǡ‘ˆˆ‹––ǡǤǤǡƬƒ•’‹ǡǤȋʹͲͳͳȌǤŠ‹Ž†Š‘‘† –”ƒ—ƒƒ† Š‹Ž†”‡̵American•‡‡”‰‹‰’•› Š‘–‹ •›’–‘•ǣƒ‰‡‡–‹ ƒŽŽ›•‡•‹–‹˜‡Ž‘‰‹–—†‹ƒŽ Journal of Psychiatry 168 ‘Š‘”–•–—†›Ǥ ǡ ȋͳȌǡ͸ͷǦ͹ʹǤ ƒ–‡ƒǡǤǡƬ ‘ƒ‰›ǡǤȋͳͻͻͻȌǤˆˆ‡ –‹˜‡‡••‘ˆ’ƒ”–‹ƒŽŠ‘•’‹–ƒŽ‹œƒ–‹‘‹–Š‡–”‡ƒ–‡–‘ˆAmerican journal of Psychiatry,„‘”†‡”Ž‹‡’‡”•‘ƒŽ‹–›†‹•‘”†‡”ǣ 156 ƒ”ƒ†‘‹œ‡† ‘–”‘ŽŽ‡†–”‹ƒŽǤ ȋͳͲȌǡͳͷ͸͵Ǧͳͷ͸ͻǤ ƒ–‡ƒǡǤǡƬ ‘ƒ‰›ǡǤȋʹͲͲͳȌǤ”‡ƒ–‡–‘ˆ„‘”†‡”Ž‹‡’‡”•‘ƒŽ‹–›†‹•‘”†‡”™‹–ŠAmerican ’•› Š‘ƒƒŽ›–‹ ƒŽŽ›‘”‹‡–‡†’ƒ”–‹ƒŽŠ‘•’‹–ƒŽ‹œƒ–‹‘ǣƒͳͺJournal of psychiatry, 158 Ǧ‘–Šˆ‘ŽŽ‘™Ǧ—’Ǥ ȋͳȌǡ͵͸MentalizingǦͶʹǤ and borderline personality disorder. Handbook of ƒ–‡ƒǡǤǡƬ ‘ƒ‰›ǡǤȋʹͲͲ͸ȌǤmentalization based treatment ǡͳͺͷǦʹͲͲǤ ƒ–‡ƒǡǤǡƬ ‘ƒ‰›ǡǤȋʹͲͲͺȌǤͺǦ›‡ƒ”ˆ‘ŽŽ‘™Ǧ—’‘ˆ’ƒ–‹‡–•–”‡ƒ–‡†ˆ‘”„‘”†‡”Ž‹‡American’‡”•‘ƒŽ‹–› Journal of †‹•‘”†‡”ǣ‡–ƒŽ‹œƒ–‹‘Psychiatry, 165 Ǧ„ƒ•‡†–”‡ƒ–‡–˜‡”•—•–”‡ƒ–‡–ƒ•—•—ƒŽǤ ȋͷȌǡ͸͵ͳǦ͸͵ͺǤ ƒ–‡ƒǡǤǡ‘Ž–‘ǡǤǡƬ ‘ƒ‰›ǡǤȋʹͲͳ͵ȌǤ–‹•‘ ‹ƒŽ’‡”•‘ƒŽ‹–›†‹•‘”†‡”ǣ‡–ƒŽ‹œ‹‰Focus, 11 ˆ”ƒ‡™‘”Ǥ ȋʹȌǡͳ͹ͺǦͳͺ͸Ǥ ‡ Š†‘ŽˆǡǤǡŠ‘’•‘ǡǤǡ‡Ž•‘ǡǤǡ‘––‘ǡǤǡ‹‘•ǡǤǤǡ‹‰‡”ǡ ǤǤǡǤǤǤƬ‹†‹•ǡǤ (2010).Acta Experience Psychiatrica of trauma Scandinavica and conversion121 to psychosis in an ultra‐high‐risk (prodromal) ‰”‘—’Ǥ ǡ ȋͷȌǡ͵͹͹Ǧ͵ͺͶǤ

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146807_JonasWeijers_BNW_def.indd 18 28-10-2020 15:08 General Introduction

‡””›ǡǤǡƒ””‘™ Ž‘—‰ŠǡǤǡƬ‡ƒ”†‡ǡǤȋʹͲͲͺȌǤ––ƒ Š‡––Š‡‘”›ǣƒˆ”ƒ‡™‘”ˆ‘”Behaviour research —†‡”•–ƒ†‹‰•›’–‘•ƒ†‹–‡”’‡”•‘ƒŽ”‡Žƒ–‹‘•Š‹’•‹’•› Š‘•‹•Ǥand therapy 46  ǡ ȋͳʹȌǡͳʹ͹ͷǦͳʹͺʹǤ ”‡–ǡǤǤǡ ‘Ž–ǡǤ ǤǡƬ‡•Šƒ˜ƒǡǤǤȋʹͲͳͶȌǤ‡–ƒŽ‹œƒ–‹‘Ǧ„ƒ•‡†–”‡ƒ–‡–ˆ‘”’•› Š‘•‹•ǣ Ž‹‹‰ƒƒ––ƒ Š‡–Ǧ„ƒ•‡†‘†‡Ž–‘–Š‡’•› Š‘–Š‡”ƒ’›ˆ‘”‹’ƒ‹”‡†‡–ƒŽ•–ƒ–‡The Israel journal of psychiatry and —†‡”•–ƒ†‹‰‹’‡‘’Ž‡™‹–Š’•› Š‘–‹ †‹•‘”†‡”•Ǥrelated sciences, 51 1 ȋͳȌǡͳ͹Ǥ Š‘‹Ǧƒ‹ǡǤǤǡƬ —†‡”•‘ǡ Ǥ ǤȋʹͲͲͺȌǤ‡–ƒŽ‹œƒ–‹‘ǣ–‘‰‡›ǡƒ••‡••‡–ǡƒ†ƒ’’Ž‹ ƒ–‹‘‹. American Journal of Psychiatry, 165 –Š‡–”‡ƒ–‡–‘ˆ„‘”†‡”Ž‹‡’‡”•‘ƒŽ‹–›†‹•‘”†‡” ȋͻȌǡ ͳͳʹ͹Ǧͳͳ͵ͷǤ —–ƒŒƒ”ǡǤǤǡ—ŽŽ‡ǡǤǤǡ‰Ž‘ˆˆǡ ǤǤǡŠ‘ƒ•ǡǤǤǡ‡ŽŽ•ǡǤǤǡƬ’ƒ–ƒ”‘ǡ ǤȋʹͲͳͲȌǤ Child abuse•› Š‘’ƒ–Š‘Ž‘‰›‹ƒŽƒ”‰‡ ‘Š‘”–‘ˆ•‡š—ƒŽŽ›ƒ„—•‡† Š‹Ž†”‡ˆ‘ŽŽ‘™‡†—’–‘Ͷ͵›‡ƒ”•Ǥ & neglect 34 ǡ ȋͳͳȌǡͺͳ͵ǦͺʹʹǤ ‡„„ƒ±ǡǤǡ‡‹Ž‘—†ǡ ǤǡƒŽƒ‹‹‘•ǡ Ǥǡ‘Ž‹†ƒǦ‘œœ‹ǡǤǡ”ƒ†‘ǡǤǡ ‘ƒ‰›ǡǤǡƬƒ–‡ƒǡǤ ȋʹͲͳ͸ȌǤ‡–ƒŽ‹œƒ–‹‘JournalǦ„ƒ•‡†–”‡ƒ–‡–‹ Ž‹‹ ƒŽŠ‹‰Š of Contemporary PsychotherapyǦ”‹•ˆ‘”’•› Š‘•‹•ǣƒ”ƒ–‹‘ƒŽ‡ƒ†46 Ž‹‹ ƒŽ‹ŽŽ—•–”ƒ–‹‘Ǥ ǡ ȋͶȌǡʹͳ͹ǦʹʹͷǤ ‹ƒ‰‰‹‘ǡ ǤǡƬ›•ƒ‡”ǡǤ ǤȋʹͲͳͷȌǤ‡–ƒ ‘‰‹–‹‘ƒ†‡–ƒŽ‹œ‹‰‹Journal of Clinical–Š‡’•› Š‘–Š‡”ƒ’›‘ˆ Psychology 71 ’ƒ–‹‡–•™‹–Š’•› Š‘•‹•ƒ†’‡”•‘ƒŽ‹–›†‹•‘”†‡”•Ǥ ǡ ȋʹȌǡͳͳ͹Ǧ ͳʹͶǤ —Š‹‰ǡǤǡƒ––‡”•‘ǡǤǡ‘‡ŽŽǡǤǡ ‘Ž‡›ǡǤǡƒ’”ƒǡǤǡƒ”ǡ ǤǡǤǤǤƬ ‘––ǡ ǤȋʹͲͳͷȌǤŠ‡’”‡˜ƒŽ‡ ‡Australian & New Zealandƒ† ‘””‡Žƒ–‡•‘ˆ Š‹Ž†Š Journal of Psychiatry,‘‘†–”ƒ—ƒ‹’ƒ–‹‡–•™‹–Š‡ƒ”Ž›’•› Š‘•‹•Ǥ 49 ȋ͹Ȍǡ͸ͷͳǦ͸ͷͻǤ ‡––ǡǤǤ Ǥǡ‹‡ Š–„ƒ—‡”ǡǤǡ‡ǡǤǤǡ˜ƒ•ǡ ǤǡƬ”ƒ„„‡†ƒǡǤȋʹͲͳͳȌǤŠ‡”‡Žƒ–‹‘•Š‹’ „‡–™‡‡‡—”‘ ‘‰‹–‹‘ƒ†•‘ ‹ƒŽ ‘‰‹–‹‘™‹–Šˆ— –‹‘ƒŽ‘—– ‘‡•‹• Š‹œ‘’Š”‡‹ƒǣƒNeuroscience & Biobehavioral Reviews 35 ‡–ƒǦƒƒŽ›•‹•Ǥ Fish's schizophrenia. ǡ ȋ͵Ȍǡͷ͹͵ǦͷͺͺǤ ‹•Šǡ Ǥ ǤǡƬ ƒ‹Ž–‘ǡǤȋͳͻͺͶȌǤ ‘Š”‹‰Š–ǡŠ‡ˆˆ‹‡Ž†ǡ‹–‡†‹‰†‘Ǥ ‘ƒ‰›ǡǤȋͳͻͻͳȌǤŠ‹‹‰ƒ„‘—––Š‹‹‰ǣ‘‡ Ž‹‹ ƒŽƒ†–Š‡‘”‡–‹ ƒŽ ‘•‹†‡”ƒ–‹‘•‹–Š‡International Journal of Psycho-Analysis, 72, –”‡ƒ–‡–‘ˆƒ„‘”†‡”Ž‹‡’ƒ–‹‡–Ǥ ͸͵ͻǦ͸ͷ͸Ǥ ‘ƒ‰›ǡǤǡƬ—›–‡ǡǤȋʹͲͲͻȌǤ†‡˜‡Ž‘’‡–ƒŽǡ‡–ƒŽ‹œƒ–‹‘Ǧ„ƒ•‡†ƒ’’”‘ƒ Š–‘–Š‡Development and psychopathology,—†‡”•–ƒ†‹‰ƒ†–”‡ƒ–‡–‘ˆ„‘”†‡”Ž‹‡’‡”•‘ƒŽ‹–›†‹•‘”†‡”Ǥ 21 ȋͶȌǡͳ͵ͷͷǦͳ͵ͺͳǤ Comprehensive ‘ƒ‰›ǡǤǡƬƒ–‡ƒǡǤǤȋʹͲͳ͸ȌǤ†˜‡”•‹–›ǡƒ––ƒ Š‡–ǡƒ†‡–ƒŽ‹œ‹‰Ǥpsychiatry 64 ǡ ǡͷͻǦ͸͸Ǥ

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”‡‡ǡǤ Ǥǡ‡ǡǤǤǡ‡–ƒŽŽǡǤǡƒ”’‡–‡”ǡǤǤǡ ƒ‡„‡ŽǡǤǡ —”ǡǤǤǡǤǤǤƬ ‡‹••‡ǡǤȋʹͲͲͺȌǤ ‘ ‹ƒŽ ‘‰‹–‹‘‹• Š‹œ‘’Š”‡‹ƒǣƒ  ™‘”•Š‘’‘†‡ˆ‹‹–‹‘•ǡƒ••‡••‡–ǡƒ†Schizophrenia bulletin, 34 ”‡•‡ƒ” Š‘’’‘”–—‹–‹‡•Ǥ ȋ͸ȌǡͳʹͳͳǦͳʹʹͲǤ Nature Reviews ”‡‡ǡǤ Ǥǡ ‘”ƒǡǤǤǡƬ‡‡ǡ ǤȋʹͲͳͷȌǤ‘ ‹ƒŽ ‘‰‹–‹‘‹• Š‹œ‘’Š”‡‹ƒǤNeuroscience, 16 ȋͳͲȌǡ͸ʹͲǤ ‹„„ƒ”†ǡǤǡ‹– Š‡ŽŽǡǤǡƬ‘” ‡”‡ŽŽ‹ǡ ǤȋʹͲͲͳȌǤ –‡”ƒŽ ‘•‹•–‡ ›‘ˆ–Š‡‘„Œ‡ –”‡Žƒ–‹‘•ƒ†•‘ ‹ƒŽJournal of Personality Assessment, 77 ‘‰‹–‹‘• ƒŽ‡•ˆ‘”–Š‡–Š‡ƒ–‹ ƒ’’‡” ‡’–‹‘–‡•–Ǥ ȋ͵Ȍǡ ͶͲͺ–ͶͳͻǤ ‘”ƒǡǤǤǡƬ ”‡‡ǡǤ ǤȋʹͲͳͻȌǤ”‡ƒ–‡–‘ˆ•‘ ‹ƒŽ ‘‰‹–‹‘‹• Š‹œ‘’Š”‡‹ƒǣ—””‡–•–ƒ–—•Schizophrenia research, 203 ƒ†ˆ—–—”‡†‹”‡ –‹‘•Ǥ ǡ͵ǦͳͳǤ ‘™‡•ǡǤǤǡƬ—””ƒ›ǡǤǤȋʹͲͳͶȌǤ Š‹œ‘’Š”‡‹ƒǣƒ‹–‡‰”ƒ–‡†•‘ ‹‘The Lancet 383 Ǧ†‡˜‡Ž‘’‡–ƒŽǦ ‘‰‹–‹˜‡ ‘†‡ŽǤ ǡ ȋͻͻʹͻȌǡͳ͸͹͹Ǧͳ͸ͺ͹Ǥ ‡ŽŽ‡Š‡”ǡ Ǥǡ‡‡Ž‡›ǡ Ǥǡ‘” ‘”ƒǡǤǡƒ•ƒ›ǡ Ǥǡƒ••‡”ƒǡǤǡƒ”Ž‹ǡǤǡǤǤǤƬƒ‘ǡǤȋʹͲͳ͵ȌǤ Š‹Ž†Š‘‘†–”ƒ—ƒƒ†’•› Š‘•‹•‹ƒ’”‘•’‡ –‹˜‡ ‘Š‘”–•–—†›ǣ ƒ—•‡ǡ‡ˆˆ‡ –ǡƒ†American Journal of Psychiatry 170 †‹”‡ –‹‘ƒŽ‹–›Ǥ ǡ ȋ͹Ȍǡ͹͵ͶǦ͹ͶͳǤ ƒ”••‘ǡǤǡ†”‡ƒ••‡ǡǤǤǡƒ•ǡǤǡޕ•„‡”‰ǡ Ǥ Ǥǡ‘”ǡǤǡ–‡‡ǡǤǤǡǤǤǤƬ‡ŽŽ‡ǡ ǤȋʹͲͳ͵ȌǤ ‹‰Š ’”‡˜ƒŽ‡ ‡‘ˆ Š‹Ž†Š‘‘†–”ƒ—ƒ‹’ƒ–‹‡–•™‹–Š• Š‹œ‘’Š”‡‹ƒ•’‡ –”—ƒ†ƒˆˆ‡ –‹˜‡Comprehensive Psychiatry 54 †‹•‘”†‡”Ǥ ǡ ȋʹȌǡͳʹ͵Ǧͳʹ͹Ǥ ƒƒǡ Ǥǡˆ”‹ ƒ”—œǡǤǡ‘Žƒ‹ –‘”ǡǤǡƒ”–‹Ǧ‘ƒ›ǡ ǤȋʹͲͳ͹ȌǤ‘ ‹ƒŽ‘‰‹–‹‘ƒ•‡†Š‡”ƒ’‹‡• ˆ‘”‡‘’Ž‡™‹–Š Š‹œ‘’Š”‡‹ƒǣ ‘ —•‘‡–ƒ ‘‰‹–‹˜‡ƒ†‡–ƒŽ‹œƒ–‹‘’’”‘ƒ Š‡•ǤSchizophrenia treatment.  ”‘—’•’‡ƒ ‡••‡„‘‘•Ǥ ‡ ‘—”•ǡǤǡƬ‘— Šƒ”†ǡǤǤȋͳͻͻ͹ȌǤ‹‡•‹‘•‘ˆ‡–ƒŽ‹•ƒ–‹‘ǣ—–Ž‹‹‰Ž‡˜‡Ž•‘ˆ’•› Š‹ International Journal of Psycho-Analysis, 78 –”ƒ•ˆ‘”ƒ–‹‘Ǥ ǡͺͷͷǦͺ͹ͷǤ ‘‰†‡ǡǤǡƒ’•‘ǡǤǡƬ‡ƒ†ǡ ǤȋʹͲͳ͸ȌǤŠ‹Ž†Š‘‘†ƒ†˜‡”•‹–›ƒ†’•› Š‘•‹•ǣ‰‡‡”ƒŽ‹•‡†‘”Epidemiology and psychiatric sciences, 25 •’‡ ‹ˆ‹ ‡ˆˆ‡ –•ǫ ȋͶȌǡ͵ͶͻǦ͵ͷͻǤ —›–‡ǡǤǡƒ ‘—†‡Š‘˜‡ǡǤǡ‡ƒǡǤǡƒ”‰‡–ǡǤǡƬ ‘ƒ‰›ǡǤȋʹͲͳʹƒȌǤ‡–ƒŽ‹œƒ–‹‘Ǧ„ƒ•‡† ƒ’’”‘ƒ Š–‘–Š‡—†‡”•–ƒ†‹‰ƒ†–”‡ƒ–‡–‘ˆˆ— –‹‘ƒŽ•‘ƒ–‹ †‹•‘”†‡”•ǤPsychoanalytic Psychotherapy, 26 ȋʹȌǡͳʹͳǦͳͶͲǤ —›–‡Ǥǡ ‘ƒ‰›Ǥǡ‘™› Ǥǡ‡”‘–‡ǤȋʹͲͳʹ„ȌǤHandbook of mentalizing in mental••‡••‡–‘ˆ‡–ƒŽ‹œƒ–‹‘Ǥ ƒ–‡ƒƬ health practice, ‘ƒ‰›ȋʹͲͳʹȌǤ Ͷ͵–͸ͷǤƒ•Š‹‰–‘ǡǣ ‡”‹ ƒ•› Š‹ƒ–”‹ —„Ǥ

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146807_JonasWeijers_BNW_def.indd 20 28-10-2020 15:08 General Introduction

›‘•Ǧ—–ŠǡǤǡ‡ŽŽ‹ǡǤǡ‡Ž‹ ǡǤǡƬ–™‘‘†ǡ ǤȋʹͲͲ͵ȌǤŠ‹Ž†Š‘‘†‡š’‡”‹‡ ‡•‘ˆ–”ƒ—ƒƒ† Ž‘••Šƒ˜‡†‹ˆˆ‡”‡–”‡Žƒ–‹‘•–‘ƒ–‡”ƒŽ—”‡•‘Ž˜‡†ƒ†Š‘•–‹Ž‡Attachment & Human Development, ǦŠ‡Ž’Ž‡•••–ƒ–‡•‘ˆ‹†‘ –Š‡ Ǥ ͷȋͶȌǡ͵͵ͲǦ͵ͷʹǤ ƒ ‹ŽŽƒǡ ǤǤǡƒƒƒǡǤǡ——ǡǤǡƒ‹ŽŽƒ ‘—”–ǡǤǡƬ‘›Ž‡ǡǤ ǤȋʹͲͳ͵ȌǤŠ‹Ž†’Š›•‹ ƒŽƒ† •‡š—ƒŽƒ„—•‡‹ƒ ‘—‹–›•ƒ’Ž‡‘ˆ›‘—‰ƒ†—Ž–•ǣ‡•—Ž–•ˆ”‘–Š‡–ƒ”‹‘Š‹Ž† ‡ƒŽ–ŠChild Abuse & Neglect, 37 –—†›Ǥ ȋͳȌǡͳͶǦʹͳǤ 1 Malda‐Castillo, J., Browne, C., & Perez‐Algorta, G. (2018). Mentalization‐basedPsychology and Psychotherapy: treatment and Theory, its evidence‐baseResearch and Practice status: A systematic literature review. Ǥ ‡••‡”ǡǤǤǡƬƒ’‘Ž†ǡǤǤȋʹͲͲʹȌǤ‡–̵•ˆƒ ‡ˆƒ –•ǣ‘‘ˆƒ –‘”•ƒ”Clinical psychology: Science and practice,‡‘”‡’‘–‡––Šƒ 9 •’‡ ‹ˆ‹ –Š‡”ƒ’›‹‰”‡†‹‡–•Ǥ ȋͳȌǡʹͳǦʹͷǤ ‡›‡”ǡ Ǥ ǤȋʹͲͲͶȌǤŠ‡”‡Ž‹ƒ„‹Ž‹–›ƒ†˜ƒŽ‹†‹–›‘ˆ–Š‡‘”• Šƒ Šƒ†Š‡ƒ–‹ ’’‡” ‡’–‹‘‡•– ȋȌ ‘’ƒ”‡†–‘‘–Š‡”’•› Š‘Ž‘‰‹ ƒŽƒ†‡†‹ ƒŽ’”‘Comprehensive handbook ‡†—”‡•ǣƒƒŽ›•‹•‘ˆ of psychological assessment, 2, •›•–‡ƒ–‹ ƒŽŽ›‰ƒ–Š‡”‡†‡˜‹†‡ ‡Ǥ  ͵ͳͷǦ͵ͶʹǤ Thematic Apperception Test, —””ƒ›ǡ ǤǤȋͳͻͶ͵ȌǤ ƒ”˜ƒ”†‹˜‡”•‹–›”‡••ǡƒ„”‹†‰‡ǡǤ ‘Ž–‡ǡǤǡ‘ŽŽ‹‰ǡǤǤǡ —†ƒ ǡǤǡ ‘ƒ‰›ǡǤǡƒ›‡•ǡǤǤǡƬ‡Ž’Š”‡›ǡǤǤȋʹͲͳ͵ȌǤ”ƒ‹ ‡ Šƒ‹••—†‡”Ž›‹‰–Š‡‹’ƒ –‘ˆƒ––ƒ Š‡–Frontiers in Human Neuroscience 7 Ǧ”‡Žƒ–‡†•–”‡••‘•‘ ‹ƒŽ ‘‰‹–‹‘Ǥ ǡ ǡͺͳ͸Ǥ ‹ŠƒǡǤǤǡ‡ǡǤǤǡ ”‡‡ǡǤ Ǥǡ— ǡǤǡ ‡ƒŽ‡›ǡǤǡƬ ƒ”˜‡›ǡǤǤȋʹͲͳ͵ȌǤŠ‡•‘ ‹ƒŽ ‘‰‹–‹‘’•› Š‘‡–”‹ ‡˜ƒŽ—ƒ–‹‘•–—†›ǣ”‡•—Ž–•‘ˆ–Š‡‡š’‡”–•—”˜‡›ƒ†’ƒ‡ŽǤSchizophrenia bulletin, 40 ȋͶȌǡͺͳ͵Ǧͺʹ͵Ǥ ‡ƒ†ǡ Ǥǡ˜ƒ•ǡ Ǥǡ‘””‹•‘ǡǤǤǡƬ‘••ǡǤǤȋʹͲͲͷȌǤŠ‹Ž†Š‘‘†–”ƒ—ƒǡ’•› Š‘•‹•ƒ†Acta • Š‹œ‘’Š”‡‹ƒǣƒPsychiatrica Scandinavica,Ž‹–‡”ƒ–—”‡”‡˜‹‡™™‹–Š–Š‡‘”‡–‹ ƒŽƒ† Ž‹‹ ƒŽ‹’Ž‹ ƒ–‹‘•Ǥ 112 ȋͷȌǡ͵͵ͲǦ͵ͷͲǤ ‘„‡”–•ǡǤǤǡƬ‡ǡǤǤȋʹͲͲͻȌǤ‘ ‹ƒŽ ‘‰‹–‹‘ƒ†‹–‡”ƒ –‹‘–”ƒ‹‹‰ȋ Ȍˆ‘”‘—–’ƒ–‹‡–•Psychiatry research, 166 ™‹–Š• Š‹œ‘’Š”‡‹ƒǣƒ’”‡Ž‹‹ƒ”›•–—†›Ǥ ȋʹǦ͵ȌǡͳͶͳǦͳͶ͹Ǥ ‘„‹•‘ǡǤǡ ‡ŽŽ‹‡”ǡ Ǥǡƒ””‡––ǡǤǡƒ”œ†ƒ‹–‹‡‡ǡǤǡƒ–‡ƒǡǤǡ‘‰ƒƒ”†–ǡǤǡǤǤǤƬ‡”ǡǤȋʹͲͳ͸ȌǤ Š‡  ”ƒ†‘‹•‡† ‘–”‘ŽŽ‡†–”‹ƒŽ ‘’ƒ”‹‰‡–ƒŽ‹•ƒ–‹‘Ǧ„ƒ•‡†–”‡ƒ–‡–ˆ‘” ‡ƒ–‹‰†‹•‘”†‡”•ȋǦȌ™‹–Š•’‡ ‹ƒŽ‹•–•—’’‘”–‹˜‡ Ž‹‹ ƒŽƒƒ‰‡‡–ȋTrials,ǦȌˆ‘” ’ƒ–‹‡–•™‹–Š‡ƒ–‹‰†‹•‘”†‡”•ƒ†•›’–‘•‘ˆ„‘”†‡”Ž‹‡’‡”•‘ƒŽ‹–›†‹•‘”†‡”Ǥ17 ȋͳȌǡͷͶͻǤ

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146807_JonasWeijers_BNW_def.indd 21 28-10-2020 15:08 Chapter One

‘••‘—™ǡǤ ǤǡƬ ‘ƒ‰›ǡǤȋʹͲͳʹȌǤ‡–ƒŽ‹œƒ–‹‘Journal of theǦ „ƒ•‡†–”‡ƒ–‡–ˆ‘”•‡ŽˆAmerican Academy of ChildǦŠƒ”‹ƒ†‘Ž‡• ‡ & Adolescent –•ǣƒ Psychiatry,”ƒ†‘‹œ‡† 51 ‘–”‘ŽŽ‡†–”‹ƒŽǤ ȋͳʹȌǡͳ͵ͲͶǦͳ͵ͳ͵Ǥ  Š‡‡ŽǡǤǤǡ’ƒ—Ž†‹‰ǡǤǤǡ‹‹ŽŽ‘ǡǤǡƬ‹Ž˜‡”•–‡‹ǡǤǤȋʹͲͲͷȌǤ ‹•–‘”‹‡•‘ˆ Š‹Ž†Š‘‘† ƒŽ–”‡ƒ–‡–‹• Š‹œ‘’Š”‡‹ƒǣ”‡ŽƒSchizophrenia–‹‘•Š‹’•™‹–Š’”‡‘”„‹†ˆ— –‹‘‹‰ǡ•›’–‘ƒ–‘Ž‘‰›ǡ research, 76 ƒ† ‘‰‹–‹˜‡†‡ˆ‹ ‹–•Ǥ ȋʹǦ͵Ȍǡʹ͹͵Ǧʹͺ͸Ǥ ’ƒ—™‡ǡ Ǥǡ”ƒ„„‡†ƒǡǤǡ‹‡„ǡǤǡ‹–– Š‡ǡ ǤǤǡƬƒ•ǡ ǤȋʹͲͲ͸ȌǤ ’ƒ –‘ˆ’•› Š‘Ž‘‰‹ ƒŽ –”ƒ—ƒ‘–Š‡†‡˜‡Ž‘’‡–‘ˆ’•› Š‘The British Journal of Psychiatry, 188 –‹ •›’–‘•ǣ”‡Žƒ–‹‘•Š‹’™‹–Š’•› Š‘•‹•’”‘‡‡••Ǥ ȋ͸Ȍǡͷʹ͹Ǧͷ͵͵Ǥ ’”‹‰‡”ǡǤǤǡŠ‡”‹†ƒǡ Ǥǡ—‘ǡǤǡƬƒ”‡•ǡǤȋʹͲͲ͹ȌǤ‘‰Ǧ–‡”’Š›•‹ ƒŽƒ†‡–ƒŽŠ‡ƒŽ–Š ‘•‡“—‡ ‡•‘ˆ Š‹Ž†Š‘‘†’Š›•‹ ƒŽƒ„—•‡ǣChild abuse & neglect 31 ‡•—Ž–•ˆ”‘ƒŽƒ”‰‡’‘’—Žƒ–‹‘Ǧ„ƒ•‡†•ƒ’Ž‡‘ˆ ‡ƒ†™‘‡Ǥ ǡ ȋͷȌǡͷͳ͹Ǧͷ͵ͲǤ –ƒ‹ǡ Ǥ Ǥǡ”ސ‹ ǡǤǡ ‡‰‡Ž•–ƒ†ǡǤǤǡ ‘ƒǡ Ǥǡ ‘Šƒ‡••‡ǡ ǤǤǡƒ‰‡˜‡Ž†ǡ ǤǡǤǤǤƬƒ”•‡ǡǤǤ ȋʹͲͳ͵ȌǤ ’ƒ –‘ˆ‹–‡”’‡”•‘ƒŽ–”ƒ—ƒ‘–ŠSchizophrenia bulletin, 40 ‡•‘ ‹ƒŽˆ— –‹‘‹‰‘ˆƒ†—Ž–•™‹–Šˆ‹”•–Ǧ‡’‹•‘†‡ ’•› Š‘•‹•Ǥ ȋ͸ȌǡͳͶͻͳǦͳͶͻͺǤ —••‡”ǡǤǡƬ‹†‘ǡǤǤȋʹͲͳʹȌǤ–‹ŽŽ•‡ƒ” Š‹‰ˆ‘”Ž‘•––”—–Š•ƒ„‘—––Š‡„‹––‡”•‘””‘™•‘ˆSchizophrenia bulletin, 38 Š‹Ž†Š‘‘†Ǥ ȋͶȌǡ͸͹ʹǦ͸͹ͷǤ ˜ƒƒǡǤǤǡ˜ƒ‹‡”‘’ǡǤǡ‹‡ Š–„ƒ—‡”ǡǤǡ‡Ž–Š‘”•–ǡǤǡ˜ƒ‹‡ŽǡǤǡ”—‰‰‡ƒǡǤǡǤǤǤƬ ›‹Ǧ ‡”‡›•ǡ ǤȋʹͲͳͷȌǤŠ‹Ž†Š‘‘†ƒ„—•‡ƒ†‡‰Ž‡ –‹”‡Žƒ–‹‘–‘–Š‡’”‡•‡ ‡ƒ†Psychological Medicine, 45 ’‡”•‹•–‡ ‡‘ˆ’•› Š‘–‹ ƒ††‡’”‡••‹˜‡•›’–‘ƒ–‘Ž‘‰›Ǥ ȋ͹Ȍǡ ͳ͵͸͵Ǧͳ͵͹͹Ǥ ƒ”‡•‡ǡ Ǥǡ‡‡–•ǡ Ǥǡ”—‡”ǡǤǡ‹‡˜‡”•‡ǡǤǡƒ–ƒ•–‡”ǡǤǡ‹‡ Š–„ƒ—‡”ǡǤǡǤǤǤƬ‡–ƒŽŽǡǤǤ ȋʹͲͳʹȌǤŠ‹Ž†Š‘‘†ƒ†˜‡”•‹–‹‡•‹ ”‡ƒ•‡–Š‡”‹•‘ˆ’•› Š‘•‹•ǣƒ‡–ƒSchizophreniaǦƒƒŽ›•‹•‘ˆ’ƒ–‹‡– bulletin 38 Ǧ ‘–”‘Žǡ’”‘•’‡ –‹˜‡Ǧƒ† ”‘••Ǧ•‡ –‹‘ƒŽ ‘Š‘”–•–—†‹‡•Ǥ ǡ ȋͶȌǡ͸͸ͳǦ ͸͹ͳǤ ‡‹Œ‡”•ǡ Ǥǡ–‡ƒ–‡ǡǤǡ—”‡Ž‹‰•Ǧ‘–‡‘‡ǡǤǡ‹‡ Š–„ƒ—‡”ǡǤǡƒ’ƒƒ”–ǡǤǡƒ–‡ƒǡǤǡƬ‡Ž–‡ǡ ǤǤȋʹͲͳ͸ȌǤ‡–ƒŽ‹œƒ–‹‘BMC psychiatry,Ǧ„ƒ•‡†–”‡ƒ–‡–ˆ‘”’•› Š‘–‹ †‹•‘”†‡”ǣ’”‘–‘ ‘Ž‘ˆƒ”ƒ†‘‹œ‡† 16 ‘–”‘ŽŽ‡†–”‹ƒŽǤ ȋͳȌǡͳͻͳǤ . Journal of personality ‡•–‡ǡǤȋͳͻͻͳȌǤŽ‹‹ ƒŽƒ••‡••‡–‘ˆ‘„Œ‡ –”‡Žƒ–‹‘•—•‹‰assessment, 56 –Š‡ ȋͳȌǡͷ͸Ǧ͹ͶǤ   

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Chapter Two:

‡–ƒŽ‹œƒ–‹‘ƒ†’•› Š‘•‹•ǣƒ”ƒ–‹‘ƒŽ‡ˆ‘”–Š‡—•‡‘ˆ JournalMENTALIZATION of Contemporary Psychotherapy (2020) AND ‡–ƒŽ‹œƒ–‹‘–Š‡‘”›–‘—†‡”•–ƒ†ƒ†–”‡ƒ–‘Ǧƒˆˆ‡ –‹˜‡’•› Š‘–‹ †‹•‘”†‡” J. G. Weijers1,2*, C. ten Kate1,2, M. Debbané, A.W. Bateman, S. de Jong, J.-P.C.J Selten1,2, E.H.M. Eurelings- BontekoePSYCHOSIS: A RATIONALE

FOR THE USE OF MENTALIZATION THEORY TO UNDERSTAND AND TREAT NON-AFFECTIVE PSYCHOTIC DISORDER 2

1

‹˜‹‡”†—‹‡ •–‹–—–‡ˆ‘”‡–ƒŽ ‡ƒŽ–Šƒ”‡ǡ–Š‡‡–Š‡”Žƒ†•Ǥ ʹ  Š‘‘Žˆ‘”‡–ƒŽ ‡ƒŽ–Šƒ†‡—”‘• ‹‡ ‡ǡƒƒ•–”‹ Š–‹˜‡”•‹–›ǡŠ‡‡–Š‡”Žƒ†•Ǥ ͵ ƒ —Ž–±†‡•› Š‘Ž‘‰‹‡‡–†‡• ‹‡ ‡•†‡Ž̵2†— ƒ–‹‘ǡ‹˜‡”•‹–±†‡ ‡°˜‡ǡ™‹–œ‡”Žƒ† Ͷ J.•› Š‘ƒƒŽ›•‹•‹–ǡ‹˜‡”•‹–›‘ŽŽ‡‰‡‘†‘ǡ G. Weijers, C. ten Kate, M. Debbané, A.W. Bateman, ͷ ‡’ƒ”–‡–‘ˆŽ‹‹ ƒŽ•› Š‘Ž‘‰›ǡ ‡ƒŽ–Šƒ†‡—”‘’•› Š‘Ž‘‰›ǡ‡‹†‡‹˜‡”•‹–›ǡ‡‹†‡ǡŠ‡ S. de Jong,ȗ J.-P.C.J Selten, E.H.M. Eurelings-Bontekoe ‡–Š‡”Žƒ†•Ǥ ‘””‡•’‘†‹‰ƒ—–Š‘”ǣ ‘ƒ•‡‹Œ‡”•ǡŒǤ™‡‹Œ‡”•̷”‹˜‹‡”†—‹‡ǤŽǤ

Journal of Contemporary Psychotherapy (2020) Chapter Chapter

146807_JonasWeijers_BNW_def.indd 25 28-10-2020 15:08 Chapter Two

Abstract

‘ ‹ƒŽˆ— –‹‘‹‰ ƒ„‡•‡˜‡”‡Ž›‹’ƒ‹”‡†‹‘Ǧƒˆˆ‡ –‹˜‡’•› Š‘–‹ †‹•‘”†‡”ȋȌǤ—””‡– ‘†‡Ž•‘ˆ’•› Š‘•‹•’ƒ–Š‘‰‡‡•‹•†‘‘––‡†–‘ˆ‘ —•‘•‘ ‹ƒŽ†›•ˆ— –‹‘ƒ†’Šƒ”ƒ ‘Ž‘‰‹ ƒŽ –”‡ƒ–‡–ˆƒ‹Ž•–‘ƒ‡Ž‹‘”ƒ–‡‹–Ǥ –Š‹•ƒ”–‹ Ž‡ǡ™‡’”‘’‘•‡–Šƒ–‡–ƒŽ‹œƒ–‹‘–Š‡‘”›’”‘˜‹†‡•ƒ ˜ƒŽ—ƒ„Ž‡ ‘–”‹„—–‹‘–‘–Š‡—†‡”•–ƒ†‹‰ƒ†–”‡ƒ–‡–‘ˆǤ ’ƒ‹”‡†‡–ƒŽ‹œ‹‰ƒ› ‘–”‹„—–‡–‘„‘–Š’‘•‹–‹˜‡ƒ†‡‰ƒ–‹˜‡••›’–‘•ƒ•™‡ŽŽƒ••‘ ‹ƒŽ†›•ˆ— –‹‘‘„•‡”˜‡†‹ Ǥ —”–Š‡”‘”‡ǡ‹’ƒ‹”‡†‡–ƒŽ‹œ‹‰ƒ›Š‡Ž’‡š’Žƒ‹–Š‡”‡Žƒ–‹‘„‡–™‡‡ Š‹Ž†Š‘‘†ƒ„—•‡ǡ ‹•‡ —”‡ƒ––ƒ Š‡–ƒ†’•› Š‘•‹•Ǥ‡–ƒŽ‹œƒ–‹‘„ƒ•‡†–”‡ƒ–‡–ƒ› ‘–”‹„—–‡–‘–Š‡ˆ— –‹‘ƒŽ ”‡ ‘˜‡”›‘ˆ’ƒ–‹‡–•ƒ•‹––ƒ”‰‡–•–Š‡•‘ ‹ƒŽ ‘‰‹–‹˜‡’”‘ ‡••‡•—†‡”Ž›‹‰•‘ ‹ƒŽ‹–‡”ƒ –‹‘Ǥ Š‡ƒ”–‹ Ž‡‹ Ž—†‡•ƒ†‡• ”‹’–‹‘‘ˆ–Š‡’”‹ ‹’Ž‡•‘ˆ‹‰‡‡”ƒŽǡ•’‡ ‹ˆ‹  Šƒ”ƒ –‡”‹•–‹ •‘ˆ —•‹‰™‹–Š’ƒ–‹‡–•™‹–Šƒ†ƒ Ž‹‹ ƒŽ˜‹‰‡––‡–‘‹ŽŽ—•–”ƒ–‡–Š‡•‡’”‹ ‹’Ž‡•Ǥ Keywords: ’•› Š‘•‹•ǡ• Š‹œ‘’Š”‡‹ƒǡƒ––ƒ Š‡––Š‡‘”›ǡ‡–ƒŽ‹œ‹‰ǡ‡’‹•–‡‹ –”—•–ǡ ‡–ƒŽ‹œƒ–‹‘„ƒ•‡†–”‡ƒ–‡–  Part I: A mentalization based model of psychosis pathogenesis

Introduction.

”‡ ‡–ǡ†‘‹ƒ–‘†‡Ž‘ˆ’•› Š‘•‹•’ƒ–Š‘‰‡‡•‹•ȋ ‘™‡•Ƭ—””ƒ›ǡʹͲͳͶȌ •—‰‰‡•–•–Šƒ–ƒ›ˆƒ –‘”• ‘–”‹„—–‡–‘–Š‡‡–‹‘Ž‘‰›‘ˆ’•› Š‘•‹•ǡ•— Šƒ•˜ƒ”‹ƒ–‰‡‡•ǡ•–”‡••ǡ ‡—”‘‹ˆŽƒƒ–‹‘ǡ†›•”‡‰—Žƒ–‡†ƒ –‹˜‹–›‹–Š‡Š›’‘–ŠƒŽƒ‹ –’‹–—‹–ƒ”›–ƒ†”‡ƒŽƒš‹•ǡƒ† †‡˜‡Ž‘’‡–ƒŽ‹•—Ž–•ȋ‡Ǥ‰Ǥǡ’”‡Ǧƒ†’‡”‹ƒ–ƒŽ ‘’Ž‹ ƒ–‹‘•ȌǤ –‹•ˆ—”–Š‡”‘”‡Š‡Ž†–Šƒ––Š‡ ƒ••‹‰‡–‘ˆƒ„‡””ƒ–•ƒŽ‹‡ ‡ȋ‹Ǥ‡Ǥǡ‘–‹˜ƒ–‹‘ƒŽ˜ƒŽ—‡Ȍ–‘—†ƒ‡•–‹—Ž‹†—‡–‘ƒ•‡•‹–‹œ‡† ‡•‘Ž‹„‹ †‘’ƒ‹‡•›•–‡‹•–Š‡ˆ‹ƒŽ ‘‘’ƒ–Š™ƒ›–Š”‘—‰Š™Š‹ Š–Š‡•‡˜ƒ”‹ƒ„Ž‡•‹ ”‡ƒ•‡ ’•› Š‘•‹•”‹•Ǥ††‹–‹‘ƒŽŽ›ǡ–Š‡”‡‹•‹ ”‡ƒ•‡† ‘•‡•—•–Šƒ–‹•ƒ––”‹„—–‹‘’”‘ ‡••‡•‹–Š‡ˆ‘” ‘ˆ ‘‰‹–‹˜‡„‹ƒ•‡•ƒ”‡ƒŽ•‘‹˜‘Ž˜‡†‹–Š‡‡–‹‘Ž‘‰›‘ˆ’•› Š‘•‹•Ǥ ‘”‡šƒ’Ž‡ǡŠƒŽŽ— ‹ƒ–‹‘•†‘‘– •‘Ž‡Ž›‹˜‘Ž˜‡ƒ„‡””ƒ–‡š’‡”‹‡ ‡„—–ƒŽ•‘‹˜‘Ž˜‡–Š‡‹•ƒ––”‹„—–‹‘‘ˆ•— Š‡š’‡”‹‡ ‡•–‘ ‘—–•‹†‡•‘—” ‡•ȋŽ‡ƒƬƒ”Þ‹ǡʹͲͲͺȌǤŠ‹”†Ž›ǡ‡˜‹†‡ ‡•—‰‰‡•–•–Šƒ–•‘ ‹‘Ǧ†‡˜‡Ž‘’‡–ƒŽ ƒ†˜‡”•‹–›’Žƒ›•ƒ˜‹–ƒŽ”‘Ž‡‹–Š‡†‡˜‡Ž‘’‡–‘ˆ’•› Š‘•‹•–Š”‘—‰Š–Š‡•‡•‹–‹œƒ–‹‘‘ˆ–Š‡ ‡•‘Ž‹„‹ †‘’ƒ‹‡•›•–‡ȋ‡Ǥ‰Ǥǡ‡Ž–‡ǡ˜ƒ†‡”‡ǡ—––‡ǡƬƒ–‘”Ǧ ”ƒƒ‡ǡʹͲͳ͵ȌǤ ••— Šǡ–Š‡”‡ ‡– ‘ ‡’–—ƒŽ‹œƒ–‹‘‘ˆ’•› Š‘•‹•ȋ ‘™‡•Ƭ—””ƒ›ǡʹͲͳͶȌ‘ˆˆ‡”•ƒ— Š ‡‡†‡†‹–‡‰”ƒ–‹‘‘ˆ†‹ˆˆ‡”‡–‡—”‘†‡˜‡Ž‘’‡–ƒŽǡ„‹‘Ž‘‰‹ ƒŽǡƒ† ‘‰‹–‹˜‡‘†‡Ž•–‘ƒ ‘—–ˆ‘” psychotic or “positive” symptoms, such as delusions or hallucinations. However, nonǦƒˆˆ‡ –‹˜‡

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146807_JonasWeijers_BNW_def.indd 26 28-10-2020 15:08 Mentalization and psychosis

ͳ ’•› Š‘–‹ †‹•‘”†‡”•ȋ ȌŽ‹‡• Š‹œ‘’Š”‡‹ƒǡ„”‹‡ˆ’•› Š‘–‹ †‹•‘”†‡”ƒ†• Š‹œ‘ƒˆˆ‡ –‹˜‡ †‹•‘”†‡”ǡƒŽ•‘‹˜‘Ž˜‡‡‰ƒ–‹˜‡•›’–‘••— Šƒ•Žƒ ‘ˆ‹‹–‹ƒ–‹˜‡‘”ˆŽƒ––‡‡†ƒˆˆ‡ –‹˜‡‡š’”‡••‹‘ ƒ†•‘ ‹ƒŽ†›•ˆ— –‹‘ȋ ”‡‡ǡ ‘”ƒƬ‡‡ǡʹͲͳͻȌǡ™Š‹ Šƒ”‡Ž‡••’”‘‹‡–Ž›ˆ‡ƒ–—”‡†‹‘•– —””‡–‡–‹‘Ž‘‰‹ ƒŽ‘†‡Ž•‘ˆ’•› Š‘•‹•Ǥ‡ ƒ—•‡‡–ƒŽ‹œƒ–‹‘–Š‡‘”›ˆ‘ —•‡•‘–Š‡†‡˜‡Ž‘’‡– ‘ˆ•‘ ‹ƒŽ ‘‰‹–‹˜‡’”‘ ‡••‡•ǡ‹–ƒ›‘ˆˆ‡”ƒ˜ƒŽ—ƒ„Ž‡ ‘–”‹„—–‹‘–‘ —””‡–‘†‡Ž•‘ˆSocial dysfunction and social cognition in NAPD. Ǥ ‡•‡ƒ” Š•Š‘™•–Šƒ–’”‡‘”„‹†•‘ ‹ƒŽ †›•ˆ— –‹‘ƒ†ƒ†˜‡”•‹–›’”‡†‹ –’‘‘” Ž‹‹ ƒŽƒ†ˆ— –‹‘ƒŽ‘—– ‘‡‹ȋ‡Ǥ‰ǤŠ‹–‡‡–ƒŽǤǡ ʹͲͲͻǢ‡Ž–Š‘”•–‡–ƒŽǤǡʹͲͳͲǢ–—„‘‡–ƒŽǤǡʹͲͳͷȌǤŠ‡”‡ƒ•’‘•‹–‹˜‡•›’–‘•‘ˆ–‡ ƒ„‡–”‡ƒ–‡† 2 ƒ†‡“—ƒ–‡Ž›™‹–Šƒ–‹’•› Š‘–‹ ‡†‹ ƒ–‹‘ǡ•‘ ‹ƒŽ†›•ˆ— –‹‘ ƒ‘–ȋ‹Šƒǡ‡ǡ‡”‹•Ƭ ‹‡„‡”ƒǡʹͲͲ͵Ȍǡ‘ˆ–‡ ”‡ƒ–‹‰ƒ™‹†‡‰ƒ’„‡–™‡‡–Š‡•‡˜‡”‹–›‘ˆ•›’–‘•ƒ††›•ˆ— –‹‘‹ ’ƒ–‹‡–•™‹–Š Š”‘‹ isȋ‡Ǥ‰Ǥǡ‹” Š™‘‘†‡–ƒŽǤǡʹͲͳ͵ȌǤ ‘™‡˜‡”ǡƒ”‡ ‡–”‡˜‹‡™•Š‘™‡†–Šƒ– ˆ— –‹‘ƒŽ”‡ ‘˜‡”› ’‘••‹„Ž‡ǡ™‹–Š–Š‡”ƒ–‡ˆ‘””‡ ‘˜‡”›‘ˆƒ†‡“—ƒ–‡•‘ ‹ƒŽˆ— –‹‘‹‰Ž›‹‰ „‡–™‡‡ͳͶΨƒ†ͷ͵Ψȋ‡‘Šƒ”†–‡–ƒŽǤsocial ǡʹͲͳ͹ȌǤƒ–Š‡”–Šƒ’Šƒ”ƒ ‘Ž‘‰‹ ƒŽˆƒ –‘”•Š‘™‡˜‡”ǡ ˆƒ –‘”••— Šƒ•ˆ‡‡Ž‹‰ ‘‡ –‡†ȋ‹•‡•–ƒ†–ǡ‘–‡‹”‘ǡ‹‹œƬŠƒ˜‡•ǡʹͲͳʹǢ ‡†”›š ”‡‡ Ƭ‡””‹ǡʹͲͲͻȌƒ†‡š’‡”‹‡ ‹‰•‘ ‹ƒŽ•—’’‘”–ȋ‘”ƒǡ‹†‡ŽŽǡ› ŠƬƒ Šƒ†ƒǡʹͲͳ͵Ǣ Š‘ƒ•ǡ—”ƒŽ‹†Šƒ”ƒǡ‡†‘ˆˆǡƬ”ƒ’ƒŽ•‹ǡʹͲͳ͸Ȍ•‡‡‹•–”—‡–ƒŽ–‘•—„Œ‡ –‹˜‡ƒ†‘„Œ‡ –‹˜‡ ˆ— –‹‘ƒŽ”‡ ‘˜‡”›Ǥ•ƒ”‡•—Ž–ǡ–Š‡†‡˜‡Ž‘’‡–‘ˆ‘’Šƒ”ƒ ‘Ž‘‰‹ ƒŽǡƒ†Œ— –‹˜‡–”‡ƒ–‡–• –Šƒ–‹’”‘˜‡ˆ— –‹‘‹‰‹Šƒ•„‡‡ƒ‹’‘”–ƒ–‰‘ƒŽ‹”‡ ‡–’•› Š‘•‹•”‡•‡ƒ” Šȋ‡Ǥ‰Ǥǡ ‘Ž–Šƒ—•‡‡–ƒŽǤǡʹͲͲ͹ȌǤ ‘ ‹ƒŽ ‘‰‹–‹‘‹•–Š‡—Ž–‹ˆƒ ‡–‡††‘ƒ‹‘ˆ ‘‰‹–‹˜‡ƒ†ƒˆˆ‡ –‹˜‡’”‘ ‡••‡•–Šƒ– —†‡”Ž‹‡•‘ ‹ƒŽ‹–‡”ƒ –‹‘Ǥ ‹˜‡–Šƒ–•‘ ‹ƒŽ ‘‰‹–‹˜‡†‡ˆ‹ ‹–•ƒ”‡™‹†‡Ž›Ž‹‡†–‘’‘‘”•‘ ‹ƒŽ ˆ— –‹‘‹‰‹’ƒ–‹‡–•™‹–Šȋ•‡‡ ‡––ǡ‹‡ Š–„ƒ—‡”ǡ‡ǡ˜ƒ•Ƭ”ƒ„„‡†ƒǡʹͲͳͳȌǡ–Š‡› Šƒ˜‡‰ƒ”‡”‡†‹ ”‡ƒ•‡†‹–‡”‡•–ƒ•ƒ–”‡ƒ–‡––ƒ”‰‡–Ǥƒ›Ž‹‡•‘ˆ”‡•‡ƒ” Š‘’––‘ˆ‘ —•‘ specific aspects of social cognition such as facial affect recognition or “theory of mind,” i.e., the ƒ„‹Ž‹–›–‘‹ˆ‡”‡–ƒŽ•–ƒ–‡•‘ˆ‘–Š‡”•ȋ ”‡‡‡–ƒŽǤǡʹͲͳͻȌǤ ‘™‡˜‡”ǡ‹– ƒ„‡ƒ”‰—‡†–Šƒ–™‡ŽŽǦ †‡˜‡Ž‘’‡†•‘ ‹ƒŽ ‘‰‹–‹‘ ‘’”‹•‡•–Š‡•— ‡••ˆ—Ž•›–Š‡•‹•‘ˆ‹–•†‹ˆˆ‡”‡–ƒ•’‡ –•Ǥ  ”‡ƒ•‹‰–Š‡that •— ‡••ˆ—Ž”‡ ‘‰‹–‹‘‘ˆˆƒ ‹ƒŽƒˆˆ‡ –‹˜‡‡š’”‡••‹‘ǡƒ›Š‡Ž’–‘”‡ ‘‰‹œ‡why •‘‡‘‡‹•ƒ‰”›ǡ „—–†‘‡•‘–‡ ‡••ƒ”‹Ž›‡ƒ–Šƒ–‘‡‹•„‡––‡”ƒ„Ž‡–‘‹–‡”’”‡– ƒ’‡”•‘‹•ƒ‰”›Ǥ‡ ‡– lines of research have therefore taken a more ‘holistic’ approach, proposing that underlying social ‘‰‹–‹˜‡†‡ˆ‹ ‹–•‹•ƒ‹’ƒ‹”‡†ƒ„‹Ž‹–›–‘–Š‹ƒ„‘—––Š‘—‰Š–•ƒ†‡‘–‹‘•ȋ‡‡”ƒ”‹‡–ƒŽǤǡʹͲͲ͵Ȍ ƒŽ•‘–‡”‡†‡–ƒŽ‹œƒ–‹‘ȋ ‘ƒ‰›ǡͳͻͺͻȌ‘”‡–ƒ ‘‰‹–‹‘ȋ›•ƒ‡”‡–ƒŽǤǡʹͲͲͷȌǤŠ‹Ž‡–Š‹•ƒ”–‹ Ž‡

ͳ Š‹•’ƒ’‡”™‹ŽŽˆ‘ —•‡š Ž—•‹˜‡Ž›‘‘Ǧƒˆˆ‡ –‹˜‡’•› Š‘–‹ †‹•‘”†‡”•ȋȌǡ„‡ ƒ—•‡ƒˆˆ‡ –‹˜‡’•› Š‘–‹  †‹•‘”†‡”•ƒ›Šƒ˜‡ƒ†‹ˆˆ‡”‡–’ƒ–Š‘‰‡‡•‹•Ǥ 

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146807_JonasWeijers_BNW_def.indd 27 28-10-2020 15:08 Chapter Two

ƒ‹Ž›ˆ‘ —•‡•‘‡–ƒŽ‹œ‹‰ǡ™‡™‹ŽŽƒŽ•‘–‘— Š—’‘‡–ƒ ‘‰‹–‹‘ǡ‰‹˜‡–Š‡ ‘ ‡’–—ƒŽ‘˜‡”Žƒ’ ‘ˆ–Š‡•‡ ‘•–”— –•ǤSocial cognition, mentalization and metacognition. ‘—†‡”•–ƒ†–Š‡ ‘•–”— –•‘ˆ ‡–ƒŽ‹œ‹‰ƒ†‡–ƒ ‘‰‹–‹‘ǡ™‡ˆ‹”•–‡‡†–‘Ž‘‘ƒ––Š‡‘”‡–‹ ƒŽƒ ‘—–•‘ˆŠ‘™’‡‘’Ž‡ ‘‡–‘ —†‡”•–ƒ†‹†•Ǥ–‹Ž”‡ ‡–Ž›ǡ–™‘–Š‡‘”‹‡•’‘Žƒ”‹œ‡†–Š‡ˆ‹‡Ž†‘ˆ•‘ ‹ƒŽ ‘‰‹–‹‘ȋ‡›•‡”•Ƭ ƒœœ‘ŽƒǡʹͲͲ͹ȌǤ‹—Žƒ–‹‘–Š‡‘”›Š‘Ž†•–Šƒ–’‡‘’Ž‡†‡˜‡Ž‘’ƒ‡š’‡”‹‡–‹ƒŽ—†‡”•–ƒ†‹‰‘ˆ others through the simulation of others’ experiences, through mirror neurons and shared sensoryǦ ƒˆˆ‡ –‹˜‡ ‹” —‹–•ȋ ƒŽŽ‡•‡ǡʹͲͲͷȌǤŠ‡‹–‡†‡†‡ƒ‹‰‘ˆƒ –‹‘•‹•˜‹‡™‡†–‘„‡—†‡”•–‘‘† implicitly, through shared feeling. ‘Theory–Š‡‘”›’ on the other hand, holds that we come to understand others through the cognitive inference of “rules” from observed social situations, thus ƒ––”‹„—–‹‰–Š‡‘”‡–‹ ƒŽ„‡Ž‹‡ˆ•ƒ†‹–‡–‹‘•–‘–Š‡ȋ‡Ǥ‰Ǥƒ”‘Ǧ‘Š‡ǡ‡•Ž‹‡Ƭ ”‹–Šǡͳͻͺ͸ȌǤŠ‡•‡ ”—Ž‡•ƒ”‡–Š‘—‰Š––‘„‡—’†ƒ–‡†‹ˆ–Š‡‘†‡Ž•†‘‘–’”‡ ‹•‡Ž›’”‡†‹ – —””‡–•‹–—ƒ–‹‘•Ǥ – ƒ„‡ƒ”‰—‡†–Šƒ–„‘–Š‡–ƒ ‘‰‹–‹‘ƒ†‡–ƒŽ‹œƒ–‹‘ǡ„”‹†‰‡–Š‡‰ƒ’„‡–™‡‡–Š‡•‡ –™‘’‘•‹–‹‘•Ǥ‡–ƒŽ‹œ‹‰—defined as a form of “imaginative mental activity through which behavior is interpreted in terms of mental states like needs, feelings, beliefs and goals” (Bateman & ‘ƒ‰›ǡʹͲͲͶȌ— ƒ„‡—†‡”•–‘‘†ƒ•–Š‡†›ƒ‹ ‹–‡”’Žƒ›„‡–™‡‡‹’Ž‹ ‹–ǡ”‡ˆŽ‡š‹˜‡ǡƒˆˆ‡ –Ǧ ‘”‹‡–‡†’”‘ ‡••‡•ƒ†‡š’Ž‹ ‹–ǡ”‡ˆŽ‡ –‹˜‡ǡ ‘‰‹–‹‘Ǧ‘”‹‡–‡†’”‘ ‡••‡•Ǥ‡–ƒ ‘‰‹–‹‘”‡ˆ‡”•–‘ƒ “spectrum of mental activities by which persons form integrated ideas about their own minds and those of others” (LysakerƬ‹ƒ‰‰‹‘ʹͲͳͶȌǤ‡–ƒ ‘‰‹–‹‘ ‘’”‹•‡•†‹• ”‡–‡ƒ –‹˜‹–‹‡••— Šƒ• ƒˆˆ‡ –”‡ ‘‰‹–‹‘ƒ†‘”‡•›–Š‡–‹ ƒ –‹˜‹–‹‡••— Šƒ•–Š‡‹–‡‰”ƒ–‹‘‘ˆ‡š’‡”‹‡ ‡•‹–‘ ‘˜‡”ƒ” Š‹‰ƒ””ƒ–‹˜‡•Ǥ‘–Š ‘ ‡’–••—‰‰‡•––Šƒ–™e do not just experience another’s mental state –Š”‘—‰Š•Šƒ”‡†‡‘–‹‘•—–Š‹•™‘—Ž†‘–†‹ˆˆ‡”‡–‹ƒ–‡—•— Šˆ”‘ƒ ƒ“—‡•ȋ ƒŽŽ‡•‡ǡʹͲͲͷȌ— „—––Šƒ–™‡—•‡Š‹‰Š‡”Ǧ‘”†‡” ‘‰‹–‹˜‡’”‘ ‡••‡•–‘–”ƒ•ˆ‘”†‹• ”‡–‡‡š’‡”‹‡ ‡•‹–‘ ‘• ‹‘—• ”‡’”‡•‡–ƒ–‹‘•–Šƒ– ƒ„‡—•‡†–‘‹’”‘˜‡‘—”—†‡”•–ƒ†‹‰‘ˆ‘—”•‡Ž˜‡•ƒ•™‡ŽŽƒ•‘–Š‡”•Ǥ ‘™‡˜‡”ǡ–Š‡ ‘ ‡’–‘ˆ‡–ƒŽ‹œƒ–‹‘‹•ƒ Š‘”‡†‹’•› Š‘ƒƒŽ›–‹ ƒ†’ƒ”–‹ —Žƒ”Ž›ƒ––ƒ Š‡– –Š‡‘”›ǡ•’‡ ‹ˆ›‹‰’ƒ”–‹ —Žƒ”’”‡ ‘†‹–‹‘•ˆ‘”–Š‡†‡˜‡Ž‘’‡–‘ˆ‡–ƒŽ‹œ‹‰ƒ„‹Ž‹–›ǡƒ‡Ž›ǡƒ parent’s capacity to reflect on the mind of –Š‡ Š‹Ž†Ǥ  ‘–”ƒ•–ǡ‡–ƒ ‘‰‹–‹‘‹•’‘•‹–‡†ƒ•ƒ ͳ ‹–‡‰”ƒ–‹˜‡‘†‡Ž–Šƒ–‹•‘–•’‡ ‹ˆ‹ ƒŽŽ›Ž‹‡†–‘ƒ†‡˜‡Ž‘’‡–ƒŽ–Š‡‘”›Mentalizing impairments and NAPD. Ǥ ‰”‘™‹‰„‘†›‘ˆ”‡•‡ƒ” ŠŠƒ•‘„•‡”˜‡†ƒ”ƒ‰‡‘ˆ †‡ˆ‹ ‹–•‹ ‘‰‹–‹˜‡ƒ†ƒˆˆ‡ –‹˜‡ƒ•’‡ –•‘ˆ‡–ƒŽ‹œ‹‰ƒ†‡–ƒ ‘‰‹–‹‘‹Ǥƒ–‹‡–•™‹–Š –‡†–‘Šƒ˜‡ƒ‹’ƒ‹”‡†ƒ„‹Ž‹–›–‘‹ˆ‡”–Š‡‡–ƒŽ•–ƒ–‡•‘ˆ‘–Š‡”•ȋˆ‘”‘˜‡”˜‹‡™••‡‡

ͳ  ‘™‡˜‡”ǡ‹–•Š‘—Ž†„‡‘–‡†–Šƒ–ƒ––ƒ Š‡––Š‡‘”›Šƒ•”‡ ‡‹˜‡†‹ ”‡ƒ•‡†ƒ––‡–‹‘‹”‡ ‡– ‡–ƒ ‘‰‹–‹˜ ‡Ž‹–‡”ƒ–—”‡ǡ•‡‡›†‹‡–ƒŽǤȋʹͲͳ͸Ȍˆ‘”‡šƒ’Ž‡Ǥ

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146807_JonasWeijers_BNW_def.indd 28 28-10-2020 15:08 Mentalization and psychosis

ƒ””‹‰–‘ǡ‹‡‰‡”–Ƭ Ž—”‡ǡʹͲͲͷǢ’”‘‰ǡ Š‘–Š‘”•–ǡ‘•ǡ ‘šǡƬƒ‰‡Žƒ†ǡʹͲͲ͹Ȍƒ† —†‡”stand others’ emotional expressions (O’Driscoll, Laing & Mason, 2014). They also tend to have –”‘—„Ž‡”‡ ‘‰‹œ‹‰–Š‡‹”‘™‹–‡”ƒŽ•‡•‘”›Ǧƒˆˆ‡ –‹˜‡‡š’‡”‹‡ ‡ȋ”—‡Ž‹‡–ƒŽǤǡʹͲͲ͹Ȍƒ† •Š‘™†‹ˆˆ‹ —Ž–›˜‡”„ƒŽ‹œ‹‰•— Š‡š’‡”‹‡ ‡ȋ”±‡ƒ—ǡʹͲͲ͸ȌǤ ”‹–ŠȋͳͻͻʹȌ™ƒ•‘‡‘ˆ–Š‡ˆ‹”•––‘ •—‰‰‡•––Šƒ–ƒ‹’ƒ‹”‡† ƒ’ƒ ‹–›–‘‡š’‡”‹‡ ‡ƒ†”‡’”‡•‡–‡–ƒŽ•–ƒ–‡•‘ˆ•‡Žˆƒ†‘–Š‡”•‹• –‹‡†–‘•’‡ ‹ˆ‹  Ž‹‹ ƒŽ•›’–‘•‘ˆǤ ‘”‡šƒ’Ž‡ǡ†‡Ž—•‹‘•‘ˆ’‡”•‡ —–‹‘ƒ†”‡ˆ‡”‡ ‡ƒ”‡ǡ ƒŽ‘•–„›†‡ˆ‹‹–‹‘ǡˆƒ‹Ž—”‡•–‘ ‘””‡ –Ž›”‡’”‡•‡––Š‡‹†•‘ˆ‘–Š‡”•Ǥ††‹–‹‘ƒŽŽ›ǡ ‹•—†‡”•–ƒ†‹‰–Šƒ– ‡”–ƒ‹‰‡•–—”‡•ǡ‡š’”‡••‹‘•ǡƒ†‹–‘ƒ–‹‘• ‘˜‡›‡–ƒŽ•–ƒ–‡•ǡƒ› 2 ƒ—•‡™Šƒ– Ž‹‹ ‹ƒ•’‡” ‡‹˜‡–‘„‡ˆŽƒ––‡‡†ƒˆˆ‡ –‹˜‡‡š’”‡••‹‘ȋ ”‹–ŠǡͳͻͻʹȌǤ‹’ƒ‹”‡†ƒ„‹Ž‹–› –‘‹ˆ‡”–Š‡‡–ƒŽ•–ƒ–‡•‘ˆ‘–Š‡”•‹•ƒŽ•‘Ž‹‡Ž›–‘•‡˜‡”‡Ž› ‘’Ž‹ ƒ–‡•‘ ‹ƒŽ‹–‡”ƒ –‹‘ǡƒ•‹–Ž‡ƒ†• –‘†‹ˆˆ‹ —Ž–›—†‡”•–ƒ†‹‰‹–•—™”‹––‡‘”‡•ǤŠ‹•ƒ›ƒ‡•‘ ‹ƒŽ‹–‡”ƒ –‹‘‘˜‡”™Š‡Ž‹‰Ž› ‘’Ž‡šƒ†‹–—”ƒ›Ž‡ƒ†–‘™‹–Š†”ƒ™ƒŽ‹’ƒ–‹‡–•‘”‘•–”ƒ ‹•ˆ”‘’‡‡”•Ǥ †‡‡†ǡ ‡–ƒŽ‹œ‹‰†‡ˆ‹ ‹–••‡‡”‡Žƒ–‡†–‘„‘–Š’‘•‹–‹˜‡ȋ‡Ǥ‰Ǥ ƒ••‘ǦŠƒ›‘ǡ ‘Ž†œ™‡‹‰ǡƒ˜‹Ǧ‘–‡„‡”‰ǡ —–Š‡”ǡ›•ƒ‡”ǡʹͲͳͺǢ Ž‡‘†ǡ —Ž‡›ǡƒ ‡–Šǡ Š™ƒƒ—‡”Ƭ›•ƒ‡”ǡʹͲͳͶȌƒ†‡‰ƒ–‹˜‡ •›’–‘•ȋ Ž‡‘†‡–ƒŽǤǡImpaired embodiedʹͲͳͶǢ‡‹Œ‡”•‡–ƒŽǤǡʹͲͳͺȌǤ mentalizing in NAPD.  ‡„„ƒ±‡–ƒŽǤȋʹͲͳ͸Ȍˆ—”–Š‡”‡š’ƒ†‡†—’‘ Frith’s hypothesis by suggesting that patients with NAPD suffer specifically from problems with ‘embodied’ mentalizing. Embodied mentalizing‹˜‘Ž˜‡•–Š‡ƒ„‹Ž‹–›–‘ ‘• ‹‘—•Ž›†‡–‡ –ƒ† ‹†‡–‹ˆ›•‡•‘”›Ǧaffective signals coming from one’s body and to critically think about them. Indeed, ’ƒ–‹‡–•–‡†–‘ƒ‡‡””‘”•‹–Š‡†‡–‡ –‹‘ƒ†‹†‡–‹ˆ‹ ƒ–‹‘‘ˆ•‡ŽˆǦ‰‡‡”ƒ–‡†‡˜‡–•ǡ‘” ‘sourcemonitoring errors’ (see Brookwell, Bentall & Varese, 2013 for an overview). Problems in detecting and accurately representing one’s own sensoryǦƒˆˆ‡ –‹˜‡‡š’‡”‹‡ ‡‹–—” ƒ—•‡ ’”‘„Ž‡•‹‡–ƒŽ‹œ‹‰ȋ‹†Ƭ‘™Ž‡”ǡʹͲͲͻǢƒ–”‘™‹–œǡ ‘’–ƒǡ‡‹–ƒǡ‹Ž‹’‘Ƭ ƒ˜‹––ǡ ʹͲͳͶȌǤŠ‡‡„‘†‹‡†‡–ƒŽ‹œ‹‰„‡ ‘‡•—„ƒŽƒ ‡†ǡ‘‡ƒ›ƒ••‹‰–‘‘— Š ‡”–ƒ‹–›–‘ one’s sensoryǦƒˆˆ‡ –‹˜‡‡š’‡”‹‡ ‡•ƒ•ƒ —”ƒ–‡”‡’”‡•‡–ƒ–‹‘•‘ˆ”‡ƒŽ‹–›Ǥ ˆ•— Š‡š’‡”‹‡ ‡•ƒ”‡ ‘– ŠƒŽŽ‡‰‡†ƒ†”‡‰—Žƒ–‡†„› ‘‰‹–‹˜‡‡ Šƒ‹•••— Šƒ•”‡ƒ’’”ƒ‹•ƒŽǡ–Š‡›ƒ› ‘‡–‘„‡ ‹–‡”’”‡–‡†ƒ•‡“—ƒ–‹‰™‹–Š”‡ƒŽ‹–›ǤŠ‡–‘‘— Š ‡”–ƒ‹–›‹•ƒ••‹‰‡†–‘’”‹‘” ‘‰‹–‹˜‡„‡Ž‹‡ˆ• ‘–Š‡‘–Š‡”Šƒ†ǡ–Š‹•”—•–Š‡”‹•‘ˆ‹• ‘•–”—‹‰”‡ƒŽ‹–›‹ˆ•— Š„‡Ž‹‡ˆ•™‹ŽŽˆƒ‹Ž–‘„‡—’†ƒ–‡†„› •‡•‘”›EpistemicǦƒˆˆ‡ –‹˜‡‡š’‡”‹‡ ‡Ǥ mistrust and cognitive biases in NAPD. ƒ–‹‡–•™‹–Š‘–‘Ž›Šƒ˜‡†‹ˆˆ‹ —Ž–› —’†ƒ–‹‰–Š‡‹”„‡Ž‹‡ˆ•‘–Š‡„ƒ•‹•‘ˆ•‡•‘”›Ǧƒˆˆ‡ –‹˜‡‡š’‡”‹‡ ‡„—–‘ˆ–‡„‡ ‘‡—•—• ‡’–‹„Ž‡ to others’ viewpoints. Psychosis ofte ‘‹ ‹†‡•™‹–ŠƒŽ‘••‘ˆ•‘ ‹ƒŽŽ› ‘•–”—‡†‡ƒ‹‰ (‘common’ sense in its literal meaning) and ‘epistemic trust’ (e.g. Pereira & Debbané, 2018).

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Epistemic trust is defined as the “willingness to consider new knowledge from another person as –”—•–™‘”–Š›ǡgeneralizable, and relevant to the self” (Fonagy et al., 2015). According to the ‡’‹•–‡‹ –”—•–Š›’‘–Š‡•‹•ǡ–Š‡”‡ƒ”‡–™‘™ƒ›•‹™Š‹ Š’‡‘’Ž‡ƒ› ‘‡–‘ƒ ‡’–‡™˜‹‡™•ƒ• –”—‡ǣŠ‡› ƒ–”›–‘†‡†— ‡„›–Š‡•‡Ž˜‡•™Š‡–Š‡”•— Š‡™‘™Ž‡†‰‡‘ˆˆ‡”•ƒƒ —”ƒ–‡‘†‡Ž ‘ˆ”‡ƒŽ‹–›ǡ‘”–Š‡› ƒ”‡Ž›‘–Š‡‘™Ž‡†‰‡‘ˆ•‘‡‘‡–Š‡›†‡‡„‘–Š‡’‹•–‡‹ ƒŽŽ›–”—•–™‘”–Š› ƒ†™‡ŽŽǦ‡ƒ‹‰ȋ ‘ƒ‰›ǡ—›–‡ǡŽŽ‹•‘Ƭƒ’„‡ŽŽǡʹͲͳ͹ȌǤ  Š”‘‹ Žƒ ‘ˆ‡’‹•–‡‹ –”—•–ǡ•‘‡–‹‡•”‡ˆ‡””‡†–‘ƒ•‡’‹•–‡‹ Š›’‡”˜‹‰‹Žƒ ‡ǡ”‡•—Ž–• ‹–”‡ƒ–‹‰‘–Š‡”•ƒ•—–”—•–™‘”–Š›•‘—” ‡•‘ˆ‹ˆ‘”ƒ–‹‘Ǥ –‹•–Š‘—‰Š––‘„‡’ƒ–Š‘‰‡‹ „‡ ƒ—•‡‹– —–•‹†‹˜‹†—ƒŽ•‘ˆˆˆ”‘‡ƒ•›ǡ‹–‡”’‡”•‘ƒŽƒ’’”‘ƒ Š‡•–‘—’†ƒ–‹‰„‡Ž‹‡ˆ•›•–‡•Ǥ††‹–‹‘ƒŽŽ›ǡ ‡’‹•–‡‹ –”—•–’Žƒ›•ƒ ‡–”ƒŽ”‘Ž‡‹–Š‡•Šƒ”‹‰‘ˆ —Ž–—”ƒŽ —•–‘•ƒ†˜ƒŽ—‡•ǡ„‡ ƒ—•‡„‡Ž‘‰‹‰ –‘ƒ ‡”–ƒ‹ —Ž–—”ƒŽ‰”‘—’‰‹˜‡•”‹•‡–‘–Š‡‡š’‡ –ƒ–‹‘–Šƒ–‘‡ ‘•–”—‡•‡ƒ‹‰‘ˆ„‡Šƒ˜‹‘”‹ similar ways. Customs and values often have opaque functions but are nonetheless important to “ˆ‹– in”.  Contributors to impaired mentalizing and psychosis. –Š‡’”‡˜‹‘—••‡ –‹‘ǡ™‡ƒ”‰—‡† –Šƒ–†‹•”—’–‹‘•‹‡–ƒŽ‹œƒ–‹‘ƒ†‡’‹•–‡‹ –”—•–ƒ›„‡”‡Ž‡˜ƒ––‘–Š‡’ƒ–Š‘‰‡›‘ˆǤ ‡”‡ǡ™‡ƒ”‰—‡–Šƒ– Š‹Ž†Š‘‘†ƒ„—•‡ƒ›Š‹†‡”–Š‡†‡˜‡Ž‘’‡–‘ˆ‡–ƒŽ‹œ‹‰ƒ†‡’‹•–‡‹  –”—•–ƒ†–Š—•ˆ‘•–‡”•’•› Š‘•‹•Ǥ ƒ›•–—†‹‡•Šƒ˜‡•Š‘™–Šƒ– Š‹Ž†Š‘‘†ƒ„—•‡ ‘•–‹–—–‡•ƒ•‹‰‹ˆ‹ ƒ–”‹•ˆƒ –‘”–‘–Š‡ ‡‡”‰‡ ‡‘ˆ’•› Š‘•‹•ȋ•‡‡ƒ”‡•‡‡–ƒŽǤǡʹͲͳʹǢ‡ƒ†ǡ ‘••‡ǡ‘•‘™‹–œǡƬ‡””›ǡʹͲͳͶˆ‘” ‘˜‡”˜‹‡™•ȌǤŠ‹Ž†Š‘‘†ƒ„—•‡”ƒ–‡•ˆ‘”–Š‘•‡ƒ–—Ž–”ƒǦŠ‹‰Š”‹•–‘†‡˜‡Ž‘’’•› Š‘•‹•ƒ›„‡ƒ•Š‹‰Š ƒ•ͺ͸Ψȋ•‡‡”ƒƒ‡–ƒŽǤǡʹͲͳͷˆ‘”ƒ‘˜‡”˜‹‡™Ȍǡƒ†’”‘•’‡ –‹˜‡•–—†‹‡••Š‘™–Šƒ–ƒ„—•‡† Š‹Ž†”‡ ƒ”‡‘”‡Ž‹‡Ž›–‘†‡˜‡Ž‘’’•› Š‘•‹•ȋ‡Ǥ‰Ǥ‡ŽŽ‡Š‡”‡–ƒŽǤǡʹͲͳ͵ȌǤŠ‹Ž†Š‘‘†ƒ„—•‡Šƒ•ƒŽ•‘„‡‡ ™‹†‡Ž›•Š‘™–‘Š‹†‡”–Š‡†‡˜‡Ž‘’‡–‘ˆ‡–ƒŽ‹œ‹‰ƒ„‹Ž‹–›ȋ•‡‡ ‘ƒ‰›‡–ƒŽǤǡʹͲͳ͹ˆ‘”ƒ ‘˜‡”˜‹‡™Ȍƒ†‹’ƒ‹”‡†‡–ƒŽ‹œ‹‰Šƒ•„‡‡•Š‘™–‘ƒ ‘—–ˆ‘”•‘‡‘ˆ–Š‡”‡Žƒ–‹‘„‡–™‡‡ Š‹Ž†Š‘‘†ƒ„—•‡ƒ†‡‰ƒ–‹˜‡•›’–‘•‹ȋ‡‹Œ‡”•‡–ƒŽǤǡʹͲͳͺȌǤ ‘—–‡”–‘ƒ–‹˜‹•–ƒ ‘—–•‘ˆ•‘ ‹ƒŽ ‘‰‹–‹‘ǡ‡–ƒŽ‹œƒ–‹‘–Š‡‘”›’”‘’‘•‡•–Šƒ– ‡–ƒŽ‹œ‹‰‹•‹‹–‹ƒŽŽ›ˆ‘”‡†‹•‡ —”‡ƒ––ƒ Š‡–”‡Žƒ–‹‘•Š‹’•™‹–Š ƒ”‡‰‹˜‡”•ȋ‡Ǥ‰Ǥǡ‹ǡʹͲͳͷȌǤ Such relationships are characterized by a genuine interest in the child’s mental state that is ‘˜‡›‡†through ostensive cues (e.g., eye contact) and ‘marked mirroring,’ wherein emotions are imitated in a slightly exaggerated fashion, sometimes referred to as ‘motherese’ (Kim, 2015). In this way, a child has his emotions “reǦpresented” back to him, which p”‘˜‹†‡•Š‹™‹–Š–Š‡‘’’‘”–—‹–› –‘ ‘‡‹–‘ ‘–ƒ –™‹–Š‘–Š‡”’‡”•’‡ –‹˜‡•‘Š‹•‹‡”‡š’‡”‹‡ ‡•ȋ ‘ƒ‰›ƬŽŽ‹•‘ǡʹͲͳͶȌǡ –Š—•‡ƒ„Ž‹‰Š‹–‘„‡‰‹†‡˜‡Ž‘’‹‰•‡ ‘†Ǧ‘”†‡””‡’”‡•‡–ƒ–‹‘•‘ˆ„‘†‹Ž›ˆ‡‡Ž‹‰•–ƒ–‡•Ǥ

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Ž–Š‘—‰ŠŽ‡••‡’Šƒ•‹œ‡†ǡ–Š‹•Š›’‘–Š‡•‹•‹•ƒŽ•‘’”‡•‡–‹‡–ƒ ‘‰‹–‹˜‡–Š‡‘”›ǡ™Š‹ Š•–”‡••‡• –Šƒ––Š‡†‡˜‡Ž‘’‡–‘ˆ•‡ŽˆǦreflectivity is fostered by ‘intersubjectivity’, a communicative process „‡–™‡‡ Š‹Ž†ƒ†’ƒ”‡––Šƒ–”‡˜‘Ž˜‡•ƒ”‘—†–Š‡ƒ””ƒ–‹‘‘ˆ‹‡”‡š’‡”‹‡ ‡ȋ›•ƒ‡”‡–ƒŽǤǡ ʹͲͲͷȌǤŠ‡‡š’‡”‹‡ ‡‘ˆ ƒ”‡‰‹˜‡”ƒ„—•‡‘–Š‡‘–Š‡”Šƒ†‹•–Š‘—‰Š––‘Ž‡ƒ†–‘ƒ’Š‘„‹ ƒ˜‘‹†ƒ ‡ of mentalizing in children (Kim, 2015) “to protect themselves from acknowledging their caregiver’s wishes to harm them” (Fonagy, 1989). Inhibiting me–ƒŽ‹œ‹‰‹–Š‹•ƒ‡”ƒ›„‡–Š‡‘Ž›‡ƒ• ͳ –‘‡‰‘–‹ƒ–‡–Š‡‡‡†ˆ‘”’”‘š‹‹–›ƒ†„‡ ‘‹‰‘˜‡”™Š‡Ž‡†„›’•› Š‘Ž‘‰‹ ƒŽ’ƒ‹Ǥ  Š‹Ž†Š‘‘†ƒ„—•‡ƒ›ƒŽ•‘ ‘–”‹„—–‡–‘’‘‘”‡–ƒŽ‹œ‹‰–Š”‘—‰Š–Š‡‡•–ƒ„Ž‹•Š‡–‘ˆ’‘‘” 2 ‡‘–‹‘”‡‰—Žƒ–‹‘•–”ƒ–‡‰‹‡•Ǥ––ƒ Š‡––Š‡‘”›’”‘’‘•‡•–Šƒ–Š—ƒ•Šƒ˜‡ƒ‹•–‹ –—ƒŽ‡‡†–‘ ˆ‘” Ž‘•‡•‘ ‹ƒŽ„‘†•Ǥ –Š‡ˆƒ ‡‘ˆ†ƒ‰‡”‘”— ‡”–ƒ‹–›ǡ Š‹Ž†”‡†‹•’Žƒ›ƒ––ƒ Š‡–„‡Šƒ˜‹‘” –‘’”‘‘–‡•ƒˆ‡–›ƒ†–‘”‡‰—Žƒ–‡ƒˆˆ‡ –ȋ‘™Ž„›ǡͳͻͺͲȌǤ•’‡ ‹ƒŽŽ›ǡ™Š‡’”‹ƒ”› ƒ”‡‰‹˜‡”•ƒ”‡ ƒ„—•‹˜‡ǡ–Š‡›ƒ”‡‡š’‡”‹‡ ‡†ƒ•„‘–Šƒ•‘—” ‡‘ˆ–Š”‡ƒ–ƒ†ƒ•‘—” ‡‘ˆ•‡ —”‹–›–‘–Š‡ Š‹Ž†™Š‘‹• •–‹ŽŽ†‡’‡†‡–‘–Š‡ˆ‘”‘—”‹•Š‡–ƒ†•ƒˆ‡–›Ǥ •— Š ƒ•‡•ǡ•–”‡••”‡•—Ž–•‹ƒƒŽ–‡”ƒ–‹‘ „‡–™‡‡•–”‘‰‹’—Ž•‡•–‘‡• ƒ’‡ƒ†–‘•‡‡ ƒ”‡ǡ‹ ”‡ƒ•‹‰Ž›‡• ƒŽƒ–‹‰–Š‡Ž‡˜‡Ž•‘ˆ‡‘–‹‘ƒŽ †›•”‡‰—Žƒ–‹‘Ǥƒ•‡†‘–Š‡“—ƒŽ‹–›‘ˆ‡ƒ”Ž›ƒ––ƒ Š‡–‹–‡”ƒ –‹‘•ƒ Š‹Ž††‡˜‡Ž‘’•‡š’‡ –ƒ–‹‘• ‘ˆ”‡Žƒ–‹‘•Š‹’•ƒ†Š‘™‡‘–‹‘•™‹ŽŽ„‡ ‘ Ǧregulated called ‘attachment styles’ (e.g., Berry, ƒ””‘™ Ž‘—‰ŠƬ‡ƒ”†‡ǡʹͲͲͺȌǤ ‡”Šƒ’•—•—”’”‹•‹‰Ž›ǡƒ––ƒ Š‡–•–›Ž‡• Šƒ”ƒ –‡”‹œ‡†„›ƒ†‹•–”—•–‘ˆ‘–Š‡”• ’”‡†‘‹ƒ–‡‹’ƒ–‹‡–•™‹–Š’•› Š‘•‹•Ǥ‡–™‡‡͹ͲΨƒ†ͺͻΨ‘ˆ’ƒ–‹‡–•ȋ†‡’‡†‡–‘ –Š‡ Žƒ••‹ˆ‹ ƒ–‹‘•›•–‡—•‡†Ȍƒ”‡†‹•‹••‹‰‘ˆƒ––ƒ Š‡–‘”ƒ––ƒ Š‡†‹ƒ†‹•‘”‰ƒ‹œ‡†ˆƒ•Š‹‘ ȋ‡Ǥ‰Ǥǡ —Ž‡›ǡƒ›Ž‘”ǡ Š™ƒƒ—‡”Ƭƒ ‡–ŠǡʹͲͳͶȌǤ•–‹ƒ–‡•‹–Š‡‰‡‡”ƒŽ’‘’—Žƒ–‹‘”ƒ‰‡ „‡–™‡‡ʹͲΨƒ†ʹͷΨˆ‘”†‹•‹••‹‰ƒ––ƒ Š‡–ȋ‹•™‘”–ŠǡŽ‡Šƒ”ǡƒ–‡”•ƬƒŽŽǡͳͻ͹ͺǢ ‹ ‡Ž•‘ǡ‡••Ž‡”ƬŠƒ˜‡”ǡͳͻͻ͹Ȍƒ†„‡–™‡‡ͳʹΨƒ†ͳͷΨˆ‘”†‹•‘”‰ƒ‹œ‡†ƒ––ƒ Š‡–ȋ‡Ǥ‰Ǥǡ ƒ‹Ƭ‘Ž‘‘ͳͻͻͲȌǤ‘”‡‘˜‡”ǡ‰”‡ƒ–‡”‹•‡ —”‡ƒ––ƒ Š‡–‹Šƒ•„‡‡Ž‹‡†–‘‰”‡ƒ–‡” †‹ˆˆ‹ —Ž–›”‡‰—Žƒ–‹‰‡‘–‹‘•ȋ™‡•ǡ ƒ††‘ Ƭ‡””›ǡʹͲͳ͵ȌǤ ‡–ƒŽ‹œ‹‰‹–—”‹•˜—Ž‡”ƒ„Ž‡–‘‡š ‡••‹˜‡Ž‡˜‡Ž•‘ˆ‡‘–‹‘ƒŽƒ”‘—•ƒŽȋ‘Ž–‡‡–ƒŽǤǡʹͲͳ͵ȌǤ Here, it is important to note that mentalizing is viewed as a complex ‘higherǦ‘”†‡” ‘‰‹–‹˜‡

ͳ ›•–‹’—Žƒ–‹‰–Šƒ– Š‹Ž†Š‘‘†ƒ„—•‡ƒ†‹•‡ —”‡ƒ––ƒ Š‡–’Žƒ›ƒ”‘Ž‡‹–Š‡’ƒ–Š‘‰‡‡•‹•‘ˆ‹’ƒ‹”‡† ‡–ƒŽ‹œ‹‰ƒ†’•› Š‘•‹•ǡ™‡‹‘™ƒ›ƒ†˜‘ ƒ–‡ƒ”‡–—”to the days of the “schizophrenogenic” mother ȋ•‡‡ ƒ”–™‡ŽŽǡͳͻͻ͸ˆ‘”ƒ‘˜‡”˜‹‡™ȌǤŠ‡ ‘–”‹„—–‹‘‘ˆ’‡‡”•–‘–Š‡†‡˜‡Ž‘’‡–‘ˆ‡–ƒŽ‹œ‹‰ƒ†•‡ —”‡ ƒ––ƒ Š‡–”‡Žƒ–‹‘•Š‹’••‡‡••—„•–ƒ–‹ƒŽȋ•‡‡Š‘—†Š—”›ǡŽƒ‡‘”‡ƬŠƒ”ƒǡʹͲͲ͸Ǣ”‘—ˆ‡ǡʹͲͲͷȌƒ† ƒ––ƒ Š‡–•–›Ž‡•ƒ”‡‘–ƒ•‹—–ƒ„Ž‡ƒ•‘ ‡–Š‘—‰Š–ȋ‹—Ž‹ ‡”ƬŠƒ˜‡”ʹͲͳʹȌǤ††‹–‹‘ƒŽŽ›ǡƒ› ˆ‘”•‘ˆ•‘ ‹ƒŽƒ†˜‡”•‹–›„‡›‘† Š‹Ž†– ƒ”‡‰‹˜‡”ƒ––ƒ Š‡–”‡Žƒ–‹‘•Š‹’•’”‡†‹ –”‹•‘ˆ’•› Š‘•‹•ȋ‡Ž–‡ǡ ˜ƒ†‡”‡ǡ—––‡Ƭƒ–‘”Ǧ ”ƒƒ‡ǡʹͲͳ͵ȌǤƒ–Š‡”•‘ ‹ƒŽ”‡Žƒ–‡†‡••–Š”‘—‰Š‘—–Ž‹ˆ‡•‡‡• ”— ‹ƒŽˆ‘”‡–ƒŽ Š‡ƒŽ–Šȋ ‘ƒ‰›‡–ƒŽǤǡʹͲͳ͹ȌǤ 

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process’ in which functions of the prefrontal cortex, such as working memory and the direction of ƒ––‡–‹‘ǡƒ”‡—•‡†–‘‹–‡‰”ƒ–‡’‹‡ ‡•‘ˆ‹ˆ‘”ƒ–‹‘ˆ”‘†‹ˆˆ‡”‡–•‡•‘”›ǡ‘–‘”ǡƒ†ƒˆˆ‡ –‹˜‡ ͳ ‡–™‘”•ȋ ‘ƒ‰›Ƭƒ–‡ƒǡʹͲͳ͸ȌǤ When overly stressed, the orchestration of the brain’s ƒ –‹˜‹–›„›–Š‡’”‡ˆ”‘–ƒŽ ‘”–‡š‹•—†‡”‹‡†ƒ†‘˜‡”–ƒ‡„›•—„ ‘”–‹ ƒŽ•–”— –—”‡•ǡ•— Šƒ•–Š‡ ƒ›‰†ƒŽƒǡ–Š‡— Ž‡—•ƒ —„‡•ǡƒ†–Š‡Š›’‘–ŠƒŽƒ—•ȋ”•–‡ǡʹͲͲͻȌƒ––Š‡‡š’‡•‡‘ˆŠ‹‰Š‡” ‘”†‡” ‘‰‹–‹‘ǤInsecure attachment and epistemic mistrust.  ‘ƒ‰›ƒ†ŽŽ‹•‘ȋʹͲͳͶȌƒŽ•‘ƒ‹–ƒ‹–Šƒ– ‡’‹•–‡‹ –”—•–ǡ— ŠŽ‹‡‡–ƒŽ‹œ‹‰ ƒ’ƒ ‹–›ǡ‹•†‡˜‡Ž‘’‡†‹•‡ —”‡ƒ––ƒ Š‡–”‡Žƒ–‹‘•Š‹’•Ǥ When a child finds himself accurately represented by a caregiver “as a thinking and feeling intentional being”, this is thought to engender the secure feeling that the caregiver’s in–‡–‹‘•ƒ”‡ „‡‹‰ǡ™Š‹ ŠŠ‡Ž’•–Š‡ Š‹Ž†‘”‡‡ƒ•‹Ž›ƒ ‡’–•Šƒ”‡†‹ˆ‘”ƒ–‹‘ƒ•–”—‡Ǥ †‡‡†ǡ–Š‡“—ƒŽ‹–›‘ˆ –Š‡”‡Žƒ–‹‘•Š‹’„‡–™‡‡ƒ Š‹Ž†ƒ†ƒ ‘—‹ ƒ–‘”†‡–‡”‹‡•–Š‡‡š–‡––‘™Š‹ Š•— Š ‹ˆ‘”ƒ–‹‘‹•ƒ ‡’–‡†ƒ•–”—–Šȋƒ‡Ƭ ƒ””‹•ǡʹͲͳͷȌǤ ‘™‡˜‡”ǡ Š‹Ž†”‡™Š‘”‡’‡ƒ–‡†Ž› ‡š’‡”‹‡ ‡–Šƒ––Š‡‹”‹–‡”ƒŽ•–ƒ–‡•ƒ”‡‡–™‹–Š†‹•–‘”–‡†‘”‹ƒ —”ƒ–‡ ƒ”‡‰‹˜‡””‡•’‘•‡•ǡƒ› develop a chronic mistrust regarding others’ messages. Indeed, both insecure attachment styles and †‹ƒ‰‘•‡•ƒ”‡”‡Žƒ–‡†–‘ƒ•’‡ –•‘ˆ‡’‹•–‡‹ Š›’‡”˜‹‰‹Žƒ ‡•— Šƒ•”‡•‹•–ƒ ‡–‘‘–Š‡”˜‹‡™• ™Š‡–Š‡› ‘ˆŽ‹ –™‹–Š’”‡Ǧ‡š‹•–‹‰‘‡•ȋ‡–ƒŽŽƬ™ƒ”„”‹ ǡʹͲͲ͵Ȍƒ†ƒ–‡†‡ ›ˆ‘”†‘‰ƒ–‹  „‡Ž‹‡ˆ•ȋ‡Ǥ‰Ǥǡ‹—Ž‹ ‡”ǡͳͻͻ͹ȌǤŽ‡ƒ•‡”‡ˆ‡”–‘ˆ‹‰—”‡ͳˆ‘”ƒ• Š‡ƒ–‹ ‘˜‡”˜‹‡™‘ˆ–Š‡‘†‡Ž †‡• ”‹„‡†‹–Š‹••‡ –‹‘Ǥ

ͳ Similarly, synthetic metacognition is thought to be the process combining “atoms of experience” into larger, ‘˜‡”ƒ” Š‹‰ƒ””ƒ–‹˜‡•ȋ ƒ••‘ ǦŠƒ›‘‡–ƒŽǤǡʹͲͳͺȌǤ

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2

Fig.1 A heuristic, mentalization based model of psychosis pathogenesis. 

‘‰‡–Š‡”™‹–Šƒ ‘•–‹–—–‹‘ƒŽŽ‹ƒ„‹Ž‹–› ƒ—•‡†„›˜ƒ”‹ƒ–‰‡‡•ǡ†‡˜‡Ž‘’‡–ƒŽˆƒ –‘”••— Š ƒ• Š‹Ž†Š‘‘†ƒ„—•‡ƒ†‹•—Ž–•ǡƒ†‹–‡”‡†‹ƒ–‡ˆƒ –‘”••— Šƒ•‹•‡ —”‡ƒ––ƒ Š‡–ƒ†‹’ƒ‹”‡† ‡–ƒŽ‹œ‹‰ ‘’”‹•‡ƒˆ‡”–‹Ž‡‰”‘—†ˆ‘”•‘ ‹ƒŽ†‹ˆˆ‹ —Ž–‹‡•–‘•‡•‹–‹œ‡–Š‡‡•‘Ž‹„‹ †‘’ƒ‹‡ •›•–‡Ǥ‹•‹••‹‰‘”†‹•‘”‰ƒ‹œ‡†ƒ––ƒ Š‡–”‡Žƒ–‹‘•Š‹’•–‘ ƒ”‡‰‹˜‡”•ƒ†’‡‡”•ƒ›”‡•—Ž–‹ †‹•–”‡••ƒ†’‘‘” ‘Ǧ”‡‰—Žƒ–‹‘‘ˆ‡‘–‹‘•™Š‡‹–Š‡’”‘š‹‹–›‘ˆ‘–Š‡”•ǤŠ‹• ‘’Ž‹ ƒ–‡• •‘ ‹ƒŽ‹–‡”ƒ –‹‘ǡƒ†ƒ›Ž‡ƒ†–‘‹•‘Žƒ–‹‘‘”™‹–Š†”ƒ™ƒŽǡƒ†–Š—•‘”‡•–”‡••ƒ†‹’ƒ‹”‡† ‡–ƒŽ‹œ‹‰ǤŠ‡•‡•‹–‹œƒ–‹‘‘ˆ–Š‡†‘’ƒ‹‡•›•–‡‹–—””‡•—Ž–•‹ƒ„‡””ƒ–‡š’‡”‹‡ ‡•Ǥ—‡ –‘‡’‹•–‡‹ ‹•–”—•–ǡ‹–‡”’”‡–ƒ–‹‘‘ˆ–Š‡•‡‡š’‡”‹‡ ‡•ƒ›„‡ ‘‡’”‘‰”‡••‹˜‡Ž›‹†‹‘•› ”ƒ–‹  ƒ†–‡ƒ ‹‘—•Ǥ ˆ‹†‹˜‹†—ƒŽ•ƒ––”‹„—–‡‡š–”‡‡ ‡”–ƒ‹–›–‘•‡•‘”›Ǧƒˆˆ‡ –‹˜‡‡š’‡”‹‡ ‡•ǡ–Š‹• ”‡•—Ž–•‹’”‘’‡”ŠƒŽŽ— ‹ƒ–‹‘•Ǥ–Š‡‘–Š‡”Šƒ†ǡ•‡•‘”›Ǧƒˆˆ‡ –‹˜‡‹ˆ‘”ƒ–‹‘‘”–Š‡˜‹‡™’‘‹– ‘ˆ‘–Š‡”•ƒ›‘–„‡—•‡†–‘—’†ƒ–‡ ‘‰‹–‹˜‡„‡Ž‹‡ˆ•ǡ”‡•—Ž–‹‰‹†‡Ž—•‹‘ƒŽ‹†‡ƒ–‹‘Ǥ

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Part II: Implementation of mentalization based treatment for NAPD

’‹•–‡‹ Š›’‡”˜‹‰‹Žƒ ‡‹–‡†•–‘ ‘’Ž‹ ƒ–‡’•› Š‘–Š‡”ƒ’‡—–‹ ‹–‡”˜‡–‹‘•„‡ ƒ—•‡‹– ‡–ƒ‹Ž•–Šƒ–‡™’‡”•’‡ –‹˜‡•–Šƒ–ƒ–Š‡”ƒ’‹•–‘ˆˆ‡”•ƒ”‡•‡‡ƒ•‹””‡Ž‡˜ƒ–ǡ‘”ƒ––‡’–•ƒ– ‘‡” ‹‘ ȋ ‘ƒ‰›ƬŽŽ‹•‘ǡʹͲͳͶȌǤ‡ ‘†Ž›ǡƒ›’ƒ–‹‡–•™‹–Š‡š’‡”‹‡ ‡†‹ˆˆ‹ —Ž–›‡–ƒŽ‹œ‹‰ —†‡”•–”‡••ǡ‡ƒ‹‰–Šƒ–’•› Š‘–Š‡”ƒ’‡—–‹ ‹–‡”˜‡–‹‘•ƒ›„‡ƒ–”‹•‘ˆ„‡‹‰–‘‘ ‘’Ž‡šǤPrinciples of Mentalization Based Treatment.  ‡–ƒŽ‹œƒ–‹‘„ƒ•‡†–”‡ƒ–‡–ȋȌ™ƒ• •’‡ ‹ˆ‹ ƒŽŽ›†‡˜‡Ž‘’‡†–‘ƒ††”‡••‹’ƒ‹”‡†‡–ƒŽ‹œ‹‰ȋƒ–‡ƒƬ ‘ƒ‰›ǡͳͻͻͻȌƒ†‡’‹•–‡‹  mistrust (Fonagy & Allison, 2014), through four main principles: a ‘notǦknowing’ therapeutic •–ƒ ‡ǡ—ƒ••—‹‰‹–‡”˜‡–‹‘•ǡƒˆ‘ —•‘ —””‡–Ž›ˆ‡Ž–ƒˆˆ‡ –ǡƒ† ƒ”‡ˆ—Žƒ†Œ—•–‡––‘–Š‡ patient’sŽ‡˜‡Ž‘ˆ‡–ƒŽ‹œƒ–‹‘ƒ†ƒ”‘—•ƒŽǤ Firstly, MBT emphasizes that therapists adopt a ‘notǦknowing stance,’ which entails that the therapist actively questions the patient and cultivates a genuine interest in the patient’s current ‡š’‡”‹‡ ‡™‹–Š‘—–ˆ‘” ‹‰ƒ›•‹‰Ž‡‹–‡”’”‡–ƒ–‹‘—’‘–Š‡’ƒ–‹‡–ǤŠ‡—•‹‰–Š‹••–ƒ ‡ǡ–Š‡ therapist communicates that she is trying to interpret the patient’s actions in line with her own •—„Œ‡ –‹˜‡‡š’‡”‹‡ ‡ƒ†–Šƒ––Š‡’ƒ–‹‡–‹•„‡‹‰–”‡ƒ–‡†ƒ•ƒ‹–‡–‹‘ƒŽƒ‰‡–ȋ‡„„ƒ±‡–ƒŽǤǡ 2016; Fonagy et al., 2017). Feeling “mentalized about” in therapy is thought to make the patient feel •ƒˆ‡‡‘—‰Š–‘–Š‹ƒ„‘—–Š‹•‡Žˆ‹”‡Žƒ–‹‘–‘Š‹••‘ ‹ƒŽ™‘”Ž†ƒ†Š‘™Š‡‘’‡”ƒ–‡•‹‹–ȋ ‘ƒ‰› ƬŽŽ‹•‘ǡʹͲͳͶȌǡ™Š‹ Šƒ‹†•–Š‡”‡•tructuring of the “organization of thinking into less rigid, delusional and pervasive patterns of reality testing” (Pereira & Debbané, 2018). Becoming more flexible in one’s cognitive beliefs, opens up the opportunity to again learn from experience and ‘–Šer perspectives, which is thought to lead to an improvement of understanding one’s self and the •‘ ‹ƒŽ™‘”Ž†Ǥ ‡ ‘†Ž›ǡ‹–‡”˜‡–‹‘•ƒ”‡‡’–—ƒ••—‹‰ƒ†ƒ”‡ƒ‹‡†ƒ–‰‡––‹‰–Š‡’ƒ–‹‡––‘‹†‡–‹ˆ› ƒ†˜‡”„ƒŽ‹œ‡•‡•‘”›Ǧƒˆˆ‡ –‹˜‡‡š’‡”‹‡ ‡•Ǥ• ‘ƒ‰›ƒ†ƒ–‡ƒȋʹͲͲ͸Ȍ—†‡”• ‘”‡ǡ “psychotherapists of many orientations often attempt to provide mentalistic understandings for ‹••—‡•–Šƒ––”‹‰‰‡”‹–‡•‡‡‘–‹‘ƒŽ”‡ƒ –‹‘•ƒ–ƒ–‹‡™Š‡–Š‡ ƒ’ƒ ‹–›ˆ‘”‡ˆˆ‡ –‹˜‡‡š’Ž‹ ‹– ‡–ƒŽ‹œƒ–‹‘‹•’”ƒ –‹ ƒŽŽ›inaccessible.” Therefore, MBT deǦemphasizes the exploration of ‘deep’ — ‘• ‹‘—•‘–‹˜‡•ǡ‘ˆ–‡’”‡•‡–‹’•› Š‘†›ƒ‹ –”‡ƒ–‡–ǡ‹•–‡ƒ†ˆ‘ —•‹‰‘‘”‡”‡ƒ†‹Ž› ƒ˜ƒ‹Žƒ„Ž‡•—„Œ‡ –‹˜‡‡š’‡”‹‡ ‡‹–Š‡Š‡”‡ƒ†‘™Ǥ Š‹”†Ž›ǡ–Š‡ˆ‘ —•‘ˆ„‘–Š’ƒ–‹‡–and therapist should be on the patient’s current affective ‡š’‡”‹‡ ‡Ǥ›Š‡Ž’‹‰–Š‡’ƒ–‹‡–ƒ –‹˜‡Ž›”‡ˆŽ‡ –‘–Š‡‹” —””‡–Ž›ˆ‡Ž–‡š’‡”‹‡ ‡ǡƒ––‡’–• –‘Ž‘‘•‡–Š‡†‘‹ƒ ‡‘ˆƒˆˆ‡ –Ǧ†”‹˜‡‘†‡•‘ˆ‹ˆ‘”ƒ–‹‘’”‘ ‡••‹‰‘–Š‘—‰Š–ƒ†„‡Šƒ˜‹‘” ȋ‡”‡‹”ƒƬ‡„„ƒ±ǡʹͲͳͺȌƒ•˜‡”„ƒŽ‹œ‹‰•‡•‘”›Ǧƒˆˆ‡ –‹˜‡‡š’‡”‹‡ ‡Šƒ•„‡‡•Š‘™–‘

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†‘™”‡‰—Žƒ–‡–Š‡‹–‡•‹–›‘ˆ•— Šƒˆˆ‡ –ƒ–‡—”ƒŽǡ’Š›•‹‘Ž‘‰‹ ƒŽǡƒ†•—„Œ‡ –‹˜‡Ž‡˜‡Ž•ȋ‡Ǥ‰Ǥǡ‘””‡Ƭ ‹‡„‡”ƒǡʹͲͳͺȌǤ ‘—”–ŠŽ›ǡ–Š‡‹–‡•‹–›‘ˆ‹–‡”˜‡–‹‘•ǡ–Šƒ–‹•ǡ–Š‡ ‘’Ž‡š‹–›‘ˆ‡–ƒŽ‹œƒ–‹‘”‡“—‹”‡†‘ˆ –Š‡’ƒ–‹‡–ǡ‹•ƒ†Œ—•–‡†–‘–Š‡Ž‡˜‡Ž‘ˆ‡‘–‹‘ƒŽƒ”‘—•ƒŽ–Š‡’ƒ–‹‡–‹•‡š’‡”‹‡ ‹‰Ǥ ‰‡‡”ƒŽǡ –Š‡”ƒ’‹•–•ƒ––‡’––‘‡‡’“—‡•–‹‘•ƒ†”‡ˆŽ‡ –‹‘•ƒ––Š‡ƒš‹—Ž‡˜‡Ž‘ˆ‡–ƒŽ‹œ‹‰–Šƒ––Š‡ ’ƒ–‹‡–‹•ƒ„Ž‡–‘Ǥ‘‘Ž‹––Ž‡ƒ”‘—•ƒŽ’”‘˜‹†‡•–‘‘Ž‹––Ž‡ƒ–‡”‹ƒŽ–‘ƒ –‹˜‡Ž›”‡ˆŽ‡ –—’‘ǡ™Š‹Ž‡–‘‘ much arousal will reduce a patient’s ability to mentalize. At this level only supportive interventions •Š‘—Ž†„‡—•‡••— Šƒ•ƒˆˆ‡ –˜ƒŽ‹†ƒ–‹‘ǤMentalization based treatment in contrast to other psychotherapies. 2 †‹ˆˆ‡”•ˆ”‘ ƒ†•Šƒ”‡••‹‹Žƒ”‹–‹‡•™‹–Š‘–Š‡”’•› Š‘–Š‡”ƒ’‹‡•Ǥˆ–Š‡ǡ‘‰‹–‹˜‡‡Šƒ˜‹‘”ƒŽŠ‡”ƒ’›ȋȌ ˆ‘”’•› Š‘•‹•ǡŠƒ•„‡‡–Š‡‘•–•–—†‹‡†ƒ†ƒ”‰—ƒ„Ž›‘•–’”‘‹‡–‹–‡”˜‡–‹‘‹–Š‡”‡ ‡– †‡ ƒ†‡•Ǥ ‡‡”ƒŽŽ›ǡ–Š‡ƒ‹‰‘ƒŽ‘ˆ‹•–‘ ‘””‡ –‡‰ƒ–‹˜‡„‡Ž‹‡ˆ•ƒ†–Š‘—‰Š–•‹‘”†‡”–‘–”‡ƒ– •›’–‘•Ǥ‘–Šƒ†ƒ‹–‘‹ ”‡ƒ•‡–Š‡—†‡”•–ƒ†‹‰‘ˆŠ‘™ ‘‰‹–‹‘•ƒ†‡‘–‹‘• ƒˆˆ‡ –„‡Šƒ˜‹‘”ȋ‡Ǥ‰ǤŒÚ”‰˜‹••‘Ƭ ƒ”–ǡʹͲͲ͸ȌǤ ‘™‡˜‡”ǡ”‡“—‹”‡•–Šƒ–•‘‡Ž‡˜‡Ž‘ˆ ‡–ƒŽ‹œƒ–‹‘ ƒ’ƒ ‹–›‹•ƒŽ”‡ƒ†›’”‡•‡–ǡƒ•‹‰’ƒ–‹‡–•–‘ ”‹–‹ ƒŽŽ›ƒ’’”ƒ‹•‡–Š‡‹”–Š‘—‰Š–•ǡ ™Š‡”‡ƒ•†‘‡•‘–Ǥ —”–Š‡”‘”‡ǡƒ•ƒ’•› Š‘†›ƒ‹ ˆ‘”‘ˆ–Š‡”ƒ’›ǡ‹•Ž‡••†‹”‡ –‹˜‡ǡ ƒ‹Ž›ƒ‹‹‰–‘Š‡Ž’’ƒ–‹‡–•–‘„‡––‡””‡’”‡•‡–•‡•‘”›Ǧƒˆˆ‡ –‹˜‡‡š’‡”‹‡ ‡Ǥ††‹–‹‘ƒŽŽ›ǡ„‡‹‰ ”‘‘–‡†‹ƒ––ƒ Š‡––Š‡‘”›ǡ–‡†•–‘„‡‘”‡†‹”‡ –Ž› ‘ ‡”‡†™‹–Š–Š‡–Š‡”ƒ’‡—–‹  relationship than CBT. Lastly, CBT takes a less ‘holistic’ approach to treatmen–’ƒ–‹‡–ǡˆ‘ —•‹‰‘ •’‡ ‹ˆ‹ •›’–‘•‹•–‡ƒ†Ǥ More akin to MBT, are the so called ‘third wave’ cognitive behavioral therapies. Whereas ™ƒ•†‡˜‡Ž‘’‡†–‘–”‡ƒ–•’‡ ‹ˆ‹ •›’–‘•ǡ–Š‡–Š‹”†™ƒ˜‡ ‘‰‹–‹˜‡–Š‡”ƒ’‹‡•ǡŽ‹‡ǡŠƒ˜‡ •Š‹ˆ–‡†–Š‡‹”ˆ‘ —•‘–Š‡–Š‹‹‰’”‘ ‡••—†‡”Ž›‹‰•›’–‘•”ƒ–Š‡”–Šƒ‘–Š‡ ‘–‡–‘ˆ–Šƒ– –Š‹‹‰’”‘ ‡••ȋƒƒǡ‘Žƒ‹ –‘”Ƭƒ”–‹what how Ǧ‘ƒ›ǡʹͲͳ͹ȌǤ ‘–Š‡”™‘”†•ǡ–Š‡›Šƒ˜‡•Š‹ˆ–‡†–Š‡‹” ˆ‘ —•ˆ”‘ ’‡‘’Ž‡–Š‹–‘ ’‡‘’Ž‡–Š‹ȋŒÚ”‰˜‹••‘Ƭ ƒ”–ǡʹͲͲ͸ȌǤ‘ ‹ƒŽ ‘‰‹–‹˜‡ –Š‡”ƒ’‹‡•ˆ‘”‡šƒ’Ž‡–‡†–‘ˆ‘ —•‘•’‡ ‹ˆ‹ ƒ•’‡ –•–Šƒ–—†‡”Ž‹‡‘–Š‡”Ǧ‘”‹‡–‡†‡–ƒŽ‹œ‹‰ǡ •— Šƒ•ƒˆˆ‡ –”‡ ‘‰‹–‹‘ǡ•‘ ‹ƒŽƒ––”‹„—–‹‘„‹ƒ•‡•‘”–Š‡‘”›‘ˆ‹†ȋ•‡‡ƒƒ‡–ƒŽǤǡʹͲͳ͹ˆ‘”ƒ ‘˜‡”˜‹‡™‘ˆ†‹ˆˆ‡”‡–ƒ’’”‘ƒ Š‡•ȌǤ— Šƒ’’”‘ƒ Š‡•–‡†–‘†‹ˆˆ‡”ˆ”‘ǡŠ‘™‡˜‡”ǡ„‡ ƒ—•‡ –Š‡›ƒ”‡‘”‡†‹”‡ –‹˜‡‹ƒ–—”‡ƒ†ƒŽ•‘–‡†–‘ˆ‘ —•‘Œ—•–‘‡†‹•–‹ –‡Ž‡‡–‘ˆ‡–ƒŽ‹œ‹‰Ǥ ††‹–‹‘ƒŽŽ›ǡ•— Š–”‡ƒ–‡–•†‘‘––ƒ”‰‡–•‡ŽˆǦ‘”‹‡–‡†ƒ•’‡ –•‘ˆ‡–ƒŽ‹œ‹‰Ǥ ‡”Šƒ’•‘•–ƒ‹–‘‹•‡–ƒ ‘‰‹–‹˜‡ •‹‰Š–ƒ†‡ˆŽ‡ –‹‘Š‡”ƒ’›ȋ Ǣ†‡ ‘‰ ‡–ƒŽǤǡʹͲͳͺȌǤ‹†‡‘—”‡–ƒŽǤȋʹͲͳͻȌŠƒ˜‡’”‡˜‹‘—•Ž›‘–‡†–Šƒ–†‡• ”‹’–‹‘•ƒ† ƒ•‡”‡’‘”–• •—‰‰‡•––Šƒ–ƒ† ƒ”‡Žƒ”‰‡Ž› ‘’ƒ–‹„Ž‡™‹–Š‘‡ƒ‘–Š‡”Ǥ ǡŽ‹‡ǡˆ‘ —•‡•‘

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–Š‡‹†‡–‹ˆ‹ ƒ–‹‘‘ˆ‡–ƒŽ•–ƒ–‡•ǡ–Š‡†‹ˆˆ‡”‡–‹ƒ–‹‘‘ˆ•—„Œ‡ –‹˜‡‡š’‡”‹‡ ‡•ˆ”‘‘„Œ‡ –‹˜‡ ”‡ƒŽ‹–›ǡ”‡Žƒ–‹‰‡–ƒŽ•–ƒ–‡•–‘„‡Šƒ˜‹‘”ǡƒ†‹–‡‰”ƒ–‹‰•— Š‘™Ž‡†‰‡‹–‘ƒ””ƒ–‹˜‡•Ǥ‹‹Žƒ” –‘ǡ ˆ‘ —•‡•‘Š‹‰Š‡”‘”†‡” ‘‰‹–‹˜‡’rocessing by engaging the patient’s ability to ˜‡”„ƒŽ‹œ‡–Š‡‹”•—„Œ‡ –‹˜‡‡š’‡”‹‡ ‡ǤŠ‡–Š‡”ƒ’‹•––ƒ‡•ƒ‹“—‹•‹–‹˜‡•–ƒ ‡–‘™ƒ”†•–Š‡’ƒ–‹‡–ǡ searching for the patient’s narrative rather than ‘the truth’. Lastly, both emphasize that therapeutic “—‡•tions should be adjusted towards the patient’s level of metacognition.  Š‡”‡ƒ”‡Š‘™‡˜‡”•—„–Ž‡†‹•–‹ –‹‘•„‡–™‡‡ ƒ†ǡŠ‘™‡˜‡”ǡ™Š‹ ŠŠƒ˜‡„‡‡ ‡š–‡•‹˜‡Ž›†‡–ƒ‹Ž‡†„›‹†‡‘—”‡–ƒŽǤȋʹͲͳͻȌǤŠ‹‡ˆ‘ˆ–Š‡•‡ƒ”‡–Šƒ–•’‡ ‹ˆ‹ ƒŽŽ›‘ˆˆ‡”• ’•› Š‘Ǧ‡†— ƒ–‹‘’”‹‘”–‘–”‡ƒ–‡––‘‡Žƒ„‘”ƒ–‡‘‡–ƒŽ‹œ‹‰ƒ†‹–•”‡Žƒ–‹‘–‘ƒ––ƒ Š‡–Ǧ ’”‘ ‡••‡•ƒ†‡‘–‹‘•ǤŠƒ•ƒŽ•‘„‡‡ƒ”‰—‡†–‘’ƒ›‘”‡ƒ––‡–‹‘–‘–Š‡„‘†‹Ž›ƒ•’‡ –‘ˆ ‡‘–‹‘ƒŽ‡š’‡”‹‡ ‡ȋ‡„„ƒ±‡–ƒŽǤǡʹͲͳ͸ȌǤ ”‘–Š‡–Š‡”ƒ’‹•–’‡”•’‡ –‹˜‡ǡǦ–”ƒ‹‹‰ ’”‘˜‹†‡••’‡ ‹ˆ‹  Ž‹‹ ƒŽ‰—‹†‡•–‘ƒ••‡••‡‘–‹‘ƒŽƒ”‘—•ƒŽ‹•‡••‹‘•ǡƒ•™‡ŽŽƒ•Š‘™–‘™‘” •ƒˆ‡Ž›™‹–Š‹–Š‡ Ž‹‡–Ǧ–Š‡”ƒ’‹•–”‡Žƒ–‹‘•Š‹’ȋ”‡–ǡʹͲͲͻǢ‡„„ƒ±‡–ƒŽǤǡʹͲͳ͸ȌǤ–Š‡‘–Š‡” Šƒ†ǡ ƒ”‰—ƒ„Ž›ˆ‘ —•‡•‘”‡‡š’Žicitly on the patient’s agency, by explicitly making the ’ƒ–‹‡–•‡––Š‡ƒ‰‡†ƒˆ‘”‡ƒ Š–”‡ƒ–‡–•‡••‹‘Ǥƒ•–Ž›ǡ‰”‘—’Ǧ–Š‡”ƒ’›‹•ƒ‹’‘”–ƒ–‡Ž‡‡–‘ˆ ǡ„—––Š‹•‹•‘––Š‡ ƒ•‡ˆ‘” ǤMentalization based treatment for psychotic disorder. Ž–Š‘—‰Š™ƒ•‘”‹‰‹ƒŽŽ› †‡•‹‰‡†ˆ‘”„‘”†‡”Ž‹‡’‡”•‘ƒŽ‹–›†‹•‘”†‡”ȋǢƒ–‡ƒƬ ‘ƒ‰›ǡͳͻͻͻȌǡ‰‹˜‡‹–•ˆ‘ —•‘ ‹’ƒ‹”‡†‡–ƒŽ‹œ‹‰ƒ„‹Ž‹–›ǡ‹–ƒ›„‡•—‹–ƒ„Ž‡ˆ‘”’ƒ–‹‡–•™‹–Šƒ•™‡ŽŽǤ‡ ‡–ƒ”–‹ Ž‡•Šƒ˜‡ ‡š’Ž‘”‡†–Š‡ƒ’’Ž‹ ƒ„‹Ž‹–›‘ˆƒ•ƒ–”‡ƒ–‡–ˆ‘”’•› Š‘–‹ †‹•‘”†‡”•‘”‹–•’”‘†”‘ƒŽ•–ƒ–‡• ȋ”‡–Ƭ ‘ƒ‰›ǡʹͲͳͶǢ‡‹Œ‡”•‡–ƒŽǤǡʹͲͳ͸Ǣ‡„„ƒ±‡–ƒŽǤǡʹͲͳ͸Ȍƒ†–Š‡‡ˆˆ‡ –‹˜‡‡••‘ˆˆ‘” ’•› Š‘–‹ †‹•‘”†‡”•‹• —””‡–Ž›„‡‹‰‡šƒ‹‡†‹ƒ”ƒ†‘‹œ‡† ‘–”‘ŽŽ‡†–”‹ƒŽȋ‡‹Œ‡”•‡–ƒŽǤǡ ʹͲͳ͸ȌǤ ‘™‡˜‡”ǡ†‹•‘”†‡”Ǧ•’‡ ‹ˆ‹  Šƒ”ƒ –‡”‹•–‹ •†‘™ƒ””ƒ–•‘‡†‹ˆˆ‡”‡–ƒ’’”‘ƒ Š‡•‹ ™Š‡†‡ƒŽ‹‰™‹–Š’ƒ–‹‡–•™‹–ŠǤ ‹”•–ǡƒ›’ƒ–‹‡–•–‡†–‘†‡ƒ –‹˜ƒ–‡ƒ––ƒ Š‡–Ǧ”‡Žƒ–‡†ƒˆˆ‡ ––‘ƒƒ‰‡‘˜‡”Ǧ ƒ”‘—•ƒŽ–”‹‰‰‡”‡†„›•‘ ‹ƒŽ‹–‡”ƒ –‹‘ǤŠ‹•ƒ›‰‹˜‡ƒˆƒŽ•‡‹’”‡••‹‘‘ˆƒŽƒ ‘ˆƒ”‘—•ƒŽǤ ‘”‡‘˜‡”ǡ‡‰ƒ–‹˜‡•›’–‘••— Šƒ•ˆŽƒ––‡‡†ƒˆˆ‡ –‹˜‡‡š’”‡••‹‘ǡ ƒˆ—”–Š‡” ‘’Ž‹ ƒ–‡ ‰ƒ—‰‹‰–Š‡Ž‡˜‡Ž‘ˆƒ”‘—•ƒŽ‘ˆ–Š‡’ƒ–‹‡–ƒ†ƒ•‹‰–Š‡’ƒ–‹‡––‘†‘ ‘’Ž‡š‡–ƒŽ™‘”‹–Š‡ ‘–‡š–‘ˆŠ‹‰Šƒ”‘—•ƒŽ‹•‘–†‡‡‡†Š‡Ž’ˆ—ŽǤ–Š‡”ƒ’‹•–•—•––Š‡”‡ˆ‘”‡„‡ƒ —–‡Ž›ƒ™ƒ”‡‘ •Ž‹‰Š–•‹‰•‘ˆ‡‘–‹‘ƒŽ†‹•–—”„ƒ ‡–Šƒ–ƒ”‡’ƒ”–‹ —Žƒ”–‘ǡ•— Šƒ••Ž‘™‹‰‘ˆ•’‡‡ Š‘” †‡ ”‡ƒ•‡† ‘Š‡”‡ ‡Ǥ ‡ ‘†ǡ‰‹˜‡–Š‡‹”‹ Ž‹ƒ–‹‘ˆ‘”†‹•‘”‰ƒ‹œ‡†‘”†‹•‹••‹˜‡ƒ––ƒ Š‡–ǡ’ƒ–‹‡–•†‘ ‘––‡†–‘„‡ ‘‡˜‡”›ƒ––ƒ Š‡†–‘–Š‡‹”–Š‡”ƒ’‹•–‘”‰”‘—’‡„‡”•ǡƒ–Ž‡ƒ•–‹–Š‡‹‹–‹ƒŽ’Šƒ•‡

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‘ˆ–”‡ƒ–‡–ǤŠ‹•‡ƒ•–Šƒ–ƒ––ƒ Š‡–„‘†•–‡†–‘”‡ƒ‹ˆ”ƒ‰‹Ž‡ˆ‘”ƒŽ‘‰‡”–‹‡ǡƒ† ’ƒ–‹‡–•ƒ›ˆ‹nd it relatively easy to drop out of treatment. Keeping patients ‘in mind’ through –‡Ž‡’Š‘‡ ƒŽŽ•‘”Š‘—•‡˜‹•‹–•ˆ‘ŽŽ‘™‹‰‹••‡†•‡••‹‘•ǡŠ‡Ž’•Ǥ Third, we concur with Gumley and Liotti’s (2008) observation that a more severe ‡–ƒŽ‹œƒ–‹‘†‡ˆ‹ ‹–†‹•–‹‰—‹•Š‡•ˆ”‘Ǥ‡–ƒŽ‹œ‹‰‹•‡‡•–‘„‡ Šƒ”ƒ –‡”‹œ‡† ‘”‡„›ƒ‹•–ƒ„‹Ž‹–›”ƒ–Š‡”–Šƒƒ†‡ˆ‹ ‹–ǡ™Š‹Ž‡’ƒ–‹‡–•™‹–Š–‡†–‘Šƒ˜‡ƒ‘”‡ •–”— –—”ƒŽ†‹ˆˆ‹ —Ž–›†‡–‡ –‹‰ƒ†‹–‡”’”‡–‹‰•‡•‘”›Ǧƒˆˆ‡ –‹˜‡‡š’‡”‹‡ ‡•ǤŠ‡”ƒ’›•‡••‹‘•‹ –Š‡‹‹–‹ƒŽ’Šƒ•‡•Š‘—Ž†–Š‡”‡ˆ‘”‡ˆ‘ —•‘‡Ž‡‡–ƒ”›Ž‡˜‡Ž•‘ˆ‡–ƒŽ‹œ‹‰•— Šƒ•†‡–‡ –‹‰ 2 ƒˆˆ‡ –‹˜‡‡š’‡”‹‡ ‡•ƒ†˜‡”„ƒŽ‹œ‹‰–Š‡Ǥ ‘—”–Šǡ‘ˆ–‡ƒ–‹’•› Š‘–‹ ‡†‹ ƒ–‹‘Šƒ•ƒ•—„•–ƒ–‹ƒŽ†ƒ’‡‹‰‡ˆˆ‡ –‘‡‘–‹‘•ǤŠ‹• ƒ›‹’”‘˜‡‡–ƒŽ‹œ‹‰ƒ„‹Ž‹–›‹ ‡”–ƒ‹”‡•’‡ –•ǡ„—–‹– ƒƒŽ•‘ƒ‡‹–†‹ˆˆ‹ —Ž––‘–ƒŽƒ„‘—––Š‡ ‡‘–‹‘ƒŽ•‹‰‹ˆ‹ ƒ ‡‘ˆ‡˜‡–•‹ˆ•— Š‡‘–‹‘•ƒ”‡Šƒ”†Ž›‡š’‡”‹‡ ‡†Ǥ –‹•–Š‡”‡ˆ‘”‡‹’‘”–ƒ– –Šƒ–ƒ–‹’•› Š‘–‹ ‡†‹ ƒ–‹‘‹•ƒ––‡—ƒ–‡†™‹–Šƒ•’‡ ‹ˆ‹ ˆ‘ —•‘–ŠClinical Vignette. ‡ƒ„‹Ž‹–›–‘•–‹ŽŽˆ‡‡Žƒˆˆ‡ –Ǥ ‘ ‘ Ž—†‡ǡ™‡™‹ŽŽ•Š‘”–Ž›‹ŽŽ—•–”ƒ–‡–Š‡’”‹ ‹’Ž‡•‘ˆˆ‘”’•› Š‘–‹  †‹•‘”†‡”™‹–Šƒ’ƒ–‹‡–™Š‘•—ˆˆ‡”•ˆ”‘’ƒ”ƒ‘‹††‡Ž—•‹‘•ƒ†ˆ‹†•‹–†‹ˆˆ‹ —Ž––‘”‡Žƒ–‡–‘‘–Š‡”• ™Š‘†‘‘–•Šƒ”‡Š‹•„‡Ž‹‡ˆ•Ǥ Hi, how are you feeling? Š‡”ƒ’‹•–ǣ: Yeah, I’m good; I’ve been onȋŠ‡–Š‡”ƒ holiday with’‹•–‹‡†‹ƒ–‡Ž›ˆ‘ —•‡•‘ —””‡–ƒˆˆ‡ –ǤȌ my girlfriend, which was mostly good. ƒ–‹‡– Mostly good? ǣ Yeah, we had fun,ȋŠ‡–Š‡”ƒ’‹•–ƒ†‘’–•ƒ‘– but I also had a falling-outǦ‘™‹‰•–ƒ ‡Ȍ with her, which is still bothering me. I tried to talk to ǣher about my views on the world. I really wanted her to see my point of view. In what way is this still bothering you?

ǣ I have experiences like this all the time, ȋ‰ƒ‹ǡ–Š‡–Š‡”ƒ’‹•–ˆ‘ —•‡•‘ —””‡–ƒˆˆ‡ –ǤȌwith friends, for example. I sometimes just feel that if they ǣsaw it my way, they would agree with me. (Here, the patient is focused on the ‘then and there,’ but is ‘– ‘• ‹‘—•Ž›ƒ––‡†‹‰Š‹•‘™ —””‡–ƒˆˆ‡ –‹˜‡‡š’‡”‹‡ ‡ǤȌ How does that make you feel now? ǣ ȋ‰ƒ‹ˆ‘ —•‹••Š‹ˆ–‡†–‘ —””‡–ƒˆˆ‡ –‹˜‡‡š’‡”‹‡ ‡ǤȌ I have put a lot ǣof researchȋŠ‡’ƒ–‹‡–•–ƒ”–•ƒ˜‘‹†‹‰‡›‡ ‘–ƒ –ǡƒ†„‡‰‹•–‘–ƒŽ‹ƒƒ‰‹–ƒ–‡†ƒ‡”ǤȌ into how the world works. We are being deceived; the evidence is there. ȋŠ‡’ƒ–‹‡–‘™ •Š‘™••‹‰•‘ˆƒ‰‹–ƒ–‹‘ǢŠ‹•ƒ•™‡”•†‘‘– Ž‡ƒ”Ž›ƒ††”‡••–Š‡“—‡•–‹‘•ƒ•‡†ǡƒ†Š‡™‹–Š†”ƒ™• ˆ”‘ ‘–ƒ –Ǥ –Š‹••–ƒ–‡‹–‹•—Ž‹‡Ž›–Šƒ–Š‹•–Š‡”ƒ’‹•–™‹ŽŽ”‡ƒ ŠŠ‹Ǥ‡‹‰ƒ•‡†–‘–Š‹ƒ„‘—– Š‹• —””‡–ˆ‡‡Ž‹‰•ƒ›Šƒ˜‡„‡‡–‘‘ ‘’Ž‡šƒ––Š‹•–‹‡ƒ† ‘’Ž‡š‹–›‡‡†•–‘„‡• ƒŽ‡†„ƒ  ƒ––Š‹•’‘‹–ǤȌ

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Hey, I see you are getting a bit agitated. This must be difficult for you!

ǣ ȋ ‡”‡ǡ–Š‡–Š‡”ƒ’‹•––”‹‡•–‘ reduce the levelIt’s no of use stress talking by validating about this the stuff, patient’s because feelings.) you people simply adhere to what we have been ǣȋŠ”—‰•Ȍfed by the media, like sheep. I get the feeling that you are all against me, but I am used to it. ȋ ‡”‡ǡ–Š‡ ’ƒ–‹‡–•Š‘™• Ž‡ƒ–•‹‰•‘ˆ‹’ƒ‹”‡†‡–ƒŽ‹œ‹‰Ǥ ‡Šƒ•Ž‘•––Š‡ƒ„‹Ž‹–›–‘†‹•–‹‰—‹•Š„‡–™‡‡ individuals, lumping everyone in one category, he is now likely unable to consider therapist’s ’‡”•’‡ I’m very–‹˜‡ƒ•‡ƒ‹‰ˆ—ŽǤȌ sorry to hear that you perceive everyone is against you. That must be so difficult to bear, ǣthat perception that everyone is against you. ȋ‹ ‡–Š‡Ž‡˜‡Ž‘ˆ•–”‡••ˆ‘”–Š‡’ƒ–‹‡–‹•–‘‘Š‹‰Šǡ–Š‡ –Š‡”ƒ’‹•–”‡•‘”–•–‘•—’’‘”–‹˜‡‹–‡”˜‡–‹‘•ǡ˜ƒŽ‹†ƒ–‹‰Š‹• —””‡–ƒˆˆ‡ –‹˜‡•–ƒ–‡Ǥ›—•‹‰–‡”• like ‘perceive’ and ‘perception’ the therapist also addresses the fact that the patient’s view is ‹’”‡••‹‘‹•–‹ ǡ‹’Ž›‹‰‹–†‘‡•‘–‡ ‡••ƒ”‹Ž›”‡ˆŽ‡ –”‡ƒŽ‹–›ǤȌ I don’t necessarily think are against me, but many people are. ǣ ȋ‡Žƒš‡•˜‹•‹„Ž›Ȍ ›‘— ȋŠ‡ƒ„‹Ž‹–›–‘ ‡–ƒŽ‹œ‡•‡‡•–‘”‡–—”ǡƒ•Š‡”‡‰ƒ‹•–Š‡ƒ„‹Ž‹–›–‘†‹•–‹‰—‹•Š„‡–™‡‡’‡‘’Ž‡ǤȌ Hey, it seems to me that you got a little worked up there, but that now you have also calmed down a ǣbit. Could you help me understand what happened there? ȋ ‡”‡ǡ–Š‡–Š‡”ƒ’‹•––”‹‡•–‘‰‡––Š‡’ƒ–‹‡– –‘”‡ˆŽ‡ –‘–Š‡ƒˆˆ‡ –‹˜‡”‡•’‘•‡Š‡Œ—•–Šƒ†ǤȌ I get worked up about this stuff, and then I get angry with people for no reason. ǣ: Shall we look at what happened there then? It seems like you lumped me together with people you dislike ȋ ‡”‡ǡ–Š‡ Ž‹‹ ‹ƒ ‘•‹†‡” •–Š‡‹–‡”ƒ –‹‘–Šƒ–Œ—•–‘ —””‡†Œ—•–ƒ•ƒ’”‘–‘–›’‡ˆ‘” ‹–‡”ƒ –‹‘•™‹–Š‘–Š‡”•ǤȌ I react to people too quickly because I don’t like it when people do not agree with me. I think I get ǣupset, when I have the feeling people do not take me seriously. ȋ ‡”‡ǡ–Š”‘—‰Š„‡ ‘‹‰ ‘• ‹‘—•‘ˆ Š‹•ƒˆˆ‡ –‹˜‡”‡ƒ –‹‘–‘–Š‡–Š‡”ƒ’‹•–ǡ–Š‡’ƒ–‹‡– Šƒ•†‡˜‡Ž‘’‡†•‘‡‹•‹‰Š–‹–‘–Š‡™ƒ›Š‡ ”‡Žƒ–‡•–‘‘–Š‡”•‹‰‡‡”ƒŽǤȌ Concluding Remarks

‹–Š–Š‹•ƒ”–‹ Ž‡ǡ™‡ƒ––‡’–‡†–‘•Š‘™Š‘™‡–ƒŽ‹œƒ–‹‘–Š‡‘”›ƒ›‹ˆ‘”—†‡”•–ƒ†‹‰ƒ† –”‡ƒ–‡–‘ˆǡ‡•’‡ ‹ƒŽŽ›”‡‰ƒ”†‹‰†‹ˆˆ‹ —Ž–‹‡•‹‡–ƒŽ‹œ‹‰ƒ†‡’‹•–‡‹ ‹•–”—•–ǤǦŠƒ† ‡š’‡”‹‡ ‡™‹–Š‡–ƒŽ‹œƒ–‹‘„ƒ•‡†–”‡ƒ–‡–ˆ‘”’•› Š‘–‹ †‹•‘”†‡”Šƒ•‰‹˜‡–Š‡‹’”‡••‹‘ –Šƒ–ǡƒ›Š‡Ž’Ž‘‘•‡”‹‰‹†‹–‡”’”‡–ƒ–‹‘•‘ˆƒ„‡””ƒ–•‡•‘”›Ǧƒˆˆ‡ –‹˜‡‡š’‡”‹‡ ‡ƒ†–Š—• ‹’”‘˜‡••‘ ‹ƒŽ‹–‡”ƒ –‹‘Ǥ 

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Acknowledgments

‘‡Ǥ Funding

Š‹•”‡•‡ƒ” Š†‹†‘–”‡ ‡‹˜‡ƒ›•’‡ ‹ˆ‹ ‰”ƒ–ˆ”‘ˆ—†‹‰ƒ‰‡ ‹‡•‹–Š‡’—„Ž‹ ǡ ‘‡” ‹ƒŽǡ‘” ‘– Ǧˆ‘”Ǧ’”‘ˆ‹–•‡ –‘”•Ǥ Compliance with Ethical standards 2 ‡•‡ƒ” Š™ƒ• ‘†— –‡†ƒ ‘”†‹‰™‹–Š–Š‡’”‘˜‹•‹‘•‘ˆ–Š‡‘”Ž†‡†‹ ƒŽ••‘ ‹ƒ–‹‘ ‡ Žƒ”ƒ–‹‘‘ˆ ‡Ž•‹‹ǤŠ‹••–—†›‹•’ƒ”–‘ˆƒŽƒ”‰‡”•–—†›ȋ‡‹Œ‡”•ǡ‡–ƒŽǤǡʹͲͳ͸Ȍˆ‘”™Š‹ Š‡–Š‹ ƒŽ ƒ’’”‘˜ƒŽ™ƒ•‰‹˜‡„›–Š‡‡†‹ ƒŽ‡•‡ƒ” Š–Š‹ •‘‹––‡‡‘ˆ–Š‡‹˜‡”•‹–› ‘•’‹–ƒŽƒƒ•–”‹ Š– ƒ†ƒƒ•–”‹ Š–‹˜‡”•‹–›ȋͳ͵Ǧ͵ǦͲ͸͸ǤͷȀƒ„ȌǤ”‹––‡‹ˆ‘”‡† ‘•‡––‘’—„Ž‹•Š†ƒ–ƒƒ† Ž‹‹ ƒŽ ƒ–‡”‹ƒŽ™ƒ•‘„–ƒ‹‡†ˆ”‘ƒŽŽ•—„Œ‡ –•ǡ‹ Ž—†‹‰–Š‡‹†‹˜‹†—ƒŽˆ‘”™Š‘’‘–‡–‹ƒŽŽ›‹†‡–‹ˆ›‹‰ ‹ˆ‘”ƒ–‹‘‹•‹ Ž—†‡†‹–Š‹•ƒ”–‹ Ž‡Ǥ  Conflicts of interest

Š‡ƒ—–Š‘”•†‡ Žƒ”‡–Šƒ––Š‡›Šƒ˜‡‘ ‘’‡–‹‰‹–‡”‡•–Ǥ References

Patterns of attachment: A

‹•™‘”–ŠǡǤǤǤǡŽ‡Šƒ”ǡǤǤǡƒ–‡”•ǡǤǡƬpsychological study of the strange situation.ƒŽŽǡǤǤȋͳͻ͹ͺȌǤ Hallucinations: The science‘†‘ǡ‹–‡†‹‰†‘ǣ•› Š‘Ž‘‰›”‡••Ǥ of idiosyncratic perception  Ž‡ƒǡǤǡƬƒ”Þ‹ǡ ǤȋʹͲͲͺȌǤ Ǥ‡”‹ ƒ •› Š‘Ž‘‰‹ ƒŽ••‘ ‹ƒ–‹‘Ǥ ”•–‡ǡǤ ǤȋʹͲͲͻȌǤ–”‡••Nature Reviews•‹‰ƒŽ‹‰ Neuroscience’ƒ–Š™ƒ›•–Šƒ–‹’ƒ‹”’”‡ˆ”‘–ƒŽ ‘”–‡š•–”— –—”‡ƒ†10 ˆ— –‹‘Ǥ ǡ ȋ͸ȌǡͶͳͲǤ ›†‹ǡǤǡƒŽ‹ ‹ǡǤǡƒ•ǡǤǡ›†‹ǡǤǤǡƒƒ ‹ǡǤǤǡ”ò‡ǡǤǡƬ›•ƒ‡”ǡPsychiatryǤ ǤȋʹͲͳ͸ȌǤŠ‡ research †‡˜‡Ž‘’‡–ƒŽ‘”‹‰‹•‘ˆ‡–ƒ ‘‰‹–‹˜‡†‡ˆ‹ ‹–•‹• Š‹œ‘’Š”‡‹ƒǤ ǡʹͶͷǡ ͳͷǦʹͳǤ ƒ”‘Ǧ‘Š‡ǡǤǡ‡•Ž‹‡ǡǤǤǡƬ ”‹–ŠǡǤȋͳͻͺ͸ȌǤ‡ Šƒ‹ ƒŽǡ„‡Šƒ˜‹‘—”ƒŽƒ†‹–‡–‹‘ƒŽBritish Journal of Developmental —†‡”•–ƒ†‹‰‘ˆ’‹ –—”‡•–‘”‹‡•‹ƒ—–‹•–‹  Š‹Psychology, 4, Ž†”‡Ǥ ͳͳ͵–ͳʹͷǤ

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ƒ–‡ƒǡǤǡƬ ‘ƒ‰›ǡǤȋͳͻͻͻȌǤˆˆ‡ –‹˜‡‡••‘ˆ’ƒ”–‹ƒŽŠ‘•’‹–ƒŽ‹œƒ–‹‘‹–Š‡–”‡ƒ–‡–‘ˆAmerican Journal of „‘”†‡”Ž‹‡’‡”•‘ƒŽ‹–›†‹•‘”†‡”ǣƒ”ƒ†‘‹œ‡† ‘–”‘ŽŽ‡†–”‹ƒŽǤPsychiatry 156 ǡ ȋͳͲȌǡͳͷ͸͵Ǧͳͷ͸ͻǤ Journal of personality ƒ–‡ƒǡǤǤǡƬ ‘ƒ‰›ǡǤȋʹͲͲͶȌǤ‡–ƒŽ‹œƒ–‹‘disorders, 18 Ǧ„ƒ•‡†–”‡ƒ–‡–‘ˆǤ ȋͳȌǡ͵͸ǦͷͳǤ ƒ–‡ƒǡǤǡƬ ‘ƒ‰›ǡǤȋʹͲͲ͸ȌǤ‡–ƒŽ‹œ‹‰ƒ†„‘”†‡”Ž‹‡’‡”•‘ƒŽ‹–›†‹•‘”†‡”Ǥ ŽŽ‡ǡ Ǥ ǤƬThe handbook of mentalization-based treatment ‘ƒ‰›ǡǤȋ†•ǤȌǡ ȋ’’ǤͳͺͷǦʹͲͲȌǤ ‘„‘‡ǡ ‹–‡†–ƒ–‡•ǣ ‘Š‹Ž‡›Ƭ‘•  Ǥ ‡–ƒŽŽǡǤǤǡƬ™ƒ”„”‹ ǡǤȋʹͲͲ͵ȌǤŠ‡„‡•–Žƒ‹†• Š‡ƒ•‘ˆ’ƒ”ƒ‘‹†’ƒ–‹‡–•ǣƒ—–‘‘›ǡPsychology and Psychotherapy: Theory, Research and •‘ ‹‘–”‘’›ƒ†‡‡†ˆ‘” Ž‘•—”‡ǤPractice 76 ǡ ȋʹȌǡͳ͸͵Ǧͳ͹ͳǤ ‡””›ǡǤǡƒ””‘™ Ž‘—‰ŠǡǤǡƬ‡ƒ”†‡ǡǤȋʹͲͲͺȌǤ––ƒ Š‡––Š‡‘”›ǣƒˆ”ƒ‡™‘”ˆ‘”Behaviour research —†‡”•–ƒ†‹‰•›’–‘•ƒ†‹–‡”’‡”•‘ƒŽ”‡Žƒ–‹‘•Š‹’•‹’•› Š‘•‹•Ǥand therapy 46  ǡ ȋͳʹȌǡͳʹ͹ͷǦͳʹͺʹǤ ‹” Š™‘‘†ǡǤǡ‘‘”ǡǤǡ‡•–‡”ǡ Ǥǡƒ––‡”•‘ǡǤǡ ”‡‡ƒ–Ž‡ǡǤǡƒ”•ŠƒŽŽǡǤǡǤǤǤƬ˜‡”ƒ”†ǡǤ ȋʹͲͳ͵ȌǤ‡†— ‹‰†—”ƒ–‹‘‘ˆ—–”‡ƒ–‡†’•› Š‘•‹•ǣ ƒ”‡’ƒ–Š™ƒ›•–‘‡ƒ”Ž›‹–‡”˜‡–‹‘‹The British Journal of Psychiatry 203 ’•› Š‘•‹••‡”˜‹ ‡•Ǥ ǡ ȋͳȌǡͷͺǦ͸ͶǤ ŒÚ”‰˜‹••‘ǡǤǡƬ ƒ”–ǡ ǤȋʹͲͲ͸ȌǤ‘‰‹–‹˜‡„‡Šƒ˜‹‘”ƒŽ–Š‡”ƒ’›’”‘‘–‡•‡–ƒŽ‹œ‹‰Ǥ ƒ†„‘‘‘ˆ ‡–ƒŽ‹œƒ–‹‘AttachmentǦ„ƒ•‡†–”‡ƒ–‡–ǡͳͷ͹ and loss. Ǧͳ͹ͲǤ  ‘™Ž„›ǡ ǤȋͳͻͺͲȌǤ ȋ˜‘ŽǤͳȌǤ ‡™‘”ǡ‹–‡†–ƒ–‡•ǣƒ†‘ ‘—•‡JournalǤ of Brent, B.clinical (2009). psychology, Mentalization‐based 65 psychodynamic psychotherapy for psychosis. ȋͺȌǡͺͲ͵ǦͺͳͶǤ ”‡–ǡǤǤǡƬ ‘ƒ‰›ǡǤȋʹͲͳͶȌǤ‡–ƒŽ‹œƒ–‹‘ǦSocial„ƒ•‡†–”‡ƒ–‡–ƒ’’”‘ƒ Š–‘†‹•–—”„ƒ ‡•‘ˆ cognition and metacognition in •‘ ‹ƒŽ—†‡”•–ƒ†‹‰‹• Š‹œ‘’Š”‡‹ƒǤ schizophrenia ȋ’’ǤʹͶͷǦʹͷͻȌǤƒ„”‹†‰‡ǡǣ ƒ†‡‹ ”‡••Ǥ ”‘‘™‡ŽŽǡǤǤǡ‡–ƒŽŽǡǤǤǡƬƒ”‡•‡ǡ ǤȋʹͲͳ͵ȌǤš–‡”ƒŽ‹œ‹‰„‹ƒ•‡•ƒ†ŠƒŽŽ— ‹ƒ–‹‘•‹ •‘—” ‡PsychologicalǦ‘‹–‘”‹‰ǡ•‡Žˆ Medicine Ǧ43‘‹–‘”‹‰ƒ†•‹‰ƒŽ†‡–‡ –‹‘•–—†‹‡•ǣƒ‡–ƒǦƒƒŽ›–‹ ”‡˜‹‡™Ǥ ǡ ȋͳʹȌǡʹͶ͸ͷǦʹͶ͹ͷǤ ”—‡Ž‹ǡ Ǥǡ†̵ƒ–‘ǡǤǡ”—ǡǤǡ‡†‹‘—ǡǤǡƒŽŽ‡ŽǡǤǡ‡ǡǤǡǤǤǤƬƒ‘—†ǡǤȋʹͲͲ͹ȌǤ ’ƒ‹”‡† ˜‡”„ƒŽ•‘—” ‡‘‹–‘”‹‰‹• Š‹œ‘’Š”‡‹ƒǣƒ‹–‡”‡†‹ƒ–‡–”ƒ‹–˜—Ž‡”ƒ„‹Ž‹–›ƒ”‡”ǫSchizophrenia Research 89 ǡ ȋͳǦ͵Ȍǡʹͺ͹ǦʹͻʹǤ Š‘—†Š—”›ǡǤǡŽƒ‡‘”‡ǡǤ ǤǡƬŠƒ”ƒǡSocial cognitive and affectiveǤȋʹͲͲ͸ȌǤ‘ ‹ƒŽ ‘‰‹–‹˜‡†‡˜‡Ž‘’‡–†—”‹‰ neuroscience 1 ƒ†‘Ž‡• ‡ ‡Ǥ ǡ ȋ͵Ȍǡͳ͸ͷǦͳ͹ͶǤ

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146807_JonasWeijers_BNW_def.indd 40 28-10-2020 15:08 Mentalization and psychosis

‡„„ƒ±ǡǤǡƒŽƒ‹‹‘•ǡ Ǥǡ—›–‡ǡǤǡƒ†‘—†ǡǤǡ”ƒ†‘ǡǤǡ‘Ž‹†ƒ‘œœ‹ǡǤǡǤǤǤƬ”‡–ǡǤǤ ȋʹͲͳ͸ȌǤ––ƒ Š‡–ǡ‡—”‘„‹‘Ž‘‰›ǡƒ†‡–ƒŽ‹œ‹‰ƒŽ‘‰–Š‡’•› Š‘•‹• ‘–‹——ǤFrontiers in human neuroscience 10 ǡ ǡͶͲ͸Ǥ †‡ ‘‰ǡǤǡ˜ƒ‘‡”•‰‘‡†ǡǤ ǤǤǡ‹‡”ƒǡǤǤǡƒ ‡–‘–ǡǤǡ—†‡”‹ǡǤǡ”‡†•ǡ ǤǡǤǤǤ Ƭ‹Œ‡„‘”‰ǡ Ǥ ǤǤȋʹͲͳͻȌǤ‡–ƒ ‘‰‹–‹˜‡”‡ˆŽ‡ –‹‘ƒ†‹•‹‰Š––Š‡”ƒ’›ȋ Ȍˆ‘”Psychological Medicine, 49 ’ƒ–‹‡–•™‹–Š• Š‹œ‘’Š”‡‹ƒǤ ȋʹȌǡ͵Ͳ͵Ǧ͵ͳ͵Ǥ ‹•‡•–ƒ†–ǡǤǡ‘–‡‹”‘ǡǤǤǡ‹‹œǡǤ ǤǡƬŠƒ˜‡•ǡǤǤȋʹͲͳʹȌǤEarly intervention in psychiatry, 6(4) š’‡”‹‡ ‡‘ˆ”‡ ‘˜‡”›ˆ”‘ƒfirst‐ ‡’‹•‘†‡’•› Š‘•‹•Ǥ ǡͶ͹͸ǦͶͺͲǤ 2 ‡––ǡǤǤ Ǥǡ‹‡ Š–„ƒ—‡”ǡǤǡ‡ǡǤǤǡ˜ƒ•ǡ ǤǡƬ”ƒ„„‡†ƒǡǤȋʹͲͳͳȌǤŠ‡”‡Žƒ–‹‘•Š‹’ „‡–™‡‡‡—”‘ ‘‰‹–‹‘ƒ†•‘ ‹ƒŽ ‘‰‹–‹‘™‹–Šˆ— –‹‘ƒŽ‘—– ‘‡•‹• Š‹œ‘’Š”‡Neuroscience & Biobehavioral Reviews 35 ‹ƒǣƒ ‡–ƒǦƒƒŽ›•‹•Ǥ ǡ ȋ͵Ȍǡͷ͹͵ǦͷͺͺǤ Bulletin of ‘ƒ‰›ǡǤȋͳͻͺͻȌǤ–‘Ž‡”ƒ–‹‰‡–ƒŽ•–ƒ–‡•ǤŠ‡‘”›‘ˆ‹†‹„‘”†‡”Ž‹‡’ƒ–‹‡–•ǤAnna Freud Centre, 12 ǡͻͳǦͳͳͷǤ ‘ƒ‰›ǡǤǡ—›–‡ǡǤǡƬŽŽ‹•‘ǡǤȋʹͲͳͷȌǤ’‹•–‡‹ ’‡–”‹ˆ‹ ƒ–‹‘ƒ†–Š‡”‡•–‘”ƒ–‹‘‘ˆ‡’‹•–‡‹  –”—•–ǣ‡™ ‘ ‡’–—ƒŽ‹œƒ–‹‘‘ˆ„‘”†‡”Ž‹‡’‡”•‘ƒŽ‹–›†‹•‘”†‡”ƒ†‹–•’•› Š‘•‘ ‹ƒŽJournal of personality disorders, 29 –”‡ƒ–‡–Ǥ ȋͷȌǡͷ͹ͷǦ͸ͲͻǤ The ‘ƒ‰›ǡǤǡƬƒ–‡ƒǡǤȋʹͲͲ͸ȌǤ”‘‰”‡••‹–Š‡–”‡ƒ–British Journal of Psychiatry, 188 ‡–‘ˆ„‘”†‡”Ž‹‡’‡”•‘ƒŽ‹–›†‹•‘”†‡”Ǥ ȋͳȌǡͳǦ͵Ǥ ‘ƒ‰›ǡǤǡƬŽŽ‹•‘ǡǤȋʹͲͳͶȌǤŠ‡”‘Ž‡‘ˆ‡–ƒŽ‹œ‹‰ƒ†‡’‹•–‡‹ –”—•–‹–Š‡–Š‡”ƒ’‡—–‹ Psychotherapy 51 ”‡Žƒ–‹‘•Š‹’Ǥ ǡ ȋ͵Ȍǡ͵͹ʹǤ Comprehensive ‘ƒ‰›ǡǤǡƬƒ–‡ƒǡǤǤpsychiatry 64 ȋʹͲͳ͸ȌǤ†˜‡”•‹–›ǡƒ––ƒ Š‡–ǡƒ†‡–ƒŽ‹œ‹‰Ǥ ǡ ǡͷͻǦ͸͸Ǥ ‘ƒ‰›ǡǤǡ—›–‡ǡǤǡŽŽ‹•‘ǡǤǡƬƒ’„‡ŽŽǡǤȋʹͲͳ͹ȌǤŠƒ–™‡Šƒ˜‡ Šƒ‰‡†‘—”‹†•ƒ„‘—–ǤBorderline personality disorder and‘”†‡”Ž‹‡’‡”•‘ƒŽ‹–›†‹•‘”†‡”ƒ•ƒŽ‹‹–ƒ–‹‘‘ˆ”‡•‹Ž‹‡ ‡Ǥ emotion dysregulation, 4 The cognitive neuropsycȋͳȌǡͳͳǤhology of schizophrenia ”‹–ŠǡǤǤȋͳͻͻʹȌǤ Ǥ‘†‘ǡ‹–‡†‹‰†‘ǣ •› Š‘Ž‘‰›’”‡••Ǥ Phenomenology ƒŽŽ‡•‡ǡǤȋʹͲͲͷȌǤ„‘†‹‡†•‹—Žƒ–‹‘ǣ ”‘‡—”‘•–‘’Š‡‘‡ƒŽ‡š’‡”‹‡ ‡Ǥand the cognitive sciences 4 ǡ ȋͳȌǡʹ͵ǦͶͺǤ ”‡‡ǡǤ Ǥǡ ‘”ƒǡǤǤǡƬ‡‡ǡ ǤȋʹͲͳͻȌǤ‘•‘ ‹ƒWorld Psychiatry,Žƒ†•‘ ‹ƒŽ ‘‰‹–‹‘‹• Š‹œ‘’Š”‡‹ƒǣ —””‡– 18(2) ‡˜‹†‡ ‡ƒ†ˆ—–—”‡†‹”‡ –‹‘•Ǥ ǡͳͶ͸Ǧͳ͸ͳǤ —Ž‡›ǡǤǡƬ‹‘––‹ǡ ǤȋʹͲͲͺȌǤ––ƒ Š‡–‡”•’‡ –‹˜‡‘ Š‹œ‘’Š”‡‹ƒǣŠ‡‘Ž‡‘ˆ ‹•‘”‰ƒ‹œ‡†––ƒ Š‡–ǡ‹••‘ ‹ƒ–‹‘ǡƒ†‡–ƒŽ‹œƒ–‹‘Ǥ ‘•‘™‹–œǡǤǡ Š¡ˆ‡”ǡ Ǥ

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Psychosis, Trauma and Dissociation. Evolving Perspectives on Severe

Psychopathologyƒ”–‹ǡ ǤƬ‘”ƒŠ›ǡǤ Ǥǡ Ǥ‹Ž‡›Ž‹‡‹„”ƒ”›ǣͻ͹Ǧͳͳ͸Ǥ —Ž‡›ǡǤ Ǥǡƒ›Ž‘”ǡ ǤǤ Ǥǡ Š™ƒƒ—‡”ǡǤǡƬƒ ‡–ŠǡǤȋʹͲͳͶȌǤ•›•–‡ƒ–‹ ”‡˜‹‡™‘ˆActa Psychiatrica ƒ––ƒ Š‡–ƒ†’•› Š‘•‹•ǣ‡ƒ•—”‡‡–ǡ ‘•–”— –˜ƒŽ‹†‹–›ƒ†‘—– ‘‡•ǤScandinavica 129  ǡ ȋͶȌǡʹͷ͹Ǧʹ͹ͶǤ ƒ””‹‰–‘ǡǤǡ‹‡‰‡”–ǡǤǡƬ Ž—”‡ǡ ǤȋʹͲͲͷȌǤŠ‡‘”›‘ˆ‹†‹• Š‹œ‘’Š”‡‹ƒǣƒ ”‹–‹ ƒŽ”‡˜‹‡™ǤCognitive neuropsychiatry 10 ǡ ȋͶȌǡʹͶǤ Psychiatry ƒ”–™‡ŽŽǡǤǤȋͳͻͻ͸ȌǤŠ‡• Š‹œ‘’Š”‡‘‰‡‹ ‘–Š‡” ‘ ‡’–‹‡”‹ ƒ’•› Š‹ƒ–”›Ǥ59 ǡ ȋ͵Ȍǡʹ͹ͶǦʹͻ͹Ǥ ƒ••‘ǦŠƒ›‘ǡ Ǥǡ ‘Ž†œ™‡‹‰ǡ Ǥǡƒ˜‹Ǧ‘–‡„‡”‰ǡǤǡ—–Š‡”ǡǤǡ›•ƒ‡”ǡǤ ǤȋʹͲͳͺȌǤŠ‡ ‡–”ƒŽ‹–› ‘ˆ ‘‰‹–‹˜‡•›’–‘•ƒ†‡–ƒ ‘‰‹–‹‘™‹–Š‹–Š‡‹–‡”ƒ –‹‰‡–™‘”‘ˆ•›’–‘•ǡSchizophrenia Research,‡—”‘ ‘‰‹–‹‘ǡ•‘ ‹ƒŽ ‘‰‹–‹‘ƒ†‡–ƒ ‘‰‹–‹‘‹• Š‹œ‘’Š”‡‹ƒǤ 202 ǡʹ͸ͲǦʹ͸͸Ǥ ‡†”›šǡǤǡ ”‡‡ǡǤǤǡ‡””‹ǡǤǤȋʹͲͲͻȌǤ‘ ‹ƒŽ•—’’‘”–ǡƒ –‹˜Journal Behavioral Health‹–‹‡•ǡƒ†”‡ ‘˜‡”›ˆ”‘ Service Research, 36(3)•‡”‹‘—• ‡–ƒŽ‹ŽŽ‡••ǣ•–—†›ˆ‹†‹‰•Ǥ ǡ͵ʹͲǦ ͵ʹͻǤ ‘Ž–Šƒ—•‡ǡǤǤǡ‹‡”•ƒǡǤǡƒŠǡǤǡƒŠǡǤǤǡ‹‰‡ƒ•ǡǤǤǡ Š‡‡ǡǤ Ǥǡ˜ƒ†‡‘• Šǡ Ǥ ǤȋʹͲͲ͹ȌǤ”‡†‹ –‹Psychiatry˜‡˜ƒŽ—‡‘ˆ ‘‰‹–‹‘ˆ‘”†‹ˆˆ‡”‡–†‘ƒ‹•‘ˆ‘—– ‘‡‹”‡ ‡– Research, 149, Ǧ‘•‡– • Š‹œ‘’Š”‡‹ƒǤ ͹ͳ–ͺͲǤ ‘™‡•ǡǤǤǡƬ—””ƒ›ǡǤǤȋʹͲͳͶȌǤ Š‹œ‘’Š”‡‹ƒǣƒ‹–‡‰”ƒ–‡†•‘ ‹‘The Lancet 383 Ǧ†‡˜‡Ž‘’‡–ƒŽǦ ‘‰‹–‹˜‡ ‘†‡ŽǤ ǡ ȋͻͻʹͻȌǡͳ͸͹͹Ǧͳ͸ͺ͹Ǥ ƒ–”‘™‹–œǡ ǤǤǡ ‘’–ƒǡǤ Ǥǡ‡‹–ƒǡǤ Ǥǡ‹Ž‹’‘ǡ ǤǡƬ ƒ˜‹––ǡǤǤȋʹͲͳͶȌǤŠ‡ͷΨ†‹ˆˆ‡”‡ ‡ǣ ‡ƒ”Ž›•‡•‘”›’”‘ ‡••‹‰’”‡†‹ –••ƒ” ƒ•’‡” ‡’–‹‘‹• Š‹œ‘’Š”‡‹ƒƒ†• Š‹œ‘ƒˆˆ‡ –‹˜‡Psychological medicine 44 †‹•‘”†‡”Ǥ ǡ ȋͳȌǡʹͷǦ͵͸Ǥ ‡ŽŽ‡Š‡”ǡ Ǥǡ‡‡Ž‡›ǡ Ǥǡ‘” ‘”ƒǡǤǡƒ•ƒ›ǡ Ǥǡƒ••‡”ƒǡǤǡƒ”Ž‹ǡǤǡǤǤǤƬƒ‘ǡǤȋʹͲͳ͵ȌǤ Š‹Ž†Š‘‘†–”ƒ—ƒƒ†’•› Š‘•‹•‹ƒ’”‘•’‡ –‹˜‡ ‘Š‘”–•–—†›ǣ ƒ—•‡ǡ‡ˆˆ‡ –ǡƒ†American Journal of Psychiatry 170 †‹”‡ –‹‘ƒŽ‹–›Ǥ ǡ ȋ͹Ȍǡ͹͵ͶǦ͹ͶͳǤ ‡›•‡”•ǡǤǡƬ ƒœœ‘ŽƒǡǤȋʹͲͲ͹ȌǤ –‡‰”ƒ–‹‰•‹—Žƒ–‹‘ƒ†–Š‡‘”›‘ˆ‹†ǣˆ”‘•‡Žˆ–‘•‘ ‹ƒŽTrends in cognitive sciences 11 ‘‰‹–‹‘Ǥ ǡ ȋͷȌǡͳͻͶǦͳͻ͸Ǥ ‹ǡǤȋʹͲͳͷȌǤŠ‡‹†‹–Š‡ƒ‹‰ǣ‡˜‡Ž‘’‡–ƒŽƒ†‡—”‘„‹‘Ž‘‰‹ ƒŽ‘”‹‰‹•‘ˆ‡–ƒŽ‹œ‹‰ǤPersonality Disorders: Theory, Research, and Treatment 6 ǡ ȋͶȌǡ͵ͷ͸Ǥ

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”ƒƒǡǤǡ‡Ž–Š‘”•–ǡǤǡ‹–ǡ Ǥǡ†‡ ƒƒǡǤǡƬ˜ƒ†‡” ƒƒ‰ǡǤȋʹͲͳͷȌǤ”ƒ—ƒƒ†”‡ ‡–Ž‹ˆ‡ Schizophrenia‡˜‡–•‹‹†‹˜‹†—ƒŽ•ƒ–—Ž–”ƒ research, 161(2ǦŠ‹‰Š”‹•ˆ‘”’•› Š‘•‹•ǣ”‡˜‹‡™ƒ†‡–ƒ-3) ǦƒƒŽ›•‹•Ǥ ǡͳͶ͵ǦͳͶͻǤ ƒƒǡ Ǥǡˆ”‹ ƒ”—œǡǤǡ‘Žƒ‹ –‘”ǡǤǡƒ”–‹Ǧ‘ƒ›ǡ ǤȋʹͲͳ͹ȌǤ‘ ‹ƒŽ‘‰‹–‹‘ƒ•‡†Š‡”ƒ’‹‡• ˆ‘”‡‘’Ž‡™‹–Š Š‹œSchizophrenia treatment.‘’Š”‡‹ƒǣ ‘ —•‘‡–ƒ ‘‰‹–‹˜‡ƒ†‡–ƒŽ‹œƒ–‹‘’’”‘ƒ Š‡•Ǥ  ”‘—’•’‡ƒ ‡••‡„‘‘•Ǥ Lane, J. D., & Harris, P. L.Child (2015). development The roles of86 intuition and informants’ expertise in children's ‡’‹•–‡‹ –”—•–Ǥ ǡ ȋ͵ȌǡͻͳͻǦͻʹ͸Ǥ 2 ‡‘Šƒ”†–ǡǤǤǡ —Ž‹‰ǡǤǡ ƒǡ ǤǤǡ‘‡ǡǤǡ ƒ••‘ǦŠƒ›‘ǡ Ǥǡ ‡‘†ǡ Ǥ ǤǡƬ›•ƒ‡”ǡǤ Ǥ ȋʹͲͳ͹ȌǤ‡ ‘˜‡”›ƒ†•‡”‹‘—•‡–ƒŽ‹ŽŽ‡••ǣƒ”‡˜‹‡™‘ˆ —””‡– Ž‹‹ ƒŽƒ†”‡•‡ƒ” ŠExpert Review of Neurotherapeutics, 17(11) ’ƒ”ƒ†‹‰•ƒ†ˆ—–—”‡†‹”‡ –‹‘•Ǥ ǡͳͳͳ͹Ǧͳͳ͵ͲǤ ‹†ǡǤǤǡƬ‘™Ž‡”ǡǤǤȋʹͲͲͻȌǤ‡ ‘‰‹–‹‘‡‘”›ǡ•‡ŽˆJournalǦ‘–Š‡”•‘—” ‡‡‘”›ǡƒ†–Š‡‘”› of Autism and Developmental Ǧ‘ˆǦ ‹†‹ Š‹Ž†”‡™‹–Šƒ—–‹••’‡ –”—†‹•‘”†‡”ǤDisorders 39 ǡ ȋͻȌǡͳʹ͵ͳǤ ›•ƒ‡”ǡǤ Ǥǡ— ǡǤǤǡ ‘‰Ž‡›ǡǤǤǡ‹‰‡”ǡ Ǥǡ ƒ”†‡”ǡǤǡ ƒ••‘ǦŠƒ›‘ǡ Ǥǡ‡–ƒŽǤȋʹͲͲͷȌǤŠ‡ —–—ƒŽ†‡˜‡Ž‘’‡–‘ˆ‹–‡”•—„Œ‡ –‹˜‹–›ƒ†‡–ƒ ‘‰‹–‹˜‡ ƒ’ƒ ‹–›‹–Š‡’•› Š‘–Š‡”ƒ’› ˆ‘”’‡”•‘•™‹–Š• Š‹œ‘’Š”‡‹ƒǤ ‘—”ƒŽ‘ˆ‘–‡’‘”ƒ”›•› Š‘–Š‡”ƒ’›ǡͶ͵ȋʹȌǡ͸͵–͹ʹǤ ›•ƒ‡”ǡǤ ǤǡƬ‹ƒ‰‰‹‘ǡ ǤȋʹͲͳͶȌǤ‡–ƒ ‘‰‹–‹˜‡ ƒ’ƒ ‹–‹‡•ˆ‘””‡ˆŽ‡ –‹‘‹• Š‹œ‘’Š”‡‹ƒǣSchizophrenia Bulletin 40 ‹’Ž‹ ƒ–‹‘•ˆ‘”†‡˜‡Ž‘’‹‰–”‡ƒ–‡–•Ǥ ǡ ȋ͵ȌǡͶͺ͹ǦͶͻͳǤ ƒ‹ǡǤǡƬ‘Ž‘‘ǡ ǤȋͳͻͻͲȌǤ”‘ ‡†—”‡•ˆ‘”‹†‡–‹ˆ›‹‰‹ˆƒ–•ƒ•†‹•‘Attachment in the preschool”‰ƒ‹œ‡†Ȁ†‹•‘”‹‡–‡† years: Theory, research, †—”‹‰–Š‡‹•™‘”–Š–”ƒ‰‡‹–—ƒ–‹‘Ǥand intervention 1  ǡ ǡͳʹͳǦͳ͸ͲǤ  ‡‘†ǡ Ǥ Ǥǡ —Ž‡›ǡǤ Ǥǡƒ ‡–ŠǡǤǡ Š™ƒƒ—‡”ǡǤǡ›•ƒ‡”ǡǤ ǤȋʹͲͳͶȌǤ‡–ƒ ‘‰‹–‹˜‡ ˆ— –‹‘‹‰’”‡†‹ –•’‘•‹–‹˜‡ƒ†‡‰ƒ–‹˜‡•›’–‘•‘˜‡”ͳʹ‘–Š•‹ˆ‹”•–‡’‹•‘†‡ ’•› Š‘•‹•Ǥ•› Š‹ƒ–”›‡•‡ƒ” ŠǡͷͶȋͳȌǡͳͲͻ–ͳͳͷǤ ‹ ‡Ž•‘ǡǤǤǡ‡••Ž‡”ǡǤǤǡƬŠƒ˜‡”ǡǤǤȋͳͻͻ͹ȌǤ†—Ž–ƒ––ƒ Š‡–‹ƒƒ–‹‘ƒŽŽ›Journal of personality and social psychology 73 ”‡’”‡•‡–ƒ–‹˜‡•ƒ’Ž‡Ǥ ǡ ȋͷȌǡͳͲͻʹǤ ‹—Ž‹ ‡”ǡǤȋͳͻͻ͹ȌǤ†—Ž–ƒ––ƒ Š‡–•–›Ž‡ƒ†‹ˆ‘”ƒ–‹‘’”‘ ‡••‹‰ǣ †‹˜‹†—ƒŽ†‹ˆˆ‡”‡ ‡•‹Journal of personality and social psychology 72 —”‹‘•‹–›ƒ† ‘‰‹–‹˜‡ Ž‘•—”‡Ǥ ǡ ȋͷȌǡͳʹͳ͹ǤWorld  ‹—Ž‹ ‡”ǡǤǡƬŠƒ˜‡”ǡǤǤȋPsychiatry 11 ʹͲͳʹȌǤƒ––ƒ Š‡–’‡”•’‡ –‹˜‡‘’•› Š‘’ƒ–Š‘Ž‘‰›Ǥ ǡ ȋͳȌǡͳͳǦͳͷǤ

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‘Ž–‡ǡǤǡ‘ŽŽ‹‰ǡǤǤǡ —†ƒ ǡǤǡ ‘ƒ‰›ǡǤǡƒ›‡•ǡǤǤǡƬ‡Ž’Š”‡›ǡǤǤȋʹͲͳ͵ȌǤ”ƒ‹ ‡ Šƒ‹••—†‡”Ž›‹‰–Š‡‹’ƒ –‘ˆƒ––ƒ Š‡–Frontiers in Human Neuroscience 7 Ǧ”‡Žƒ–‡†•–”‡••‘•‘ ‹ƒŽ ‘‰‹–‹‘Ǥ ǡ ǡͺͳ͸Ǥ ‘”ƒǡǤǤǡ‹†‡ŽŽǡǤǡ› Šǡ ǤǡƬƒ Šƒ†ƒǡǤȋʹͲͳ͵ȌǤ‘””‡Žƒ–‡•‘ˆ•—„Œ‡ –‹˜‡”‡ ‘˜‡”›‹ƒEarly intervention in psychiatry, 7(3) ‡ƒ”Ž›‹–‡”˜‡–‹‘’”‘‰”ƒˆ‘”’•› Š‘•‡•Ǥ ǡʹ͹ͺǦʹͺͶǤ ̵”‹• ‘ŽŽǡǤǡƒ‹‰ǡ ǤǡƬƒ•‘ǡǤȋʹͲͳͶȌǤ‘‰‹–‹˜‡‡‘–‹‘”‡‰—Žƒ–‹‘•–”ƒ–‡‰‹‡•ǡƒŽ‡š‹–Š›‹ƒƒ†Clinical Psychology Review 34 †‹••‘ ‹ƒ–‹‘‹• Š‹œ‘’Š”‡‹ƒǡƒ”‡˜‹‡™ƒ†‡–ƒǦƒƒŽ›•‹•Ǥ ǡ ȋ͸Ȍǡ ͶͺʹǦͶͻͷǤ ™‡•ǡǤǤǡ ƒ††‘ ǡ ǤǡƬ‡””›ǡǤȋʹͲͳ͵ȌǤŠ‡”‘Ž‡‘ˆ–Š‡Clinical–Š‡”ƒ’‡—–‹ ƒŽŽ‹ƒ ‡‹–Š‡”‡‰—Žƒ–‹‘‘ˆ psychology & ‡‘–‹‘‹’•› Š‘•‹•ǣƒƒ––ƒ Š‡–’‡”•’‡ –‹˜‡Ǥpsychotherapy 20  ǡ ȋ͸Ȍǡͷʹ͵Ǧͷ͵ͲǤ ‡”‡‹”ƒǡ Ǥ ǤǡƬ‡„„ƒ±ǡǤȋʹͲͳͺȌǤ –‡‰”ƒ–‹˜‡Ǧ‡Žƒ–‹‘ƒŽ’’”‘ƒ Š‹ Š‹œ‘’Š”‡‹ƒǣ ”‘ Š‹Ž‘•‘’Š‹ ƒŽ”‹ ‹’Ž‡•–‘‡–ƒŽ‹œƒ–‹‘Schizophrenia and CommonǦƒ•‡†”ƒ –‹ ‡Ǥ  ‹’‘Ž‹–‘ǡ Ǥǡ ‘ ƒŽ˜‡•ǡ Ǥǡ Sense ‡”‡‹”ƒǡ Ǥȋ†•ǤȌ ȋ’’Ǥͳͻ͵ǦʹͲ͹ȌǤŠƒǡ™‹–œ‡”Žƒ†ǣ ’”‹‰‡”Ǥ ‹ŠƒǡǤǤǡ‡ǡǤǤǡ‡”‹•ǡǤǤǡƬ‹‡„‡”ƒǡ ǤȋʹͲͲ͵ȌǤ ’Ž‹ ƒ–‹‘•ˆ‘”–Š‡‡—”ƒŽ„ƒ•‹•‘ˆAmerican Journal of Psychiatry 160 •‘ ‹ƒŽ ‘‰‹–‹‘ˆ‘”–Š‡•–—†›‘ˆ• Š‹œ‘’Š”‡‹ƒǤ ǡ ȋͷȌǡͺͳͷǦ ͺʹͶǤ ‡ƒ†ǡ Ǥǡ ‘••‡ǡǤǡ‘•‘™‹–œǡǤǡƬ‡””›ǡǤȋʹͲͳͶNeuropsychiatry 4 ȌǤŠ‡–”ƒ—ƒ‰‡‹ ‡—”‘†‡˜‡Ž‘’‡–ƒŽ‘†‡Ž‘ˆ ’•› Š‘•‹•”‡˜‹•‹–‡†Ǥ ǡ ȋͳȌǡ͸ͷǤ ‹†‡‘—”ǡ Ǥǡƒ—••ǡǤǡƬ ƒǡ ǤǤȋʹͲͳͻȌǤ‘’ƒ”‹‰‡–ƒ ‘‰‹–‹‘ƒ†‡–ƒŽ‹œƒ–‹‘ƒ†Journal of Contemporary Psychotherapy,–Š‡‹”‹’Ž‹ ƒ–‹‘•ˆ‘”’•› Š‘–Š‡”ƒ’›ˆ‘”‹†‹˜‹†—ƒŽ•™‹–Š’•› Š‘•‹• 49 Ǥ ȋʹȌǡ͹ͻǦͺͷǤ ‡Ž–‡ǡ ǤǤǡ˜ƒ†‡”‡ǡǤǡ—––‡ǡǤǤǡƬƒ–‘”Schizophrenia bulletinǦ ”ƒƒ‡ǡǤȋʹͲͳ͵ȌǤ39 Š‡•‘ ‹ƒŽ†‡ˆ‡ƒ–Š›’‘–Š‡•‹•‘ˆ • Š‹œ‘’Š”‡‹ƒǣƒ—’†ƒ–‡Ǥ ǡ ȋ͸ȌǡͳͳͺͲǦͳͳͺ͸Ǥ ‡‡”ƒ”‹Ǥǡƒ” ‹‘‡Ǥǡ‹ƒ‰‰‹‘ Ǥǡ ƒŽ ‘‡Ǥǡ‹ ‘ŽÖ Ǥǡ”‘ ƒ ‹Ǥǡ‡–ƒŽǤȋʹͲͲ͵ȌǤ ‘™–‘ ‡˜ƒŽ—ƒ–‡‡–ƒ ‘‰‹–‹˜‡ˆ— –‹‘‹‰‹’•› Š‘–Š‡”ƒ’›ǫŠ‡‡–ƒ ‘‰‹–‹‘ƒ••‡••‡–• ƒŽ‡Clinical Psychological Psychotherapy, 10(4), ƒ†‹–•ƒ’’Ž‹ ƒ–‹‘•Ǥ ʹ͵ͺ–͸ͳǤ ’”‘‰ǡǤǡ Š‘–Š‘”•–ǡǤǡ‘•ǡǤǡ ‘šǡ ǤǡƬƒ‰‡Žƒ†ǡ ǤȋʹͲͲ͹ȌǤThe British Journal of PsychiatryŠ‡‘”›‘ˆ‹†‹191 • Š‹œ‘’Š”‡‹ƒǣ‡–ƒǦƒƒŽ›•‹•Ǥ ǡ ȋͳȌǡͷǦͳ͵Ǥ ”‘—ˆ‡ǡǤǤȋʹͲͲͷȌǤ––ƒ Š‡–ƒ††‡˜‡Ž‘’‡–ǣ’”‘•’‡ –‹˜‡ǡŽ‘‰‹–—†‹ƒŽ•–—†›ˆ”Attachment & human development 7 ‘„‹”–Š–‘ ƒ†—Ž–Š‘‘†Ǥ ǡ ȋͶȌǡ͵ͶͻǦ͵͸͹Ǥ

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–—„‘ǡǤǤǡƒ”„‘”‘—‰ŠǡǤ Ǥ Ǥǡƒ—Ž•‘ǡǤ ǤǡƬ ”‡‡ǡǤǤȋʹͲͳͷȌǤŠ‡‹’ƒ –‘ˆƒ†˜‡”•‡ Š‹Ž†Psychiatric rehabilitation ƒ†ƒ†—Ž–‡š’‡”‹‡ ‡•‘”‡ ‘˜‡”›ˆ”‘•‡”‹‘—•‡–ƒŽ‹ŽŽ‡••Ǥjournal, 38(4) ǡ͵ʹͲǤ Š‘ƒ•ǡǤǤǡ—”ƒŽ‹†Šƒ”ƒǡǤǡ‡†‘ˆˆǡǤǡƬ”ƒ’ƒŽ•‹ǡǤǤȋʹͲͳ͸ȌǤ‡ŽˆǦ‡ˆˆ‹ ƒ ›ƒ•ƒ‡†‹ƒ–‘”‘ˆPsychiatric –Š‡”‡Žƒ–‹‘•Š‹’„‡–™‡‡•‘ ‹ƒŽ•—’’‘”–ƒ†”‡ ‘˜‡”›‹•‡”‹‘—•‡–ƒŽ‹ŽŽ‡••Ǥrehabilitation journal, 39(4) ǡ͵ͷʹǤ ‘””‡ǡ ǤǤǡƬ‹‡„‡”ƒǡǤǤȋʹͲͳͺȌǤ—––‹‰ˆ‡‡Ž‹‰•‹–‘™‘”†•ǣˆˆ‡ –Žƒ„‡Ž‹‰ƒ•‹’Ž‹ ‹–Emotion Review 10 ‡‘–‹‘”‡‰—Žƒ–‹‘Ǥ ǡ ȋʹȌǡͳͳ͸ǦͳʹͶǤ Dialogues in clinical neuroscience 2 ”±‡ƒ—ǡ ǤȋʹͲͲ͸ȌǤ”‡˜‹‡™‘ˆ‡‘–‹‘†‡ˆ‹ ‹–•‹• Š‹œ‘’Š”‡‹ƒǤ8 ǡ ȋͳȌǡͷͻǤ ƒ”‡•‡ǡ Ǥǡ‡‡–•ǡ Ǥǡ”—‡”ǡǤǡ‹‡˜‡”•‡ǡǤǡƒ–ƒ•–‡”ǡǤǡ‹‡ Š–„ƒ—‡”ǡǤǡǤǤǤƬ‡–ƒŽŽǡǤǤ ȋʹͲͳʹȌǤŠ‹Ž†Š‘‘†ƒ†˜‡”•‹–‹‡•‹ ”‡ƒ•‡–Š‡”‹•‘ˆ’•› Š‘•‹•ǣƒ‡–ƒSchizophreniaǦƒƒŽ›•‹•‘ˆ’ƒ–‹‡– bulletin 38 Ǧ ‘–”‘Žǡ’”‘•’‡ –‹˜‡Ǧƒ† ”‘••Ǧ•‡ –‹‘ƒŽ ‘Š‘”–•–—†‹‡•Ǥ ǡ ȋͶȌǡ͸͸ͳǦ ͸͹ͳǤ  ‡Ž–Š‘”•–ǡǤǡ‹‡ƒǡǤ Ǥǡ‹•œ‡ǡǤǡ‡ ‡”ǡ Ǥǡ†‡ ƒƒǡǤǡ‹‰‡ƒ•ǡǤǤǡǤǤǤ. The British JournalƬ ‡‹œǡǤ of ȋʹͲͳͲȌǤ‹•ƒ„‹Ž‹–›‹’‡‘’Ž‡ Ž‹‹ ƒŽŽ›ƒ–Š‹‰Š”‹•‘ˆ’•› Š‘•‹•Psychiatry, 197 ȋͶȌǡʹ͹ͺǦʹͺͶǤ ‡‹Œ‡”•ǡ Ǥǡ–‡ƒ–‡ǡǤǡ—”‡Ž‹‰•Ǧ‘–‡‘‡ǡǤǡ‹‡ Š–„ƒ—‡”ǡǤǡƒ’ƒƒ”–ǡǤǡƒ–‡ƒǡǤǡƬ‡Ž–‡ǡ ǤǤȋʹͲͳ͸ȌǤ‡–ƒŽ‹œƒ–‹‘BMC psychiaǦ„ƒ•‡†–”‡ƒ–‡–ˆ‘”’•› Š‘–‹ †‹•‘”†‡”ǣ’”‘–‘ ‘Ž‘ˆƒ”ƒ†‘‹œ‡†try 16 ‘–”‘ŽŽ‡†–”‹ƒŽǤ ǡ ȋͳȌǡͳͻͳǤ ‡‹Œ‡”•ǡ Ǥǡ ‘ƒ‰›ǡǤǡ—”‡Ž‹‰•Ǧ‘–‡‘‡ǡǤǡ‡”‘”•Š—‹œ‡ǡ Ǥǡ‹‡ Š–„ƒ—‡”ǡǤǡƬ‡Ž–‡ǡ ǤǤ ȋʹͲͳͺȌǤ‡–ƒŽ‹œ‹‰‹’ƒ‹”‡–ƒ•ƒ‡†‹ƒ–‘”„‡–™‡‡”‡’‘”–‡† Š‹Ž†Š‘‘†ƒ„—•‡ƒ†Psychiatry research, 259, ‘—– ‘‡‹‘ƒˆˆ‡ –‹˜‡’•› Š‘–‹ †‹•‘”†‡”Ǥ Ͷ͸͵ǦͶ͸ͻǤ Š‹–‡Ǥǡ–‹”Ž‹‰ Ǥǡ‘””‹• Ǥǡ‘–ƒ‰—‡Ǥǡƒ–ƒǤǡ‡™‹•ǤȋʹͲͲͻȌǤ”‡†‹ –‘”•‘ˆͳͲPsychological Medicine, 39 Ǧ›‡ƒ” ‘—– ‘‡‘ˆˆ‹”•–Ǧ‡’‹•‘†‡’•› Š‘•‹•Ǥ ǡͳͶͶ͹ǦͳͶͷ͸Ǥ  











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PART II:

Š‹Ž†Š‘‘†ƒ„—•‡ƒ†’•› Š‘•‹• CHILDHOOD ABUSE

AND PSYCHOSIS

Part II Part

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146807_JonasWeijers_BNW_def.indd 48 28-10-2020 15:08

Chapter Three: REPORTED‡’‘”–‡† Š‹Ž†Š‘‘†ƒ„—•‡ƒ†•–”‡••”‡ƒ –‹˜‹–›‹ CHILDHOOD ’•› Š‘•‹•ǣƒ ‘ ‡’–—ƒŽ”‡’Ž‹ ƒ–‹‘ƒ†ƒ‡š’Ž‘”ƒ–‹‘‘ˆ•–ƒ–‹•–‹ ƒŽ FrontiersABUSE in Psychiatry AND(2018) STRESS ƒ’’”‘ƒ Š‡• JonasREACTIVITY Weijers1,2*, Wolfgang Viechtbauer 2, Elisabeth IN Eurelings -Bontekoe 3,, Jean-Paul Selten 1,2  PSYCHOSIS: A CONCEPTUAL REPLICATION AND AN EXPLORATION OF STATISTICAL APPROACHES 3

ͳ ‹˜‹‡”†—‹‡ •–‹–—–‡ˆ‘”‡–ƒŽ ‡ƒŽ–Šƒ”‡ǡ–Š‡‡–Š‡”Žƒ†•Ǥ ʹ  Š‘‘Ž‘ˆ‡–ƒŽ ‡ƒŽ–Šƒ†‡—”‘• ‹‡ ‡ǡƒƒ•–”‹ Š–‹˜‡”•‹–›ǡ–Š‡‡–Š‡”Žƒ†•Ǥ ͵ ‡’ƒ”–‡–‘ˆŽ‹‹ ƒŽ•› Š‘Ž‘‰›ǡ ‡ƒŽ–Šƒ†‡—”‘’•› Š‘Ž‘‰›ǡ‡‹†‡‹˜‡”•‹–›ǡ–Š‡‡–Š‡”Žƒ†•Ǥ ȗJ.G.‘””‡•’‘†‡ ‡ǣ Weijers, W.V. ‘ƒ• Viechtbauer,‡‹Œ‡”•ǡƒ†‹ˆ‘”–†”‡‡ˆ E.H.Mͳͻǡ ʹ͵͵͵‡‹†‡ǡ–Š‡‡–Š‡”Žƒ†•ȋ”‘‘͵ͲͺȌǤ ƒ‹ŽǣEurelings-Bontekoe,ŒǤ™‡‹Œ‡”•̷”‹˜‹‡”†—‹‡ǤŽ J.-P.C.J.ȀŒ‘ƒ•™‡‹Œ‡”•̷‰ƒ‹ŽǤ ‘ Selten 

Frontiers in Psychiatry (2018) Chapter Chapter

146807_JonasWeijers_BNW_def.indd 49 28-10-2020 15:08 Chapter Three

Abstract

’”‡˜‹‘—••–—†›‘„•‡”˜‡†–Šƒ–”‡’‘”–‡† Š‹Ž†Š‘‘†ƒ„—•‡‘†‡”ƒ–‡†’•› Š‘–‹ ƒ†‡‘–‹‘ƒŽ ”‡ƒ –‹˜‹–›–‘•–”‡••ƒ‘‰’ƒ–‹‡–•™‹–Š‘Ǧƒˆˆ‡ –‹˜‡’•› Š‘–‹ †‹•‘”†‡”Ǥ ‘™‡˜‡”ǡ–Šƒ–•–—†›—•‡† ƒ–›’‡‘ˆƒƒŽ›•‹•—•—‹–‡†ˆ‘”•‡™‡††ƒ–ƒǤŠ‹••–—†›ƒ‹‡†ͳȌ–‘”‡’Ž‹ ƒ–‡–Š‡•–—†›ƒ†ʹȌ–‘ ‡šƒ‹‡™Š‡–Š‡”™‡™‘—Ž†‘„–ƒ‹•‹‹Žƒ””‡•—Ž–•—•‹‰ƒ•–ƒ–‹•–‹ ƒŽƒ’’”‘ƒ Š„‡––‡”•—‹–‡†–‘ •‡™‡††ƒ–ƒǤ ‹ˆ–›Ǧ‹‡’ƒ–‹‡–•™‹–Š‘Ǧƒˆˆ‡ –‹˜‡’•› Š‘–‹ †‹•‘”†‡”™‡”‡‡šƒ‹‡†ˆ‘”—’–‘•‹š †ƒ›•—•‹‰ƒ‹–‡•‹˜‡†‹ƒ”›‡–Š‘†–‘ƒ••‡••Ž‡˜‡Ž•‘ˆ‡‰ƒ–‹˜‡ƒˆˆ‡ –ǡ’•› Š‘•‹•ǡƒ††ƒ‹Ž›ǦŽ‹ˆ‡ •–”‡••Ǥ‹š‡†ǦŽ‹‡ƒ””‡‰”‡••‹‘Žƒ”‰‡Ž›”‡’Ž‹ ƒ–‡†‡ƒ”Ž‹‡”ˆ‹†‹‰•ǡ„—–ƒ–™‘Ǧ ‘’‘‡–ƒƒŽ›•‹• ˆƒ‹Ž‡†–‘”‡’Ž‹ ƒ–‡–Š‡‘†‡”ƒ–‹‰‡ˆˆ‡ –‘ˆ”‡’‘”–‡† Š‹Ž†Š‘‘†ƒ„—•‡ǤŠ‡•‡”‡•—Ž–•‹ŽŽ—•–”ƒ–‡–Š‡ ‹’‘”–ƒ ‡‘ˆ‡š’Ž‘”‹‰†‹ˆˆ‡”‡–•–ƒ–‹•–‹ ƒŽƒ’’”‘ƒ Š‡•–‘•‡™‡††ƒ–ƒǤŠ‡›ƒ›ƒŽ•‘‹†‹ ƒ–‡–Šƒ– •–”‡•••‡•‹–‹œƒ–‹‘†‘‡•‘–‘ˆˆ‡”ƒ ‘’Ž‡–‡ƒ ‘—–ˆ‘”–Š‡‡ˆˆ‡ –‘ˆ”‡’‘”–‡† Š‹Ž†Š‘‘†ƒ„—•‡‘ ’•› Š‘–‹ •›’–‘•‡˜‡”‹–›Ǥ  Keywords:

š’‡”‹‡ ‡•ƒ’Ž‹‰‡–Š‘†ǡ’•› Š‘•‹•ǡ Š‹Ž†Š‘‘†ƒ„—•‡ǡ•–”‡••”‡ƒ –‹˜‹–›ǡ‘Ǧ‘”ƒŽŽ›

†‹•–”‹„—–‡††ƒ–ƒǤ Introduction

‰”‘™‹‰„‘†›‘ˆ‡˜‹†‡ ‡‹†‹ ƒ–‡•–Šƒ– Š‹Ž†Š‘‘†ƒ„—•‡’Žƒ›•ƒ”‘Ž‡‹–Š‡‡–‹‘Ž‘‰›‘ˆ‘Ǧ ƒˆˆ‡ –‹˜‡’•› Š‘–‹ †‹•‘”†‡”ȋǢƒ–Š‡•‘ǡŠ‡’Š‡”†ǡ‹ Š„‡ ǡƒ—”‡•Ƭƒ””ǡʹͲͳ͵Ǣƒ”‡•‡ ‡–ƒŽǤǡʹͲͳʹǢ‘”‰ƒƬ ‹•Š‡”ǡʹͲͲ͹Ǣ˜ƒƒ‡–ƒŽǤǡʹͲͳͷȌǤ –Šƒ•„‡‡•—‰‰‡•–‡†–Šƒ–ƒ‹ ”‡ƒ•‡† ”‡ƒ –‹˜‹–›–‘•–”‡••ˆ—Ž•‹–—ƒ–‹‘•ƒ ‘—–•ˆ‘”–Š‹•ȋ›‹Ǧ ‡”‡›•Ƭ˜ƒ•ǡʹͲͲ͹Ǣ‘ŽŽ‹’ǡ›‹Ǧ ‡”‡›•Ƭ˜ƒ•ǡʹͲͲͺǢ‡Ž‹‰ǡ‘—‘––‡ǡ‘–Ǧ‘Ž†‡”ǡ˜ƒ•Ƭ˜ƒ†‡” ƒƒ‰ǡʹͲͳ͸ȌǤ ‘”†‹‰–‘ this view, cumulative exposure to traumatic experiences during childhood results in ‘beŠƒ˜‹‘”ƒŽ sensitization’, a mechanism whereby previous exposure to adversity or stress renders individuals ‘”‡•‡•‹–‹˜‡–‘•–”‡••Žƒ–‡”‹Ž‹ˆ‡ǡ™Š‹ Š‹–—”‹•–Š‘—‰Š––‘‹ ”‡ƒ•‡–Š‡”‹•ˆ‘”’•› Š‘•‹• ȋƒ–ƒ•–‡”ǡƒŽƒ‰‰‹ƒǡƒ”†‹‘‹•ǡ˜ƒ•Ƭ›‹Ǧ ‡”‡›•ǡʹͲͳ͵Ǣƒ‡••‡‡–ƒŽǤǡʹͲͳ͹Ǣ›‹Ǧ ‡”‡›•ǡ ‡Ž‡•’ƒ—ŽƬ˜ƒ•ǡʹͲͲͷȌ. Indeed, using the ‘experience sampling method’ (ESM), it was shown –Šƒ–†ƒ‹Ž›Ž‹ˆ‡•–”‡••‹•ƒ••‘ ‹ƒ–‡†™‹–Š–Š‡‹–‡•‹–›‘ˆ’•› Š‘–‹ ‡š’‡”‹‡ ‡•‹’ƒ–‹‡–•™‹–Š ȋƒ–ƒ•–‡”‡–ƒŽǤǡʹͲͳ͵ȌǤ‹•‡•’‡ ‹ƒŽŽ›—•‡ˆ—Žˆ‘”‡šƒ‹‹‰†›ƒ‹ ’”‘ ‡••‡•‹†ƒ‹Ž›Ž‹ˆ‡ǡ „‡ ƒ—•‡‹–‹˜‘Ž˜‡•’”‘’–‹‰’ƒ”–‹ ‹’ƒ–•–‘”‡’‘”–‘–Š‡‹”‡š’‡”‹‡ ‡•—Ž–‹’Ž‡–‹‡•’‡”†ƒ›ˆ‘” ƒ‡š–‡†‡†’‡”‹‘†‘ˆ–‹‡Ǥ –Š‹•™ƒ›ǡ ‘•–‹–—–‡•ƒ‡ ‘Ž‘‰‹ ƒŽŽ›˜ƒŽ‹†ƒ’’”‘ƒ Šˆ‘”–Š‡ ‡ƒ•—”‡‡–‘ˆ’ƒ–Š‘Ž‘‰‹ ƒŽ‡š’‡”‹‡ ‡•ƒ†•–”‡••‘”•‹†ƒ‹Ž›Ž‹ˆ‡Ǥ

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146807_JonasWeijers_BNW_def.indd 50 28-10-2020 15:08 Reported childhood abuse and stress reactivity in psychosis

—„‡”‘ˆ•–—†‹‡•Šƒ˜‡•Š‘™–Šƒ––Š‡•‡˜‡”‹–›‘ˆ”‡’‘”–‡† Š‹Ž†Š‘‘†ƒ„—•‡ȋȌ ƒ‹†‡‡†ƒˆˆ‡ ––Š‡‹–‡•‹–›‘ˆ‡‘–‹‘ƒŽƒ†’•› Š‘–‹ ”‡ƒ –‹‘•–‘†ƒ‹Ž›Ž‹ˆ‡•–”‡••‘”•ȋ Žƒ•‡”ǡ ˜ƒ•ǡ‘”–‡‰‹Œ•Ƭ›‹Ǧ ‡”‡›•ǡʹͲͲ͸Ǣ”‹•–ׄƒŽǦƒ”˜ž‡œ‡–ƒŽǤǡʹͲͳ͸Ǣ˜ƒ‹‡”‘’‡–ƒŽǤǡʹͲͳͺǢ ƒ”†‹‘‹•ǡƒ–ƒ•–‡”ǡ‡‰‡Ž‡”•ǡ˜ƒ•ǡƬ›‹Ǧ ‡”‡›•ǡʹͲͳ͵Ǣ‡‹‰Šƒ—•‡–ƒŽǤǡʹͲͳ͸ȌǤ™ƒ• •Š‘™–‘„‡ ‘””‡Žƒ–‡†™‹–Š‰”‡ƒ–‡”‡‰ƒ–‹˜‡‡‘–‹‘ƒŽ”‡ƒ –‹‘•‘”’•› Š‘–‹ ”‡ƒ –‹‘•–‘•–”‡••‹ ‘ Ž‹‹ ƒŽ•ƒ’Ž‡•ȋ Žƒ•‡”‡–ƒŽǤǡʹͲͲ͸Ǣ”‹•–ׄƒŽǦƒ”˜ž‡œǡʹͲͳ͸Ǣ˜ƒ‹‡”‘’‡–ƒŽǤǡʹͲͳͺȌƒ†ǡ™‹–Š ”‡‰ƒ”†–‘ȋƒ”†‹‘‹•ǡƒ–ƒ•–‡”ǡ‡‰‡Ž‡”•ǡƒ•ǡƬ›‹Ǧ ‡”‡›•ǡʹͲͳͳȌ•Š‘™‡†–Šƒ– ’ƒ–‹‡–•™‹–ŠŠ‹‰ŠŽ‡˜‡Ž•‘ˆ”‡’‘”–‡†‹ ”‡ƒ•‡†’•› Š‘–‹ ƒ†‡‘–‹‘ƒŽ”‡ƒ –‹˜‹–›–‘‡˜‡–Ǧ ”‡Žƒ–‡†•–”‡••ȋ‹Ǥ‡Ǥǡ™Š‡ƒ—’Ž‡ƒ•ƒ–‡˜‡–Šƒ’’‡•Ȍƒ†ƒ –‹˜‹–›Ǧ”‡Žƒ–‡†•–”‡••ȋ‹Ǥ‡Ǥǡ™Š‡ƒ activity’s difficulty exceeds one’s capability). Sim‹Žƒ”‘„•‡”˜ƒ–‹‘•™‡”‡ƒ†‡„›‡‹‹‰Šƒ—•‡–ƒŽǤ

ȋʹͲͳ͸Ȍǡ„—––Š‡›‹˜‘Ž˜‡††‹ˆˆ‡”‡––›’‡•‘ˆ•–”‡••ǡƒ‡Ž›•‘ ‹ƒŽ•–”‡••ȋ‹Ǥ‡Ǥǡ–Š‡—’Ž‡ƒ•ƒ–‡••‘ˆ 3 the participant’s current social situation) and areaǦ”‡Žƒ–‡†•–”‡••ȋ‹Ǥ‡Ǥǡ–Š‡—’Ž‡ƒ•ƒ–‡••‘ˆ–Š‡ ’ƒrticipant’s current neighborhood). Contrary to Lardinois et al. (ʹͲͳͳȌǡŠ‘™‡˜‡”ǡ‡‹‹‰Šƒ—•‡– ƒŽǤȋʹͲͳ͸Ȍ†‹†‘–ˆ‹†‡˜‹†‡ ‡–Šƒ––Š‡”‡Žƒ–‹‘•Š‹’„‡–™‡‡‡˜‡–•–”‡••ƒ†‡‰ƒ–‹˜‡ƒˆˆ‡ –‘” ’•› Š‘–‹ ‡š’‡”‹‡ ‡•™ƒ•‘†‡”ƒ–‡†„›Ǥ Š—•ǡ–Š‡’”‡˜‹‘—••–—†‹‡•ƒ”‡‹‘˜‡”ƒŽŽ•—’’‘”–‘ˆ–Š‡Š›’‘–Š‡•‹•‘ˆ„‡Šƒ˜‹‘”ƒŽ •‡•‹–‹œƒ–‹‘–‘•–”‡••†—‡–‘ Š‹Ž†Š‘‘†ƒ„—•‡Ǥ ‘™‡˜‡”ǡ‹–”‡ƒ‹•— ‡”–ƒ‹™Š‡–Š‡” •’‡ ‹ˆ‹ ƒŽŽ›‘†‡”ƒ–‡•–Š‡”‡Žƒ–‹‘•Š‹’„‡–™‡‡‡˜‡–Ǧ”‡Žƒ–‡†•–”‡••ƒ†‡‰ƒ–‹˜‡ƒˆˆ‡ –‘” ’•› Š‘–‹ ‡š’‡”‹‡ ‡•ǡƒ•–Š‡ˆ‹†‹‰•‘ˆ‡‹‹‰Šƒ—•ȋʹͲͳ͸Ȍƒ†ƒ”†‹‘‹•ȋʹͲͳͳȌƒ”‡‹ ‘–”ƒ†‹ –‹‘Ǥ††‹–‹‘ƒŽŽ›ǡ–Š‡ˆ‹†‹‰„›ƒ”†‹‘‹•‡–ƒŽǤȋʹͲͳͳȌ ‘ ‡”‹‰ƒ –‹˜‹–›Ǧ”‡Žƒ–‡†•–”‡•• Šƒ•‘–„‡‡”‡’Ž‹ ƒ–‡†‹ƒ•ƒ’Ž‡Ǥ ‘—”˜‹‡™ǡ–Š‹•‹•‹’‘”–ƒ–ǡ•‹ ‡• ‹‡–‹ˆ‹  Žƒ‹• ƒ ‘Ž›„‡‰‹˜‡ ”‡†‡ ‡‹ƒ ‘”†ƒ ‡™‹–Š–Š‡”‡’”‘†— ‹„‹Ž‹–›‘ˆ–Š‡‹”•—’’‘”–‹‰‡˜‹†‡ ‡ȋ’‡  ‹‡ ‡‘ŽŽƒ„‘”ƒ–‹‘ǡʹͲͳʹȌǤƒ•–Ž›ǡƒ†‘•–‹’‘”–ƒ–Ž›ǡƒŽŽ•–—†‹‡• ‘ ‡”‹‰ƒ†•–”‡•• ”‡ƒ –‹˜‹–›•‘ˆƒ”Šƒ˜‡‡’Ž‘›‡†‹š‡†Ǧ‡ˆˆ‡ –•Ž‹‡ƒ””‡‰”‡••‹‘‘†‡Ž•Ǥ‘ ‡”•ƒ›„‡”ƒ‹•‡† ƒ„‘—––Š‡•‡ƒƒŽ›•‡•ǡ•‹ ‡–Š‡‘—– ‘‡˜ƒ”‹ƒ„Ž‡•ȋ‹Ǥ‡Ǥǡ‡‰ƒ–‹˜‡ƒˆˆ‡ –ƒ†’•› Š‘–‹ ‡š’‡”‹‡ ‡•Ȍ ƒ”‡”ƒ”‡Ž›‘”ƒŽŽ›†‹•–”‹„—–‡†ƒ†–‡†–‘„‡”‹‰Š–Ǧ•‡™‡†ȋ‡”Ž—‹ǡ†‡‘‡”Ƭ†‡‡–ǡʹͲͳ͸Ȍǡ ’‘••‹„Ž›˜‹‘Žƒ–‹‰‘”ƒŽ‹–›ƒ••—’–‹‘•—†‡”Ž›‹‰–Š‡‘†‡Ž•ȋ™‹–Š”‡•’‡ ––‘–Š‡”‡•‹†—ƒŽ•ƒ† ”ƒ†‘‡ˆˆ‡ –•ȌǤ Ž‹‰Š–‘ˆ–Š‹•ǡ‹š‡†Ǧ‡ˆˆ‡ –•Ž‹‡ƒ””‡‰”‡••‹‘ƒƒŽ›•‡•ƒ›‘–„‡•—‹–ƒ„Ž‡ ȋ‡”Ž—‹ǡ†‡‘‡”Ƭ†‡‡–ǡʹͲͳ͸ȌǤ Š‡ —””‡–•–—†›•‘—‰Š––‘”‡’Ž‹ ƒ–‡ƒ†‹’”‘˜‡—’‘–Š‡•–—†›„›ƒ”†‹‘‹•‡–ƒŽǤȋʹͲͳͳȌ ‹•‡˜‡”ƒŽ™ƒ›•Ǥ ‹”•–ƒ†ˆ‘”‡‘•–ǡ™‡‡š’Ž‘”‡†–™‘•–ƒ–‹•–‹ ƒŽƒ’’”‘ƒ Š‡•ˆ‘”–Š‡ƒƒŽ›•‹•‘ˆ–Š‡ †ƒ–ƒǣ‡š––‘ƒ‹š‡†ǦŽ‹‡ƒ””‡‰”‡••‹‘ǡ™Š‹ Š‹””‘”•–Š‡‘”‹‰‹ƒŽ•–—†›ǡ™‡ƒ††‡†ƒ•‡ ‘†ƒ”› ƒƒŽ›•‹•‘”‡•—‹–ƒ„Ž‡ˆ‘”–Š‡ƒƒŽ›•‹•‘ˆ•‡™‡†‘—– ‘‡•–‘‡šƒ‹‡–Š‡•‡•‹–‹˜‹–›‘ˆ–Š‡

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146807_JonasWeijers_BNW_def.indd 51 28-10-2020 15:08 Chapter Three

‘ Ž—•‹‘•–‘–Š‡‘†‡Ž‹‰ƒ’’”‘ƒ Š—•‡†Ǥ‡ ‘†ǡ™‡—•‡†ƒ•‡‹Ǧ•–”— –—”‡†ǡ‘„•‡”˜‡”Ǧ”ƒ–‡† ‹•–”—‡––‘‡ƒ•—”‡ǡƒ•‘’’‘•‡†–‘–Š‡•‡ŽˆǦ”‡’‘”–“—‡•–‹‘ƒ‹”‡—•‡†‹–Š‡’”‡˜‹‘—••–—†›Ǥ Š‹•‘ˆˆ‡”‡†–Š‡‘’’‘”–—‹–›–‘‰‡–ƒ‹Ǧ†‡’–Šƒ ‘—–‘ˆ Š‹Ž†Š‘‘†‡š’‡”‹‡ ‡•ǡ™Š‹Ž‡ •‹—Ž–ƒ‡‘—•Ž›’”‘˜‹†‹‰ƒŽ‡•••—„Œ‡ –‹˜‡”ƒ–‹‰‘ˆ–Š‡•‡˜‡”‹–›‘ˆƒ„—•‡Ǥ”‹•–‘„ƒŽǦƒ˜ƒ‡œ‡–ƒŽǤ ȋʹͲͳ͸Ȍ•—‰‰‡•––Šƒ–‹–‡”˜‹‡™•”‡Ž›‹‰‘‘„Œ‡ –‹˜‡†‡ˆ‹‹–‹‘•‘ˆƒ†˜‡”•‹–›Ž‹‡–Š‡‘Childhood xperience of Care and Abuse’ (Ȍ‹•–”—‡–ƒŽŽ‘™ˆ‘”ƒ‘”‡’”‡ ‹•‡ƒ••‡••‡–ǤŠ‹”†ǡ–Š‡ —””‡–•–—†›–”‡ƒ–‡†ƒ•ƒ ‘–‹—‘—•˜ƒ”‹ƒ„Ž‡ƒ•‘’’‘•‡†–‘–Š‡‡ƒ”Ž‹‡”•–—†‹‡•–Šƒ– †‹ Š‘–‘‹œ‡†—•‹‰ƒ•‘‡™Šƒ–ƒ”„‹–”ƒ”› —–Ǧ‘ˆˆ’‘‹–ȋ‡Ǥ‰Ǥǡ˜ƒ‹‡”‘’‡–ƒŽǤǡʹͲͳͺǡƒ”†‹‘‹• ‡–ƒŽǤǡʹͲͳͳǢ‡‹‹‰Šƒ—•‡–ƒŽǤǡʹͲͳ͸ȌǤƒ›ƒ—–Š‘”•Šƒ˜‡ƒ”‰—‡†ƒ‰ƒ‹•––Š‡ƒ”–‹ˆ‹ ‹ƒŽ †‹ Š‘–‘‹œƒ–‹‘‘ˆ˜ƒ”‹ƒ„Ž‡•ǡƒ•–Š‹• ƒŽ‡ƒ†–‘ƒŽ‘••‘ˆ‹ˆ‘”ƒ–‹‘ƒ†’‘™‡”ǡŽ‘™‡””‡Ž‹ƒ„‹Ž‹–›ǡ ‹ˆŽƒ–‡†–›’‡ ƒ†–›’‡ ‡””‘”•ǡƒ†’‘–‡–‹ƒŽ„‹ƒ•ȋ ”™‹Ƭ Ž‡ŽŽƒ†ǡʹͲͲ͵Ǣ‘›•–‘ǡŽ–ƒƬ ƒ—‡”„”‡‹ǡʹͲͲ͸ǢŠ‹•ƒƬ Ž‡ŽŽƒ†ǡʹͲͲͷȌǤ ‘—”–Šǡ•‘‡ƒ—–Š‘”•ȋ–‘‡ǡŠ‹ˆˆƒǡ Š™ƒ”–œǡ ”‘†‡”‹ Ƭ —ˆˆ‘”†ǡʹͲͲʹȌŠƒ˜‡ ƒ•–†‘—„–‘–Š‡”‡Ž‹ƒ„‹Ž‹–›‘ˆ–Š‡’‡Ǧƒ†Ǧ’ƒ’‡”‡š’‡”‹‡ ‡ •ƒ’Ž‹‰‡–Š‘†—•‡†‹–Š‡•–—†›„›ƒ”†‹‘‹•ƒ† ‘ŽŽ‡ƒ‰—‡•ǡ’”‡ˆ‡””‹‰–Š‡—•‡‘ˆ‡Ž‡ –”‘‹  †‡˜‹ ‡•Ž‹‡–Š‡‘‡—•‡†‹–Š‡ —””‡–•–—†›Ǥ ’‡ ‹ˆ‹ ƒŽŽ›ǡ–Š‡ƒ‹‘ˆ–Š‹••–—†›‹•–‘–‡•–™Š‡–Š‡”ǣͳȌƒ –‹˜‹–›Ǧ”‡Žƒ–‡†•–”‡••ƒ†‡˜‡–Ǧ ”‡Žƒ–‡†•–”‡••ƒ”‡”‡Žƒ–‡†–‘‡‰ƒ–‹˜‡ƒˆˆ‡ –ƒ†’•› Š‘–‹ ‡š’‡”‹‡ ‡•ƒ†ʹȌ™Š‡–Š‡”–Š‡•‡˜‡”‹–› ‘ˆ‘†‡”ƒ–‡•–Š‡‡‘–‹‘ƒŽƒ†’•› Š‘–‹ ”‡ƒ –‹˜‹–›–‘ƒ –‹˜‹–›Ǧ”‡Žƒ–‡†•–”‡••ƒ†‡˜‡–Ǧ ”‡Žƒ–‡†•–”‡••Ǥ Materials and methods Sample and procedure . Š‹••–—†›‹•’ƒ”–‘ˆƒŽƒ”‰‡”‘‡ȋ‡‹Œ‡”•‡–ƒŽǤǡʹͲͳ͸Ȍˆ‘”™Š‹ Š ‹‡–›’ƒ–‹‡–•™‹–Š™‡”‡”‡ ”—‹–‡†ˆ”‘ ‘—‹–›–”‡ƒ–‡––‡ƒ•ƒ–”‡‰‹‘ƒŽ‡–ƒŽ Š‡ƒŽ–Š ƒ”‡‹•–‹–—–‡•‹–Š‡‡–Š‡”Žƒ†•ȋ–Š‡‹˜‹‡”†—‹‡ •–‹–—–‡ˆ‘”‡–ƒŽ ‡ƒŽ–Šƒ”‡Ž‘ ƒ–‡† ‹‡‹†‡ǡ‘‘”Š‘—–ǡƒ†‘‡–‡”‡‡”ǡƒ†–Š‡Ž–”‡ Š– •–‹–—–‡ˆ‘”‡–ƒŽ ‡ƒŽ–Šƒ”‡‹‡‹•–ȌǤ ‹ƒ‰‘•‡•™‡”‡‡•–ƒ„Ž‹•Š‡†„›’•› Š‹ƒ–”‹•–•’”‹‘”–‘’ƒ”–‹ ‹’ƒ–‹‘ƒ†‹ Ž—†‡†• Š‹œ‘’Š”‡‹ƒǡ • Š‹œ‘ƒˆˆ‡ –‹˜‡†‹•‘”†‡”ǡ• Š‹œ‘’Š”‡‹ˆ‘”†‹•‘”†‡”ǡ„”‹‡ˆ’•› Š‘–‹ †‹•‘”†‡”ǡ†‡Ž—•‹‘ƒŽ†‹•‘”†‡”ǡ ‘”’•› Š‘–‹ †‹•‘”†‡”‘–‘–Š‡”™‹•‡•’‡ ‹ˆ‹‡†ǤŠ‡‹”†‹ƒ‰‘•‹•™ƒ• ‘ˆ‹”‡†„›”‡•‡ƒ” Š‡”•—•‹‰ –Š‡‘’”‡Š‡•‹˜‡••‡••‡–‘ˆ›’–‘•ƒ† ‹•–‘”›ȋ Ǣ†”‡ƒ•‡ǡ Žƒ—Ƭ”†–ǡ ͳͻͻʹȌǤŽ›’ƒ–‹‡–•™‹–Šƒ Ž‹‹ ‹ƒ†‹ƒ‰‘•‹•‹–Š‡•’‡ –”—ǡ™‡”‡‹–‡”˜‹‡™‡†™‹–Š–Š‡  ˆ‘”‡Ž‹‰‹„‹Ž‹–›Ǥ•‹‰–Š‡ ‹–™ƒ•”‡˜‡ƒŽ‡†–Šƒ–ƒŽŽ‘ˆ–Š‡‡Ž‹‰‹„Ž‡’ƒ”–‹ ‹’ƒ–•™Š‘Šƒ†„‡‡ ‰‹˜‡ƒ Ž‹‹ ‹ƒ†‹ƒ‰‘•‹•‹–Š‡•’‡ –”—ǡƒŽ•‘Šƒ†ƒ ‘”†‹‰–‘–Š‡ Ǥ ‘™‡˜‡”ǡ •’‡ ‹ˆ‹ Ǧ †‹ƒ‰‘•‡•ȋ‹Ǥ‡Ǥ• Š‹œ‘’Š”‡‹ƒ‘”• Š‹œ‘Ǧƒˆˆ‡ –‹˜‡†‹•‘”†‡”Ȍ ‘—Ž††‹ˆˆ‡”„‡–™‡‡

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146807_JonasWeijers_BNW_def.indd 52 28-10-2020 15:08 Reported childhood abuse and stress reactivity in psychosis

Ž‹‹ ‹ƒ•ƒ†”‡•‡ƒ” Š‡”•Ǥ”‡Ž‹ƒ„‹Ž‹–›ƒƒŽ›•‹•”‡˜‡ƒŽ‡†–Šƒ––Š‡”‡™ƒ•ƒƒ ‡’–ƒ„Ž‡”ƒ–‡‘ˆ ƒ‰”‡‡‡–„‡–™‡‡ Ž‹‹ ‹ƒ•ƒ†”‡•‡ƒ” Š‡”•™‹–Š”‡‰ƒ”†–‘•’‡ ‹ˆ‹ †‹ƒ‰‘•‡•ȋ”‘„ƒ Š̵• ƒŽ’ŠƒαͲǤ͹ͳ͵ȌǤ —”–Š‡”‹ Ž—•‹‘ ”‹–‡”‹ƒ™‡”‡ǣͳȌƒ–Ž‡ƒ•–ͳͺ›‡ƒ”•‘ˆƒ‰‡ǡʹȌˆŽ—‡– ‘ƒ†‘ˆ–Š‡ —– ŠŽƒ‰—ƒ‰‡ǡƒ†͵Ȍ–Š‡•–ƒ”–‘ˆ–Š‡‹”–”‡ƒ–‡–ˆ‘”’•› Š‘–‹ †‹•‘”†‡”Šƒ†–‘„‡„‡–™‡‡͸ ‘–Š•ƒ†ͳͲ›‡ƒ”•ƒ‰‘Ǥš Ž—•‹‘ ”‹–‡”‹ƒ™‡”‡ͳȌ‹–‡ŽŽ‡ –—ƒŽ†‹•ƒ„‹Ž‹–›ǡʹȌ‹ŽŽ‹–‡”ƒ ›ǡ‘”͵Ȍ •—„•–ƒ ‡ƒ††‹ –‹‘–Šƒ–‡ ‡••‹–ƒ–‡•†‡–‘š‹ˆ‹ ƒ–‹‘Ǥ”‡ƒ–‡–•–ƒˆˆ• ƒ‡†–Š‡‹” ƒ•‡Ž‘ƒ†•ˆ‘” ’‘••‹„Ž›‡Ž‹‰‹„Ž‡’ƒ–‹‡–•ǤŠ‡”‡•‡ƒ” Š‡”• ‘–ƒ –‡†–Š‡•‡’ƒ–‹‡–•„›–‡Ž‡’Š‘‡ƒ†‹˜‹–‡†–Š‡ ˆ‘”ƒ‹ˆ‘”ƒ–‹‘ ‘•—Ž–ƒ†• ”‡‡‹‰ˆ‘”‹Measures. Ǧƒ†‡š Ž—•‹‘ ”‹–‡”‹ƒǤ Š‡ —””‡–•–—†›—•‡†ƒ‹–‡•‹˜‡†‹ƒ”›‡–Š‘†ƒŽ‘•–‹†‡–‹ ƒŽ–‘–Š‡ ‘”‹‰‹ƒŽ•–—†›Ǥ‹‡–Š‡•–—†›„›ƒ”†‹‘‹•‡–ƒŽǤȋʹͲͳͳȌǡ’ƒ”–‹ ‹’ƒ–•™‡”‡’”‘’–‡†„›ƒ•‹‰ƒŽ

ȋ„‡‡’Ȍ–‡–‹‡•ƒ†ƒ›–‘ˆ‹ŽŽ‘—–ƒ“—‡•–‹‘ƒ‹”‡ˆ‘”ƒ—’–‘•‹š†ƒ›•ǤŽ‡ƒ•‡”‡ˆ‡”–‘–Š‡‘”‹‰‹ƒŽ 3 •–—†›ˆ‘”‘”‡†‡–ƒ‹Ž‡†‹ˆ‘”ƒ–‹‘ƒ„‘—––Š‹•‡–Š‘†ȋƒ”†‹‘‹•‡–ƒŽǤǡʹͲͳͳȌǤŠ‡ —””‡–•–—†› ‘Ž›†‹˜‡”‰‡†from the previous one by using an electronic diary device (called the ‘PsyMate’) to ‘ŽŽ‡ ––Š‡”‡•’‘•‡•–‘–Š‡“—‡•–‹‘•ȋ‹•–‡ƒ†‘ˆ†‹‰‹–ƒŽ™”‹•–™ƒ– Š‡•ƒ†’ƒ’‡”„‘‘Ž‡–•ȌǤ •‹’”‡˜‹‘—••–—†‹‡•ȋ‡Ǥ‰Ǥǡ Žƒ•‡”‡–ƒŽǤǡʹͲͲ͸Ǣƒ”†‹‘‹•‡–ƒŽǤǡʹͲͳͳȌǡ•–”‡••”‡ƒ –‹˜‹–›™ƒ• ‘ ‡’–—ƒŽ‹œ‡†ƒ•ƒ‹ ”‡ƒ•‡‹‡‰ƒ–‹˜‡ƒˆˆ‡ –‘”’•› Š‘–‹ ‡š’‡”‹‡ ‡•†—‡–‘–™‘–›’‡•‘ˆ •–”‡••ˆ—Ž•‹–—ƒ–‹‘•ǣƒ –‹˜‹–›•–”‡••ƒ†‡˜‡–•–”‡••Ǥ –‹˜‹–›Ǧ”‡Žƒ–‡†•–”‡••™ƒ•ƒ••‡••‡†„›–Š”‡‡ ‹–‡• ‘ ‡”‹‰–Š‡ƒ –‹˜‹–›’ƒ”–‹ ‹’ƒ–•™‡”‡‡‰ƒ‰‹‰‹™Š‡–Š‡„‡‡’™ƒ•‡‹––‡†Ǥ  ’ƒ”–‹ —Žƒ”ǡ’ƒ”–‹ ‹’ƒ–•”ƒ–‡†Š‘™—•‹ŽŽ‡†–Š‡›ˆ‡Ž–ƒ––Š‡ —””‡–ƒ –‹˜‹–›(“I am not skilled to do this activity”), how difficult their current activity was (“This activity is difficult”), and to what †‡‰”‡‡they would rather engage in some other activity (“I would rather do something else”). The ƒ˜‡”ƒ‰‡‘ˆ–Š‡–Š”‡‡‹–‡•™ƒ•—•‡†ƒ•ƒ‹†‹ ƒ–‘”‘ˆƒ –‹˜‹–›Ǧ”‡Žƒ–‡†•–”‡••Ǥ˜‡–Ǧ”‡Žƒ–‡†•–”‡•• ™ƒ•ƒ••‡••‡†„›ƒ•‹‰Ž‡‹–‡ǡƒ•‹‰’ƒ”–‹ ‹’ƒ–•–‘”ƒ–‡–Š‡’Ž‡ƒ•ƒ–‡••‘ˆ–Š‡‘•–‹’‘”–ƒ–. ‡˜‡–’”‡ ‡†‹‰–Š‡ —””‡–„‡‡’ Š‡‹–‡™ƒ•”ƒ–‡†‘ƒǦ͵ȋ˜‡”›—’Ž‡ƒ•ƒ–Ȍ–‘͵ȋ˜‡”›’Ž‡ƒ•ƒ–Ȍ • ƒŽ‡ƒ†™ƒ•”‡˜‡”•‡• ‘”‡†„‡ˆ‘”‡–Š‡ƒƒŽ›•‹•Ǥ‡‰ƒ–‹˜‡ƒˆˆ‡ –™ƒ•ƒ••‡••‡†ƒ–‡ƒ Š„‡‡’„ƒ•‡† ‘–Š‡ƒ˜‡”ƒ‰‡• ‘”‡‘ˆˆ‹˜‡•‹–‡•ǣˆ‡‡Ž‹‰‹•‡ —”‡ǡŽ‘‡Ž›ǡ‰—‹Ž–›ǡ†‘™ǡƒ†ƒš‹‘—•Ǥ•› Š‘–‹  ‡š’‡”‹‡ ‡• ‘’”‹•‡†–Š‡ƒ˜‡”ƒ‰‡• ‘”‡‘ˆ•‡˜‡‹–‡•ǣˆ‡‡Ž‹‰—”‡ƒŽǡˆ‡‡Ž‹‰†‹•Ž‹‡†ǡˆ‡‡Ž‹‰ •—•’‹ ‹‘—•ǡˆ‡ƒ”‹‰–Šƒ–‘‡‹‰Š–„‡Š—”–„›‘–Š‡”•ǡˆ‡ƒ”‹‰–‘Ž‘•‡ ‘–”‘ŽǡŠ‡ƒ”‹‰˜‘‹ ‡•ǡƒ† experiencing that one’s thoughts are being influenced by others.ŽŽ‘ˆ–Š‡•‡‹–‡•™‡”‡”ƒ–‡†‘͹Ǧ ’‘‹–‹‡”–• ƒŽ‡•Ǥ ‘”–Š‡‹–‡•‡ƒ•—”‹‰ƒ –‹˜‹–›•–”‡••ȋ͵‹–‡•Ȍǡ‡‰ƒ–‹˜‡ƒˆˆ‡ –ȋͷ‹–‡•Ȍǡƒ† psychotic experiences (7 items), we computed Cronbach’s alpha values for the personǦŽ‡˜‡Ž‡ƒ• ƒ†–Š‡™‹–Š‹Ǧ’‡”•‘‡ƒ ‡–‡”‡†˜ƒŽ—‡•ȋ–‘‘„–ƒ‹‹ˆ‘”ƒ–‹‘ƒ„‘—––Š‡”‡Ž‹ƒ„‹Ž‹–›‘ˆ–Š‡

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‹–‡•ƒ––Š‡’‡”•‘ƒ†ƒ––Š‡„‡‡p level). For activity stress, this yielded values of α=.71 and α=.46 for the person and beep levels, respectively. For negative affect, we found α=.93 and α=.69, respectively. Finally, for psychotic experiences, we obtained α=.91 and α=.70. The ‘ChildhoodExperience of Care and Abuse’ (CECA) instrument was used to assess RCA. Š‡‹•ƒ”‡–”‘•’‡ –‹˜‡ǡ•‡‹Ǧ•–”— –—”‡†‹–‡”˜‹‡™–Šƒ–ƒŽŽ‘™•”‡•‡ƒ” Š‡”•–‘”ƒ–‡–Š‡•‡˜‡”‹–› ‘ˆ’‘••‹„Ž‡ƒ„—•‡ƒ–ƒ‰‡Ͳ–16 years based on patients’ accounts. The CECA has been ˆ‘—†–‘„‡ ”‡Ž‹ƒ„Ž‡ƒ†˜ƒŽ‹†ȋ‹ˆ—Ž ‘ǡ”‘™Ƭ ƒ””‹•ǡͳͻͻͶȌǤŽƒ–‡”•–—†› ‘””‘„‘”ƒ–‡†–Š‡˜ƒŽ‹†‹–›‘ˆ–Š‡ CECA by comparing sisters’ accounts of parental abuse, finding overall strong agreement between –Š‘•‡ƒ ‘—–•ǡ‡˜‡™Š‡‘Ž›‘‡•‹•–‡”Šƒ†‡š’‡”‹‡ ‡†–Š‡ˆ‘”‘ˆƒ„—•‡”‡’‘”–‡†ȋ”‘™ǡ ”ƒ‹‰ǡ ƒ””‹•ǡ ƒ†Ž›Ƭ ƒ”˜‡›ǡʹͲͲ͹ȌǤ Š‹Ž†Š‘‘†ƒ„—•‡ ‘’”‹•‡†ˆ‘—”–›’‡•‘ˆƒŽ–”‡ƒ–‡–ǣ’•› Š‘Ž‘‰‹ ƒŽƒ„—•‡ǡ’Š›•‹ ƒŽ ƒ„—•‡ǡ•‡š—ƒŽƒ„—•‡ǡƒ†’ƒ”‡–ƒŽ ‘ˆŽ‹ –Ǥ•› Š‘Ž‘‰‹ ƒŽƒ„—•‡ ‘’”‹•‡†‡š–”‡‡ ”‹–‹ ‹•ǡ ”‡Œ‡ –‹‘ǡŠ—‹Ž‹ƒ–‹‘ǡ‘”–‡””‘”‹œ‹‰ǤŠ›•‹ ƒŽƒ„—•‡™ƒ•†‡ˆ‹‡†ƒ•„‘†‹Ž›Šƒ”–Šƒ–”‡•—Ž–‡†‹ƒ– least bruising. Sexual abuse was defined as the participant’s report of any unwanted sexual ‹ ‹†‡–ǡ‹ Ž—†‹‰•‡š—ƒŽƒ••ƒ—Ž–Ǥƒ”‡–ƒŽ ‘ˆŽ‹ –™ƒ•†‡ˆ‹‡†ƒ•–Š‡ƒ‘—–‘ˆˆ‹‰Š–‹‰„‡–™‡‡ –Š‡ ƒ”‡‰‹˜‡”•ƒ†Ȁ‘”–Š‡ Š‹Ž†Ǥƒ Š–›’‡‘ˆƒ„—•‡™ƒ•• ‘”‡†ˆ‘”„‘–Šˆ”‡“—‡ ›ƒ†‹–‡•‹–›Ǥ ”‡“—‡ ›‘ˆƒ„—•‡™ƒ•”ƒ–‡†‘ƒˆ‹˜‡Ǧ’‘‹–‹‡”–Ǧ• ƒŽ‡ǣͲȋ‡˜‡”Ȍǡͳȋ”ƒ”‡Ž›ǣ‘ ‡‘”–™‹ ‡Ȍǡʹ ȋ‹ ‹†‡–ƒŽŽ›ǣ‘”‡–Šƒ–™‘–‹‡•ǡ„—–‘–‘–ŠŽ›Ȍǡ͵ȋ”‡‰—Žƒ”Ž›ǣ‘–ŠŽ›‘”‘”‡‘ˆ–‡Ȍǡ‘”Ͷ ȋ‘ˆ–‡ǣ™‡‡Ž›‘”‘”‡‘ˆ–‡ȌǤ –‡•‹–›‘ˆƒ„—•‡™ƒ•”ƒ–‡†‘ƒˆ‘—”Ǧ’‘‹–‹‡”–• ƒŽ‡ǣͲȋ‘‡Ȍǡͳ ȋ•‘‡Ȍǡʹȋ‘†‡”ƒ–‡Ȍǡ‘”͵ȋƒ”‡†Ȍǡ™‹–Š–Š‡‡š ‡’–‹‘‘ˆ’ƒ”‡–ƒŽ ‘ˆŽ‹ –ǡ™Š‹ Š™ƒ•• ‘”‡†‘ƒ ˆ‹˜‡Ǧ’‘‹–• ƒŽ‡–Šƒ–ƒŽ•‘‹ Ž—†‡†Ͷȋ˜‹‘Ž‡ ‡ȌǤŠ‡•‡˜‡”‹–›• ‘”‡ˆ‘”‡ƒ Š–›’‡‘ˆƒ„—•‡™ƒ•–Š‡ ’”‘†— –‘ˆ‹–‡•‹–›ƒ†ˆ”‡“—‡ ›ǤŠ‡–‘–ƒŽ• ‘”‡ǡ”ƒ‰‹‰ˆ”‘Ͳ–‘ͷʹǡ™ƒ•–Š‡•—‘ˆ–Š‡ •‡˜‡”‹–›• ‘”‡•ˆ‘”‡ƒ Š•—„–›’‡‘ˆƒ„—•‡Ǥ ‘”–Š‡ƒƒŽ›•‡•ǡ™‡”‡• ƒŽ‡†–Š‡˜ƒ”‹ƒ„Ž‡„›†‹˜‹†‹‰–Š‡ –‘–ƒŽ• ‘”‡„›ͷ–‘ƒ˜‘‹†‘˜‡”Ž›•ƒŽŽ ‘‡ˆˆ‹ ‹‡–•Ǥ ‡ ‡ǡƒ‘‡Ǧ—‹–‹ ”‡ƒ•‡‘–Š‡”‡• ƒŽ‡† ˜ƒ”‹ƒ„Ž‡”‡’”‡•‡–•ƒͷData analysis. Ǧ’‘‹–‹ ”‡ƒ•‡‘–Š‡‘”‹‰‹ƒŽ–‘–ƒŽ• ‘”‡Ǥ •‹–Š‡’”‡˜‹‘—••–—†›ǡ–Š‡†ƒ–ƒŠƒ˜‡ƒ—Ž–‹Ž‡˜‡Ž•–”— –—”‡ǣ—Ž–‹’Ž‡ ‘„•‡”˜ƒ–‹‘•ȋŽ‡˜‡ŽͳȌƒ”‡‡•–‡†™‹–Š‹•—„Œ‡ –•ȋŽ‡˜‡ŽʹȌǤ ‡‡”ƒŽŽ›ǡ‘„•‡”˜ƒ–‹‘•™‹–Š‹ƒ•—„Œ‡ – ƒ”‡”‡Žƒ–‡†ƒ†Š‡ ‡–Š‡”‡•‹†—ƒŽ•ƒ”‡‘–‹†‡’‡†‡–ƒ†–Š‡ƒ••—’–‹‘‘ˆ•–ƒ–‹•–‹ ƒŽ ‹†‡’‡†‡ ‡”‡“—‹”‡†ˆ‘””‡‰—Žƒ””‡‰”‡••‹‘ƒƒŽ›•‡•‹•˜‹‘Žƒ–‡†Ǥ ‹‡”ƒ” Š‹ ƒŽŽ‹‡ƒ”‘†‡Ž‹‰‹• –Š‡”‡ˆ‘”‡”‡“—‹”‡†ȋ Žƒ•‡”‡–ƒŽǤǡʹͲͲ͸Ǣ ‘šǡͳͻͻͺȌǤ‹š‡†Ǧ‡ˆˆ‡ –•ȋ—Ž–‹Ž‡˜‡ŽȌŽ‹‡ƒ””‡‰”‡••‹‘ ‘†‡Ž•™‡”‡—•‡†–‘–‡•––Š‡Š›’‘–Š‡•‹•–Šƒ–‡˜‡–Ǧƒ†ƒ –‹˜‹–›Ǧ”‡Žƒ–‡†•–”‡••ƒ”‡”‡Žƒ–‡†–‘ ‡‰ƒ–‹˜‡ƒˆˆ‡ –ƒ†’•› Š‘–‹ ‡š’‡”‹‡ ‡•Ǥ –‡” ‡’–•ƒ†•Ž‘’‡•ˆ‘”–Š‡•–”‡••˜ƒ”‹ƒ„Ž‡™‡”‡ ƒŽŽ‘™‡†–‘˜ƒ”›ƒ ”‘•••—„Œ‡ –•ǡ™‹–Šƒ—•–”— –—”‡†˜ƒ”‹ƒ ‡Ǧ ‘˜ƒ”‹ƒ ‡ƒ–”‹šˆ‘”–Š‡”ƒ†‘

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146807_JonasWeijers_BNW_def.indd 54 28-10-2020 15:08 Reported childhood abuse and stress reactivity in psychosis

‡ˆˆ‡ –•Ǥ‡š–ǡ™‡ˆ‹––‡†‘†‡Ž•–Šƒ–‹ Ž—†‡†–Š‡•–”‡••˜ƒ”‹ƒ„Ž‡ǡǡƒ†–Š‡‹”‹–‡”ƒ –‹‘–‘–‡•– ™Š‡–Š‡”‘†‡”ƒ–‡••–”‡••”‡ƒ –‹˜‹–›–‘†ƒ‹Ž›Ž‹ˆ‡•–”‡••Ǥ Š‡‘†‡Ž‹‰ƒ’’”‘ƒ Š†‡• ”‹„‡†ƒ„‘˜‡ ‘•–‹–—–‡•–Š‡’”‹ƒ”›ƒƒŽ›•‹•ǡ™Š‹ Š‹••‹‹Žƒ” –‘–Š‡‘‡ ƒ””‹‡†‘—–„›ƒ”†‹‘‹•ƒ† ‘ŽŽ‡ƒ‰—‡•ȋʹͲͳͳȌǤŠ‹•ƒƒŽ›•‹•‘Ž›†‡˜‹ƒ–‡†ˆ”‘–Š‡ ‘”‹‰‹ƒŽ‘‡„›‘–†‹ Š‘–‘‹œ‹‰–Š‡˜ƒ”‹ƒ„Ž‡ƒ†ƒŽŽ‘™‹‰•Ž‘’‡•–‘˜ƒ”›ƒ ”‘•••—„Œ‡ –• ȋ‘Ž›”ƒ†‘‹–‡” ‡’–•™‡”‡—•‡†‹–Š‡‘”‹‰‹ƒŽ•–—†›Ǣ’‡”•‘ƒŽ ‘—‹ ƒ–‹‘ȌǤ††‹‰”ƒ†‘ •Ž‘’‡•–‘–Š‡‘†‡Ž‹•‹’‘”–ƒ––‘ƒ˜‘‹†‹ˆŽƒ–‡†›’‡ ‡””‘””ƒ–‡•ƒ†‘˜‡”Ž›ƒ””‘™ ‘ˆ‹†‡ ‡ ‹–‡”˜ƒŽ•ȋ —”ƒǡ†™ƒ”†•Ƭ—ŽŽ‡”ǡʹͲͳͳǢ Š‹‡Žœ‡–ŠƬ ‘”•–‡‹‡”ǡʹͲͲͺȌǤ ‹–Š”‡‰ƒ”†–‘–Š‡•‡ ‘†ƒ”›ƒƒŽ›•‹•ǡ‡šƒ‹ƒ–‹‘‘ˆ–Š‡†ƒ–ƒ†‹•–”‹„—–‹‘‹†‹ ƒ–‡†–Šƒ–ƒ ‰ƒƒ†‹•–”‹„—–‹‘ ‘—Ž†’”‘˜‹†‡ƒƒ†‡“—ƒ–‡ˆ‹––‘–Š‡†ƒ–ƒǡ„—–‘Ž›™Š‡ ‘•‹†‡”‹‰–Š‡•—„•‡–

‘ˆƒ••‡••‡–•™Š‡”‡‡‰ƒ–‹˜‡ƒˆˆ‡ –‘”’•› Š‘–‹ ‡š’‡”‹‡ ‡•™‡”‡ƒ –—ƒŽŽ›’”‡•‡–ȋ‹Ǥ‡Ǥǡ™Š‡ 3 ‘—– ‘‡εͳȌǤŠ‡”‡ˆ‘”‡™‡†‡ ‹†‡†–‘ ƒ””›‘—–ƒ•‡ ‘†ƒ”›ƒƒŽ›•‹•—•‹‰ƒ–™‘Ǧ’ƒ”–‘”‹š‡†Ǧ †‹•–”‹„—–‹‘‘†‡Žȋ‡Ǥ‰Ǥǡ•‡‡Ž•‡ƬŠƒˆ‡”ǡʹͲͲͳȌǤˆ–‡””‡• ƒŽ‹‰–Š‡‘—– ‘‡•ȋ‹Ǥ‡Ǥǡ‡‰ƒ–‹˜‡ƒˆˆ‡ – ƒ†’•› Š‘–‹ ‡š’‡”‹‡ ‡•Ȍ–‘ƒͲ–‘͸”ƒ‰‡ȋ‹Ǥ‡Ǥǡ›α‘—– ‘‡–ͳȌǡ™‡ ‘†— –‡†ƒ‹š‡†Ǧ‡ˆˆ‡ –• Ž‘‰‹•–‹ ”‡‰”‡••‹‘‘†‡Žˆ‘”–Š‡’”‡•‡ ‡˜•Ǥƒ„•‡ ‡‘ˆƒ›‡‰ƒ–‹˜‡ƒˆˆ‡ –Ȁ’•› Š‘–‹ ‡š’‡”‹‡ ‡ ȋ‹Ǥ‡Ǥǡ›εͲ˜•Ǥ›αͲȌƒ†ƒ‹š‡†Ǧ‡ˆˆ‡ –•‰ƒƒ”‡‰”‡••‹‘‘†‡Ž™‹–ŠƒŽ‘‰Ž‹ˆ‘”–Š‡‹–‡•‹–›‘ˆ ‡‰ƒ–‹˜‡ƒˆˆ‡ –Ȁ’•› Š‘–‹ ‡š’‡”‹‡ ‡•™Š‡‡‰ƒ–‹˜‡ƒˆˆ‡ –Ȁ’•› Š‘–‹ ‡š’‡”‹‡ ‡•™‡”‡ƒ –—ƒŽŽ› ’”‡•‡–ȋ‹Ǥ‡Ǥǡ‹ˆ›εͲȌǤŠ‡–™‘Ǧ’ƒ”–‘†‡Ž•™‡”‡ˆ‹––‡†—•‹‰ƒš‹—Ž‹‡Ž‹Š‘‘†‡•–‹ƒ–‹‘™‹–Š ƒ—••Ǧ ‡”‹–‡“—ƒ†”ƒ–—”‡ȋ‡‹–Š‡”™‹–Šͷ‘”͹‹–‡‰”ƒ–‹‘’‘‹–•ȌǤ‘””‡Žƒ–‡†”ƒ†‘‹–‡” ‡’–• ƒ†•Ž‘’‡•™‡”‡‹ Ž—†‡†ˆ‘”‡ƒ Š ‘’‘‡–ǡ„—– ‘””‡Žƒ–‹‘•ƒ ”‘•• ‘’‘‡–•ȋ‡Ǥ‰Ǥǡˆ‘”–Š‡ ”ƒ†‘‹–‡” ‡’–•‘ˆ–Š‡Ž‘‰‹•–‹ ƒ†‰ƒƒ’ƒ”–•Ȍ™‡”‡‘–ƒŽŽ‘™‡††—‡–‘‘†‡Ž ‘˜‡”‰‡ ‡ ’”‘„Ž‡•ǤŠ‡–™‘Ǧ’ƒ”–‘†‡Ž’”‘˜‹†‡•‹•‹‰Š–•‹–‘–™‘’•› Š‘Ž‘‰‹ ƒŽ‡ Šƒ‹••ǣ ‘™•–”‡•• ȋƒ†‹–•‹–‡”ƒ –‹‘™‹–ŠȌ‹•”‡Žƒ–‡†–‘‡šŠ‹„‹–‹‰ƒ›‡‰ƒ–‹˜‡ƒˆˆ‡ –Ȁ’•› Š‘–‹ ‡š’‡”‹‡ ‡• ƒ†Š‘™•–”‡••ȋƒ†‹–•‹–‡”ƒ –‹‘™‹–ŠȌ‹•”‡Žƒ–‡†–‘–Š‡‹–‡•‹–›‘ˆ‡‰ƒ–‹˜‡ƒˆˆ‡ –Ȁ ’•› Š‘–‹ ‡š’‡”‹‡ ‡•™Š‡–Š‡•‡‡š’‡”‹‡ ‡•ƒ”‡ƒ –—ƒŽŽ›’”‡•‡–Ǥ‡•—Ž–•ƒ”‡”‡’‘”–‡†‹–‡”•‘ˆp –Š‡‡•–‹ƒ–‡† ‘‡ˆˆ‹ ‹‡–•ƒ† ‘””‡•’‘†‹‰ͻͷΨ ‘ˆ‹†‡ ‡‹–‡”˜ƒŽ•ȋ •Ȍƒ† Ǧ˜ƒŽ—‡•ǤŠ‡ˆ‹–‘ˆ –Š‡•–ƒ†ƒ”†‹š‡†Ǧ‡ˆˆ‡ –•‘†‡Žƒ†–Š‡–™‘Ǧ’ƒ”–‘†‡Ž™ƒ• ‘’ƒ”‡†„› ‘’—–‹‰–Š‡ †‹ˆˆ‡”‡ ‡in AIC values. Analyses were carried out with SPSS 23, R 3.4.0 using the ‘nlme’ ȋ‹Š‡‹”‘ Ƭƒ–‡•ǡʹͲͲʹȌand `lme4’ ȋƒ–‡•ǡƒ ŠŽ‡”ǡ‘Ž‡”ƬƒŽ‡”ǡʹͲͳͶȌ’ƒ ƒ‰‡•ǡƒ†Ȁ software 9.2, using the ‘proc glimmix’ and ‘proc nlmixed’ procedures. ƒ•–Ž›ǡ™‡‡šƒ‹‡†’‘–‡–‹ƒŽ˜‹‘Žƒ–‹‘•‘ˆ•–ƒ–‹•–‹ ƒŽƒ••—’–‹‘••’‡ ‹ˆ‹ –‘‹š‡†Ǧ‡ˆˆ‡ –• ‘†‡Ž•ǡƒ‡Ž›–Š‡ƒ••—’–‹‘‘ˆŠ‘‘• ‡†ƒ•–‹ ‹–›ƒ†—Ž–‹ ‘ŽŽ‹‡ƒ”‹–›Ǥ ‹”•–Ž›ǡ–Š‡ƒ••—’–‹‘ ‘ˆŠ‘‘• ‡†ƒ•–‹ ‹–›‹•”‡Ž‡˜ƒ–ˆ‘”ƒ›‹†‘ˆ”‡‰”‡••‹‘ƒƒŽ›•‹•Ǥ‹‡–Š‡•–ƒ†ƒ”†‹š‡†Ǧ‡ˆˆ‡ –•

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‘†‡Ž—•‡†„›ƒ”†‹‘‹•‡–ƒŽǤȋʹͲͳͳȌǡ–Š‡ƒ••—’–‹‘‘ˆŠ‘‘• ‡†ƒ•–‹ ‹–›‘ˆ”‡•‹†—ƒŽ•‘ˆ–Š‡ ‹š‡†Ǧ‡ˆˆ‡ –•‘†‡Ž—•‡†‹–Š‡ —””‡–•–—†›ǡ™ƒ•Š‹‰ŠŽ›Ž‹‡Ž›–‘„‡˜‹‘Žƒ–‡††—‡–‘–Š‡„‘—†‡† ƒ–—”‡‘ˆ–Š‡‘—– ‘‡˜ƒ”‹ƒ„Ž‡•ȋ‡‰ƒ–‹˜‡ƒˆˆ‡ –ƒ†’•› Š‘–‹ ‡š’‡”‹‡ ‡•ȌǤ‡šƒ‹ƒ–‹‘‘ˆƒ ’Ž‘–‘ˆ–Š‡ˆ‹––‡†˜ƒŽ—‡•ƒ‰ƒ‹•––Š‡‡ƒ”•‘”‡•‹†—ƒŽ•ˆ‘”–Š‡ —””‡–•–ƒ†ƒ”†‹š‡†Ǧ‡ˆˆ‡ –•‘†‡Žǡ •Š‘™•–Šƒ––Š‹•‹• Ž‡ƒ”Ž›–Š‡ ƒ•‡ȋŽ‘™‡”˜ƒ”‹ƒ„‹Ž‹–›ˆ‘”Ž‘™ˆ‹––‡†˜ƒŽ—‡•ǡŠ‹‰Š‡”˜ƒ”‹ƒ„‹Ž‹–›ˆ‘” Š‹‰Š‡”ˆ‹––‡†˜ƒŽ—‡•ȌǤ–Š‡‘–Š‡”Šƒ†ǡ‹–Š‡–™‘Ǧ’ƒ”–‘†‡Žǡ™‡†‘‘–ƒ••—‡Š‘‘• ‡†ƒ•–‹ ‹–› –‘„‡‰‹™‹–Šǡ•‹ ‡–Š‡Ž‘‰‹•–‹ ƒ†‰ƒƒ’ƒ”–•‘ˆ–Š‡‘†‡Ž†‘‘–ƒ‡•— Šƒƒ••—’–‹‘Ǥ ‡ ‘†Ž›ǡ—Ž–‹ ‘ŽŽ‹‡ƒ”‹–›‹•ƒŽ•‘ƒ‹••—‡ˆ‘”ƒ›‹†‘ˆ”‡‰”‡••‹‘ƒƒŽ›•‹•Ǥ –Š‡’”‡•‡– ƒ•‡ǡ –Š‡‘Ž›’”‡†‹ –‘”•ƒ”‡–Š‡•–”‡••ƒ†–Š‡ Š‹Ž†Š‘‘†ƒ„—•‡ȋȌ˜ƒ”‹ƒ„Ž‡•Ǥ‡‡šƒ‹‡†–Š‡ ‘””‡Žƒ–‹‘•„‡–™‡‡–Š‡•—„Œ‡ –ǦŽ‡˜‡Ž‡ƒ•‘ˆ–Š‡ƒ –‹˜‹–›ƒ†‡˜‡–•–”‡••ƒ†–Š‡ ˜ƒ”‹ƒ„Ž‡•ǤŠ‡ ‘””‡Žƒ–‹‘•™‡”‡‡“—ƒŽ–‘Ǥʹ͹ƒ†ǤͶʹǡ”‡•’‡ –‹˜‡Ž›ǡ™Š‹ Š™‡”‡‘–˜‹‡™‡†–‘„‡ ’ƒ”–‹ —Žƒ”Ž›™‘””‹•‘‡’ƒ”–‹ —Žƒ”Ž›™‘””‹•‘‡Ǥ

Results Sample characteristics

 Ǥˆ–Š‡ͻͲ’ƒ–‹‡–•™Š‘‡–‡”‡†–Š‡•–—†›ǡ‹‡’ƒ”–‹ ‹’ƒ–• ”‡ˆ—•‡†–‘ˆ‹ŽŽ‘—–ƒ›•›ƒ–‡“—‡•–‹‘ƒ‹”‡Ǥ‡’ƒ”–‹ ‹’ƒ–”‡ˆ—•‡†–‘ƒ•™‡”“—‡•–‹‘• ‘ ‡”‹‰•‡š—ƒŽƒ„—•‡ƒ†™ƒ•‡š Ž—†‡†Ǥƒ•–Ž›ǡʹͳ’ƒ–‹‡–•ˆƒ‹Ž‡†–‘ˆ‹ŽŽ‘—–ƒ–Ž‡ƒ•–ʹͲ “—‡•–‹‘ƒ‹”‡•ƒ†ƒ•‹’”‡˜‹‘—••–—†‹‡•ȋƒ”†‹‘‹•‡–ƒŽǤǡʹͲͳͳǡ‡‹‹‰Šƒ—•‡–ƒŽǤǡʹͲͳ͸Ȍ™‡”‡ ‡š Ž—†‡†ˆ”‘–Š‡ƒƒŽ›•‡•ǤŠ‡ˆ‹ƒŽ•ƒ’Ž‡—•‡†ˆ‘”–Š‡ƒƒŽ›•‡•–Š‡”‡ˆ‘”‡‹ Ž—†‡†ͷͻ ’ƒ”–‹ ‹’ƒ–•ǡ’”‘˜‹†‹‰”‡SD •’‘•‡•–‘ƒ–‘–ƒŽ‘ˆͳͻʹ͸„‡‡’•ȋ‘ƒ˜‡”ƒ‰‡ǡ͵ʹǤ͸”‡•’‘•‡•’‡”•—„Œ‡ –Ǣ αͺǤ͸Ǣ”ƒ‰‡ǣʹͲǦͷͺȌǤ‡‘‰”ƒ’Š‹ ˜ƒ”‹ƒ„Ž‡•ƒ•™‡ŽŽƒ•–Š‡‡ƒ• ‘”‡•‘ˆ–Š‡†‡’‡†‡–ƒ† ‹†‡’‡†‡–˜ƒ”‹ƒ„Ž‡•‘ˆ–Š‡•ƒ’Ž‡ƒ”‡•Š‘™‹ƒ„Ž‡ͳǤPrimary analyses.  Main effects. b p b

‘–Šƒ –‹˜‹–›•–”‡••ȋp αͲǤͳͶǡͻͷΨ ȏͲǤͲͺǡͲǤʹͲȐǡ δͲǤͲͲͳȌƒ†‡˜‡–•–”‡••ȋ αͲǤͲͺǡͻͷΨ ȏͲǤͲ͵ǡͲǤͳʹȐǡb αͲǤͲͲͳȌ™‡”‡’‘•‹–‹˜‡Ž›ƒ†•‹‰‹ˆ‹ ƒ–Ž›ƒ••‘ ‹ƒ–‡†™‹–Š‡‰ƒ–‹˜‡p ƒˆˆ‡ –Ǥ –‹˜‹–›•–”‡••ȋ αͲǤͳͲǡͻͷΨ ȏͲǤͲ͸ǡͲǤͳͶȐǡ δͲǤͲͲͳȌ™ƒ•ƒŽ•‘ƒ••‘ ‹ƒ–‡†™‹–Š–Š‡‹–‡•‹–›b ‘ˆ’•› Š‘–‹ ‡š’‡”‹‡ ‡•ǡ™Š‹Ž‡‡˜‡–•–”‡••Œ—•–ˆƒ‹Ž‡†–‘„‡•‹‰‹ˆ‹ ƒ–ȋp αͲǤͲ͵ǡͻͷΨ ȏǦͲǤͲͲǡ ͲǤͲͷȐǡ ReportedαͲǤͲ͸ȌǤ childhood abuse and emotional stress reactivity. ™‘ƒƒŽ›•‡•™‡”‡ ‘†— –‡†™‹–Š ‡‰ƒ–‹˜‡ƒˆˆ‡ –ƒ•–Š‡‘—– ‘‡˜ƒ”‹ƒ„Ž‡Ǥ –Š‡ˆ‹”•–ƒƒŽ›•‹•ǡǡƒ –‹˜‹–›•–”‡••ǡƒ†–Š‡‹” ‹–‡”ƒ –‹‘™‡”‡ƒ††‡†ƒ•’”‡†‹ –‘”•ǤŠ‡•‡ ‘†ƒƒŽ›•‹••—„•–‹–—–‡†ƒ –‹˜‹–›•–”‡••ˆ‘”‡˜‡– •–”‡••Ǥ‡•—Ž–••Š‘™‡†–Šƒ–•‹‰‹ˆ‹ ƒ–Ž›‘†‡”ƒ–‡†–Š‡”‡Žƒ–‹‘•Š‹’„‡–™‡‡ƒ –‹˜‹–›•–”‡••

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146807_JonasWeijers_BNW_def.indd 56 28-10-2020 15:08 Reported childhood abuse and stress reactivity in psychosis

b p

ƒ†‡‰ƒ–‹˜‡ƒˆˆ‡ –ȋ αͲǤͲ͵ǡͻͷΨ ȏͲǤͲͳǡͲǤͲ͸Ȑǡb αͲǤͲʹȌǡ„—–‘––Š‡”‡Žƒ–‹‘•Š‹’„‡–™‡‡‡˜‡–p •–”‡••ƒ†‡‰ƒ–‹˜‡ƒˆˆ‡ –ȋReported childhood abuseαͲǤͲʹǡͻͷΨ ȏͲǤͲͲǡͲǤͲ͵Ȑǡ and psychotic stress reactivity.αͲǤͲ͹ȌǤ ™‘ƒ††‹–‹‘ƒŽƒƒŽ›•‡••‹‹Žƒ”–‘ –Š‡‘‡•ƒ„‘˜‡™‡”‡ ‘†— –‡†™‹–Š’•› Š‘–‹ ‡š’‡”‹‡ ‡•ƒ•–Š‡‘—– ‘‡˜ƒ”‹ƒ„Ž‡Ǥ‡•—Ž–• •Š‘™‡†–Šƒ–•‹‰‹ˆ‹ ƒ–Ž›‘†‡”ƒ–‡†–Š‡ƒ••‘ ‹ƒ–‹‘„‡–™‡‡ƒ –‹˜‹–›•–”‡••ƒ†’•› Š‘–‹ b p ‡š’‡”‹‡ ‡•ȋb αͲǤͲʹǡͻͷΨ ȏͲǤͲͲǡͲǤͲͶȐǡpαͲǤͲ͵Ȍǡƒ†„‡–™‡‡‡˜‡–•–”‡••ƒ†’•› Š‘–‹  ‡š’‡”‹‡ ‡•ȋ αͲǤͲͳǡͻͷΨ ȏͲǤͲͲǡͲǤͲʹȐǡ αͲǤͲ͵ȌǤ

3

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Table 1. Demographic and clinical characteristics of 59 patients with non-affective psychotic disorder who completed electronic diaries and reported on stress reactivity.

‰‡ȏ‡ƒȋȌǡ”ƒ‰‡Ȑ     ͵ͳǤͺ͵ȋͻǤͶͲȌǡͳͻǦͷ͹ ‡šȏȀ ȋΨȌȐ       ͵ͶȀʹͷȋͷ͹Ǥ͸ΨȀͶʹǤͶΨȌ  Ǧ †‹ƒ‰‘•‹•ȏȋΨȌȐ   Š‹œ‘’Š”‡‹ƒ      ͵Ͷȋͷ͹Ǥ͸ΨȌ  •› Š‘–‹ ‹•‘”†‡”    ͳͲȋͳ͸ǤͻΨȌ   Š‹œ‘ƒˆˆ‡ –‹˜‡‹•‘”†‡”    ͳͲȋͳ͸ǤͻΨȌ  SD”‹‡ˆ•› Š‘–‹ ‹•‘”†‡”    ͵ȋͷǤͳΨȌ  ‡Ž—•‹‘ƒŽ‹•‘”†‡”     ʹȋ͵ǤͶΨȌ ‡ƒȋ Ȍǡ”ƒ‰‡ ESM‡ƒ”••‹ ‡‘•‡–‘ˆ’•› Š‘•‹• Variables:      ͷǤ͸ͳȋͶǤͲ͹Ȍǡͳ SD , Ǧʹʹ  ( nonmissing) observations     ͳͲǤͳȋͳͳǤ͵ȌǡͲǦͶ͵ ‡ƒ ȋ Ȍ ”ƒ‰‡

‡‰ƒ–‹˜‡ˆˆ‡ –      ʹǤͳ͹ȋͳǤͳ͸ȌǡͳǦ͹   ͳͻͲͺ •› Š‘–‹ š’‡”‹‡ ‡•     ͳǤͺʹȋͳǤͲͲȌǡͳǦ͹   ͳͺͻ͵ ˜‡–Ǧ”‡Žƒ–‡†•–”‡••      ͵ǤʹͷȋͳǤͶ͵ȌǡͳǦ͹   ͳͺ͹ͺ  –‹˜‹–›Ǧ”‡Žƒ–‡†•–”‡••      ʹǤͺͲȋͳǤʹͷȌǡͳǦ͹  Note ͳͺͻͳ  ǣ ᑏ’”‡Š‡•‹˜‡•• ‡••‡–‘ˆ›’–‘•ƒ† ‹•–‘”›ǢαŠ‹Ž†Š‘‘†š’‡”‹‡ ‡‘ˆƒ”‡ ƒ†„—•‡‹•–”—‡–Ǣαš’‡”‹‡ ‡ƒ’Ž‹‰‡–Š‘†Ǣα‡’‘”–‡†Š‹Ž†Š‘‘†„—•‡ Secondary analyses.

Š‡•‡ ‘†ƒ”›ƒƒŽ›•‡•—•‹‰–Š‡–™‘Ǧ’ƒ”–‘†‡Ž•‹†‹ ƒ–‡†–Šƒ– ‡‹–Š‡”ƒ –‹˜‹–›‘”‡˜‡–•–”‡••™ƒ••‹‰‹ˆ‹ ƒ–Ž›”‡Žƒ–‡†–‘–Š‡ Šƒ ‡‘ˆ–Š‡’ƒ”–‹ ‹’ƒ–”‡’‘”–‹‰ ƒ›‡‰ƒ–‹˜‡ƒˆˆ‡ –ȋ‹Ǥ‡Ǥǡƒ›• ‘”‡ƒ„‘˜‡ͲȌǢ‡‹–Š‡”™ƒ•‡˜‡–•–”‡••”‡Žƒ–‡†–‘–Š‡ Šƒ ‡‘ˆ–Š‡p ’ƒ”–‹ ‹’ƒ–”‡’‘”–‹‰ƒ›’•› Š‘–‹ ‡š’‡”‹‡ ‡ȋƒŽŽ ’s ≥ 0.20; see Table 2 for full results). However,b ƒ –‹˜‹–›•–”‡••™ƒ•”‡Žƒ–‡†–‘–Š‡ Šƒ ‡‘ˆ–Š‡’ƒ”–‹ ‹’ƒ–”‡’‘”–‹‰ƒ›’•› Š‘–‹ ‡š’‡”‹‡ ‡ȋp α ͲǤ͵ͻǡͻͷΨ ȏͲǤͲͻǡͲǤ͹ͲȐǡ αͲǤͲͳȌǤ†‹†‘–•‹‰‹ˆ‹ ƒ–Ž›‘†‡”ƒ–‡–Š‡”‡Žƒ–‹‘•Š‹’•„‡–™‡‡ ƒ –‹˜‹–›•–”‡••‘”‡˜‡–•–”‡••ǡƒ†–Š‡’”‡•‡ ‡‘ˆƒ›‡‰ƒ–‹˜‡ƒˆˆ‡ –‘”’•› Š‘–‹ ‡š’‡”‹‡ ‡ȋƒŽŽp ’s ≥ 0.12; see Table 3 for full results). –Š‡‘–Š‡”Šƒ†ǡ„‘–Šƒ –‹˜‹–›ƒ†‡˜‡–•–”‡••™‡”‡•‹‰‹ˆ‹ ƒ–Ž›ƒ†’‘•‹–‹˜‡Ž›p ”‡Žƒ–‡†–‘ –Š‡‹–‡•‹–›‘ˆ‡‰ƒ–‹˜‡ƒˆˆ‡ –ƒ†’•› Š‘–‹ ‡š’‡”‹‡ ‡•‹ˆ’”‡•‡–ȋƒŽŽ ’s ≤ 0.01; see Table 2 for ˆ—ŽŽ”‡•—Ž–•ȌǤ ‘™‡˜‡”ǡ–Š‡”‡™ƒ•‘‡˜‹†‡ ‡–‘•—‰‰‡•––Šƒ–‘†‡”ƒ–‡†–Š‡”‡Žƒ–‹‘•Š‹’• „‡–™‡‡ƒ –‹˜‹–›•–”‡••Ȁ‡˜‡–•–”‡••ƒ†–Š‡‹p’ –‡•‹–›‘ˆ‡‰ƒ–‹˜‡ƒˆˆ‡ –Ȁ’•› Š‘–‹ ‡š’‡”‹‡ ‡•‹ˆ ’”‡•‡–ȋƒŽŽ s ≥ 0.22; see Table 2 for full results).

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ƒ•‡†‘–Š‡ ˜ƒŽ—‡•ǡ–Š‡–™‘Ǧ’ƒ”–‘†‡ŽƒŽ™ƒ›•’”‘˜‹†‡†ƒ„‡––‡”ˆ‹––Šƒ–Š‡•–ƒ†ƒ”† ‹š‡†Ǧ‡ˆˆ‡ –•‘†‡ŽǤ ”‘••ƒŽŽͺ‘†‡Ž•ˆ‹––‡†ǡ–Š‡†‹ˆˆ‡”‡ ‡‹ ˜ƒŽ—‡•™ƒ•ƒ–Ž‡ƒ•–͹Ͷ’‘‹–•‹ ˆƒ˜‘”‘ˆ–Š‡–™‘Table 2. ResultsǦ’ƒ”–‘†‡ŽǤ of the two-part analysis of main and interaction effects on negative affect and psychotic experiences. Independent Dependent variable Estimate CI (95%) P- variable value or interaction

ƒ –‹˜‹–›•–”‡•• ›‡‰ƒ–‹˜‡ƒˆˆ‡ –ȋ‹Ǥ‡Ǥ›αͲ˜•Ǥ›εͲȌ ͲǤ͸Ͳ ǦͲǤ͵͵–ͳǤͷ͵ ͲǤʹͲ  ‡˜‡–•–”‡•• ›‡‰ƒ–‹˜‡ƒˆˆ‡ –ȋ‹Ǥ‡Ǥ›αͲ˜•Ǥ›εͲȌ ǦͲǤͲͲ ǦͲǤʹͷ–ͲǤʹͶ ͲǤͻͺ 

ƒ –‹˜‹–›•–”‡•• ›’•› Š‘–‹ ‡š’‡”‹‡ ‡ȋ‹Ǥ‡Ǥ›αͲ˜•Ǥ ͲǤ͵ͻ ͲǤͲͻ–ͲǤ͹Ͳ ͲǤͲͳ 3 ›εͲȌ ‡˜‡–•–”‡•• ›’•› Š‘–‹ ‡š’‡”‹‡ ‡ȋ‹Ǥ‡Ǥ›αͲ˜•Ǥ ǦͲǤͲͳ ǦͲǤʹͲ–ͲǤͳͻ ͲǤͻͷ ›εͲȌ ƒ –‹˜‹–›•–”‡•• –‡•‹–›‘ˆ‡‰ƒ–‹˜‡ƒˆˆ‡ –™Š‡ ͲǤͳʹ ͲǤͲ͹–ͲǤͳ͹ δͲǤͲͳ ’”‡•‡– ȋ‹Ǥ‡Ǥ‹ˆ›εͲȌ ‡˜‡–•–”‡•• –‡•‹–›‘ˆ‡‰ƒ–‹˜‡ƒˆˆ‡ –™Š‡ ͲǤͲ͸ ͲǤͲ͵–ͲǤͳͲ δͲǤͲͳ ’”‡•‡–ȋ‹Ǥ‡Ǥ‹ˆ›εͲȌ ƒ –‹˜‹–›•–”‡••  –‡•‹–›‘ˆ’•› Š‘–‹ ‡š’‡”‹‡ ‡™Š‡ ͲǤͳʹ ͲǤͲ͸–ͲǤͳͺ δͲǤͲͳ ’”‡•‡–ȋ‹Ǥ‡Ǥ‹ˆ›εͲȌ ‡˜‡–•–”‡•• –‡•‹–›‘ˆ’•› Š‘–‹ ‡š’‡”‹‡ ‡™Š‡ ͲǤͲ͸ ͲǤͲʹ–ͲǤͳʹ ͲǤͲͳ ’”‡•‡–ȋ‹Ǥ‡Ǥ‹ˆ›εͲȌ  ȗƒ –‹˜‹–›•–”‡•• ›‡‰ƒ–‹˜‡ƒˆˆ‡ –ȋ‹Ǥ‡Ǥ›αͲ˜•Ǥ›εͲȌ ͲǤͳͶ ǦͲǤͲ͵–ͲǤ͵Ͳ ͲǤͳʹ  ȗ‡˜‡–•–”‡•• ›‡‰ƒ–‹˜‡ƒˆˆ‡ –ȋ‹Ǥ‡Ǥ›αͲ˜•Ǥ›εͲȌ ͲǤͲͶ ǦͲǤͲͻ–ͲǤͳ͹ ͲǤͷ͹  ȗƒ –‹˜‹–›•–”‡•• ›’•› Š‘–‹ ‡š’‡”‹‡ ‡ȋ‹Ǥ‡Ǥ›αͲ˜•Ǥ ͲǤͲ͹ ǦͲǤͲͶ–ͲǤͳͻ ͲǤʹͳ ›εͲȌ ȗ‡˜‡–•–”‡•• ›’•› Š‘–‹ ‡š’‡”‹‡ ‡ȋ‹Ǥ‡Ǥ›αͲ˜•Ǥ ͲǤͲͲ ǦͲǤͲ͸–ͲǤͲ͹ ͲǤͺͻ ›εͲȌ ȗƒ –‹˜‹–›•–”‡•• –‡•‹–›‘ˆ‡‰ƒ–‹˜‡ƒˆˆ‡ –™Š‡ ͲǤͲʹ ǦͲǤͲͳ–ͲǤͲͶ ͲǤʹʹ ’”‡•‡–ȋ‹Ǥ‡Ǥ‹ˆ›εͲȌ ȗ‡˜‡–•–”‡•• –‡•‹–›‘ˆ‡‰ƒ–‹˜‡ƒˆˆ‡ –™Š‡ ͲǤͲͳ ǦͲǤͲͳ–ͲǤͲ͵ ͲǤ͵͸ ’”‡•‡–ȋ‹Ǥ‡Ǥ‹ˆ›εͲȌ ȗƒ –‹˜‹–›•–”‡•• –‡•‹–›‘ˆ’•› Š‘–‹ ‡š’‡”‹‡ ‡™Š‡ ͲǤͲͳ ǦͲǤͲʹ–ͲǤͲ͵ ͲǤͷͻ ’”‡•‡– ȋ‹Ǥ‡Ǥ‹ˆ›εͲȌ ȗ‡˜‡–•–”‡•• –‡•‹–›‘ˆ’•› Š‘–‹ ‡š’‡”‹‡ ‡™Š‡ ͲǤͲͲ ǦͲǤͲͳ–ͲǤͲʹ ͲǤ͸ͳ ’”‡•‡– Note ȋ‹Ǥ‡Ǥ‹ˆ›εͲȌ  ǣα‡’‘”–‡†Š‹Ž†Š‘‘†„—•‡ 

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Discussion

ƒ”†‹‘‹•ƒ† ‘ŽŽ‡ƒ‰—‡•ȋʹͲͳͳȌ’”‡˜‹‘—•Ž›‘„•‡”˜‡†–Šƒ–’ƒ–‹‡–•™‹–Š”‡’‘”–‡†‹ ”‡ƒ•‡† ‡‰ƒ–‹˜‡ƒˆˆ‡ –ƒ†’•› Š‘–‹ ‡š’‡”‹‡ ‡•‹”‡•’‘•‡–‘„‘–Šƒ –‹˜‹–›Ǧƒ†‡˜‡–Ǧ”‡Žƒ–‡†•–”‡••Ǥ ‘”‡‘˜‡”ǡ–Š‡›‘„•‡”˜‡†–Šƒ–‘†‡”ƒ–‡†–Š‡•‡”‡Žƒ–‹‘•Š‹’•ǡ•— Š–Šƒ–Š‹‰ŠŽ‡˜‡Ž•‘ˆ™‡”‡ ”‡Žƒ–‡†–‘‘”‡‹–‡•‡‡‘–‹‘ƒŽƒ†’•› Š‘–‹ ”‡ƒ –‹˜‹–›–‘•–”‡••ǤŠ‡ —””‡–•–—†›†‹†‘– —‡“—‹˜‘ ƒŽŽ›”‡’Ž‹ ƒ–‡–Š‡•‡ˆ‹†‹‰•ǤŠ‹Ž‡–Š‡ˆ‹”•–ƒƒŽ›•‹•ǡ‹””‘”‹‰–Š‡•–ƒ–‹•–‹ ƒŽƒ’’”‘ƒ Š‘ˆ –Š‡‘”‹‰‹ƒŽ•–—†›ǡ†‹†”‡’Ž‹ ƒ–‡‘•–ˆ‹†‹‰•––Š‡ƒ‹‡ˆˆ‡ –•ƒ•™‡ŽŽƒ•‘•–‘ˆ–Š‡‘†‡”ƒ–‹‘ ‡ˆˆ‡ –•––Š‡–™‘Ǧ ‘’‘‡–ƒƒŽ›•‹•ˆƒ‹Ž‡†–‘”‡’Ž‹ ƒ–‡–Š‡‘†‡”ƒ–‹‘‡ˆˆ‡ –•Ǥƒ‹‡ˆˆ‡ –•‘ˆ •–”‡••‘‡‰ƒ–‹˜‡ƒˆˆ‡ –ƒ†’•› Š‘–‹ ‡š’‡”‹‡ ‡•™‡”‡‘–”‡’Ž‹ ƒ–‡†‹–Š‡‹š‡†Ǧ‡ˆˆ‡ –•Ž‘‰‹•–‹  ”‡‰”‡••‹‘ǡ„—–™‡”‡”‡’Ž‹ ƒ–‡†‹–Š‡‹š‡†Ǧ‡ˆˆ‡ –•‰ƒƒǦ”‡‰”‡••‹‘Ǥ ‡–Š‘†‘Ž‘‰‹ ƒŽ†‹ˆˆ‡”‡ ‡•„‡–™‡‡–Š‡•‡•–—†‹‡•ƒ›ƒ ‘—–ˆ‘”•‘‡‘ˆ–Š‡†‹˜‡”‰‡ ‡Ǥ ‹”•–ǡ–Š‡ —””‡–•–—†›—•‡†–Š‡ǡ™Š‹ Š‹•ƒ‹–‡”˜‹‡™Ǧ„ƒ•‡†‡ƒ•—”‡ǡ™Š‹Ž‡–Š‡‘”‹‰‹ƒŽ •–—†›—•‡†–Š‡ǡƒ“—‡•–‹‘ƒ‹”‡ǤŠ‹•ƒ›Šƒ˜‡‹ˆŽ—‡ ‡†’ƒ”–‹ ‹’ƒ–”‡•’‘•‡Ǥ‘”‡‘˜‡”ǡ–Š‡ †‘‡•‘–‹ Ž—†‡ƒ•—„• ƒŽ‡ˆ‘”’Š›•‹ ƒŽƒ†‡‘–‹‘ƒŽ‡‰Ž‡ –Ǥ‡”Šƒ’•–Š‡•‡•—„• ƒŽ‡• ƒ ‘—–‡†ˆ‘”•‘‡ƒ‘—–‘ˆ–Š‡‘”‹‰‹ƒŽ‡ˆˆ‡ –Ǥ‡ƒŽ•‘‘„•‡”˜‡†–Šƒ–‘”‡’ƒ”–‹ ‹’ƒ–•ˆƒ‹Ž‡†–‘n n ˆ‹ŽŽ‘—––Š‡”‡“—‹”‡†—„‡”‘ˆ“—‡•–‹‘ƒ‹”‡•ȋ αʹͳȌǡ ‘’ƒ”‡†–‘–Š‡‘”‹‰‹ƒŽ•–—†›ȋ α͵ȌǤ †‹ˆˆ‡”‡ ‡‹–Š‡™‘”Ž‘ƒ†„‡–™‡‡–Š‡–™‘•–—†‹‡•‹•Ž‹‡Ž›–‘ƒ ‘—–ˆ‘”–Š‹•ǣ–Š‡ —””‡–•–—†›‹• ’ƒ”–‘ˆƒŽƒ”‰‡”’”‘Œ‡ –ǡ‹˜‘Ž˜‹‰•‹‰‹ˆ‹ ƒ–Ž›‘”‡–‡•–‹‰–Šƒ–Š‡‘”‹‰‹ƒŽ•–—†›ȋ•‡‡‡‹Œ‡”•‡– ƒŽǤʹͲͳ͸ˆ‘”–Š‡–‡•–•—•‡†ȌǤ‡ ‘—Ž†ƒ”‰—‡–Šƒ–•— Š†”‘’Ǧ‘—–ƒ›Šƒ˜‡„‡‡•‡Ž‡ –‹˜‡ǡ–Š—• ‹ˆŽ—‡ ‹‰”‡•—Ž–•Ǥ ‘™‡˜‡”ǡ’‘•–ǦŠ‘ Ž‘‰‹•–‹ ”‡‰”‡••‹‘”‡˜‡ƒŽ‡†–Šƒ–‡‹–Š‡”•‡˜‡”‹–›‘ˆ ’•› Š‘–‹ •›’–‘•ƒ•‡ƒ•—”‡†„›–Š‡‘•‹–‹˜‡ƒ†‡‰ƒ–‹˜‡›†”‘‡ ƒŽ‡p ȋƒ›ǡ ‹•œ„‡‹Ƭ ’ˆ‡”ǡͳͻͺ͹Ȍ‘”’”‡†‹ –‡††”‘’‘—–ˆ”‘–Š‡•–—†›ȋ ’s > .18).  ‘–Š‡”’‘••‹„Ž‡Ž‹‹–ƒ–‹‘‹•–Šƒ–‘—”•ƒ’Ž‡‹•ˆƒ‹”Ž›Š‡–‡”‘‰‡‡‘—•ǡ‹ Ž—†‹‰’ƒ–‹‡–• ™‹–Šƒˆ‹”•–Ǧ‡’‹•‘†‡’•› Š‘•‹•ƒ•™‡ŽŽƒ•Ž‘‰Ǧ–‡”–”‡ƒ–‡†’ƒ–‹‡–•Ǥ —–—”‡”‡•‡ƒ” Š ‘ ‡”‹‰ •–”‡••”‡ƒ –‹˜‹–›‹•Š‘—Ž†ƒ––‡†–‘–Š‡•‡†‹ˆˆ‡”‡–•—„–›’‡•ƒ†–‘‹ŽŽ‡••†—”ƒ–‹‘Ǥ”‡ ‡– •–—†›Šƒ••Š‘™–Šƒ–ƒ‰‡ƒ–‹ŽŽ‡••‘•‡–Šƒ•ƒ•‹‰‹ˆ‹ ƒ–‹’ƒ –‘•‘‡‘ˆ–Š‡‘—– ‘‡•‘ˆ • Š‹œ‘’Š”‡‹ƒȋ ‘‡ǡ ¡¡•‡Ž¡‹‡ǡ‘”’‡ŽƒǡƬ‹‡––—‡ǡʹͲͳ͹Ȍǡ™Š‹ ŠƒŽ•‘ƒ›Šƒ˜‡ ‹’ƒ –‡†–Š‡ —””‡–”‡•—Ž–•ǤŽ•‘ǡ•–”‡••ƒ›Šƒ˜‡†‹˜‡”‰‡–‡ˆˆ‡ –•‘†‹ˆˆ‡”‡–•—„–›’‡•‘ˆǤ ‘™‡˜‡”ǡ™‡ˆ‡‡Ž–Šƒ–‹–‹•„‡›‘†–Š‡• ‘’‡‘ˆ–Š‡ —””‡–•–—†›–‘‡šƒ‹‡–Š‡‹’ƒ –‘ˆ–Š‡•‡ ˆƒ –‘”•Ǣ‹–•ƒ‹ƒ‹™ƒ•–‘”‡’Ž‹ ƒ–‡–Š‡•–—†›„›ƒ”†‹‘‹•‡–ƒŽǤȋʹͲͳͳȌƒ†–Š‡ƒ‘—–‘ˆ heterogeneity of both studies is fairly similar. Patients in Lardinois et al.’s ȋʹͲͳͳȌ•–—†›”‡ ‡‹˜‡† „‡–™‡‡ͳ‘–Šƒ†ͳͲ›‡ƒ”•‘ˆ–”‡ƒ–‡–’”‹‘”–‘–Š‡•–—†›ǡƒ†™‡”‡„‡–™‡‡ͳ͹ƒ†Ͷͷ›‡ƒ”•

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‘Ž†Ǥ ‘—”•–—†›’ƒ–‹‡–•”‡ ‡‹˜‡†„‡–™‡‡͸‘–Š•ƒ†ͳͲ›‡ƒ”•‘ˆ’”‹‘”–”‡ƒ–‡–ǡƒ†™‡”‡ „‡–™‡‡ͳͻƒ†ͷ͹›‡ƒ”•‘Ž†Ǥ ‡•’‹–‡–Š‡‘„•‡”˜‡††‹ˆˆ‡”‡ ‡•ǡ™‡™‘—Ž†ƒŽ•‘Ž‹‡–‘—†‡”• ‘”‡–Šƒ–™‡†‹†”‡’Ž‹ ƒ–‡ ˆ‹†‹‰•—•‹‰ƒ•‹‹Žƒ”•–ƒ–‹•–‹ ƒŽƒ’’”‘ƒ ŠǤ˜‡ƒ‹ƒ†‹–‡”ƒ –‹‘‡ˆˆ‡ –Ǧ•‹œ‡•™‡”‡”‘—‰ŠŽ› ”‡’Ž‹ ƒ–‡†ǡ•—‰‰‡•–‹‰–Šƒ––Š‡–™‘•–—†‹‡•ƒ”‡‘––Šƒ–†‹••‹‹Žƒ”Ǥ ‘—”˜‹‡™ǡ–Š‡ƒ‹“—‡•–‹‘ Š‡”‡‹•™Š›–Š‡”‡‹•ƒŽƒ ‘ˆ•–ƒ–‹•–‹ ƒŽ•—’’‘”–ˆ‘”ƒ‹‡ˆˆ‡ –•‹–Š‡‹š‡†Ǧ‡ˆˆ‡ –•Ž‘‰‹•–‹  ”‡‰”‡••‹‘ƒ•‘’’‘•‡†–‘–Š‡‹š‡†Ǧ‡ˆˆ‡ –•‰ƒƒ”‡‰”‡••‹‘ƒ†™Š›–Š‡”‡‹•ƒŽƒ ‘ˆ‡˜‹†‡ ‡ ˆ‘”‘†‡”ƒ–‹‘‹–Š‡‡–‹”‡–™‘absence Ǧ ‘’‘‡–ƒƒŽ›•‹•ƒ•‘’’‘•‡†–‘–Š‡•–ƒ†ƒ”†‹š‡†Ǧ‡ˆˆ‡ –• ‘†‡ŽǤ ‹”•–ǡ–Š‡ presence‘ˆ•–ƒ–‹•–‹ ƒŽ‡˜‹†‡ ‡ˆ‘”ƒ‹‡ˆˆ‡ –•‹–Š‡‹š‡†Ǧ‡ˆˆ‡ –•Ž‘‰‹•–‹  ”‡‰”‡••‹‘ƒ†–Š‡ ‘ˆ•–ƒ–‹•–‹ ƒŽ‡˜‹†‡ ‡‹–Š‡‹š‡†Ǧ‡ˆˆ‡ –•‰ƒƒ”‡‰”‡••‹‘ƒ›

‹†‹ ƒ–‡–Šƒ–•–”‡••”ƒ–Š‡”‹ˆŽ—‡ ‡•–Š‡‹–‡•‹–›‘ˆ’•› Š‘–‹ •›’–‘•ƒ†‡‰ƒ–‹˜‡ƒˆˆ‡ ––Šƒ 3 –Š‡‹”ƒ –—ƒŽ†‡˜‡Ž‘’‡–Ǥ‡ ‘†ǡ ‘ ‡”‹‰–Š‡Žƒ ‘ˆ•–ƒ–‹•–‹ ƒŽ‡˜‹†‡ ‡ˆ‘”–Š‡‘†‡”ƒ–‹‘ ‡ˆˆ‡ –•‹–Š‡‡–‹”‡–™‘Ǧ ‘’‘‡–ƒƒŽ›•‹•ǡ‘‡ ‘—Ž†ƒ”‰—‡–Šƒ––Š‡”‡•—Ž–•‘ˆ–Š‡–™‘Ǧ ‘’‘‡– ƒƒŽ›•‡•ƒ›”‡ˆŽ‡ –ƒŽƒ ‘ˆ’‘™‡”Ǥ—–‘ˆ‡ ‡••‹–›ǡ–‘ƒƒŽ›œ‡–Š‡ Ž—’‡†ƒ†”‹‰Š–Ǧ•‡™‡† †ƒ–ƒǡ™‡†‹ Š‘–‘‹œ‡†–Š‡‘—– ‘‡ˆ‘”–Š‡„‹ƒ”›Ž‘‰‹•–‹ ƒƒŽ›•‡•Ǥ ‘”–Š‡‰ƒƒ‘†‡Ž•ǡ‘Ž› †ƒ–ƒ™‹–Š’•› Š‘–‹ ‡š’‡”‹‡ ‡•‘”‡‰ƒ–‹˜‡ƒˆˆ‡ –ƒ –—ƒŽŽ›„‡‹‰’”‡•‡–™ƒ•–ƒ‡‹–‘ ‘•‹†‡”ƒ–‹‘Ǥ›„”‡ƒ‹‰†‘™–Š‡†ƒ–ƒ‹–Š‹•ƒ‡”ǡ™‡ƒ›Šƒ˜‡Ž‘•–‹ˆ‘”ƒ–‹‘ƒ† –Š‡”‡ˆ‘”‡’‘™‡”Ǥ‘”‡’ƒ”–‹ ‹’ƒ–•ƒ›„‡‡‡†‡†–‘ˆ‹†‡š‹•–‹‰‡ˆˆ‡ –•™‹–Š•— Šƒƒ’’”‘ƒ ŠǤ ƒ•–Ž›ǡƒ‘”‡•–”ƒ‹‰Š–ˆ‘”™ƒ”†‹–‡”’”‡–ƒ–‹‘‘ˆ–Š‡†ƒ–ƒ‹•–Šƒ–•— Š‘†‡”ƒ–‹‘ƒ›‘– ƒ –—ƒŽŽ›‡š‹•–Ǥ–”‡•••‡•‹–‹œƒ–‹‘‹•’‡”Šƒ’•ƒ‹ ‘’Ž‡–‡‘”‘˜‡”•‹’Ž‹ˆ‹‡†ƒ ‘—–‘ˆ–Š‡‡ˆˆ‡ – ‘ˆ‘’•› Š‘–‹ •›’–‘•Ǥ‡”Šƒ’•‘–Š‡”ˆƒ –‘”•ǡ•— Šƒ•‰‡‡–‹ Ž‹ƒ„‹Ž‹–›ȋ˜ƒ‹‡Žǡ–‡ˆƒ‹• Ƭ›‹Ǧ ‡”‡›•ǡʹͲͲͺȌǡ‘—–•‹†‡”•–ƒ–—•ȋ‡Ž–‡Ƭƒ–‘”Ǧ ”ƒƒ‡ǡʹͲͳͶȌǡ‘”‹•‡ —”‡ƒ––ƒ Š‡– •–›Ž‡ȋ‹–‘ǡ‡–ƒŽŽǡŠ‡˜Ž‹ǡƬ‡ŽŽ™‘‘†ǡʹͲͳͶȌƒ›—Ž–‹ƒ–‡Ž›†‡–‡”‹‡™Š‡–Š‡”ƒ„—•‹˜‡ ‡š’‡”‹‡ ‡•‹ Š‹Ž†Š‘‘†”‡•—Ž–‹’•› Š‘•‹•ǤŠ‡•‹‰‹ˆ‹ ƒ–‘†‡”ƒ–‹‘‡ˆˆ‡ –•‘ˆ‘—”’”‹ƒ”› ƒƒŽ›•‹•–Š‡ƒ›”‡ˆŽ‡ –›’‡ ‡””‘”• ƒ—•‡†„›˜‹‘Žƒ–‹‘•‘ˆƒ••—’–‹‘•‘ˆŽ‹‡ƒ”‹–›ƒ† ‘”ƒŽ‹–›ǡ™Š‹ Šƒ›ƒŽ•‘ƒ ‘—–ˆ‘”’”‡˜‹‘—• ‘–”ƒ†‹ –‘”›ˆ‹†‹‰•ȋƒ”†‹‘‹•‡–ƒŽǤǡʹͲͳͳǢ ‡‹‹‰Šƒ—•‡–ƒŽǤǡʹͲͳ͸ȌǤˆ ‘—”•‡ǡ–Š‹•†‘‡•‘–‡ ‡••ƒ”‹Ž›‡ƒ–Šƒ––Š‡‘”‹‰‹ƒŽˆ‹†‹‰• ȋƒ”†‹‘‹•‡–ƒŽǤǡʹͲͳͳȌƒ”‡”‡ˆŽ‡ –‹˜‡‘ˆ›’‡ ‡””‘”ƒ•™‡ŽŽǤ ‘™‡˜‡”ǡ‰‹˜‡–Šƒ–‹–Š‡‘”‹‰‹ƒŽ •–—†›‡‰ƒ–‹˜‡ƒˆˆ‡ –ƒ†’•› Š‘–‹ ‡š’‡”‹‡ ‡•ƒ˜‡”ƒ‰‡†ͳǤͺͲƒ†ͳǤͷͳ”‡•’‡ –‹˜‡Ž›‘ƒ• ƒŽ‡‘ˆͳ –‘͹–•—‰‰‡•–‹˜‡‘ˆŠ‡ƒ˜›”‹‰Š–Ǧ•‡™‡••–ƒ‹š‡†Ǧ‡ˆˆ‡ –•Ž‹‡ƒ””‡‰”‡••‹‘‹•—Ž‹‡Ž›–‘Šƒ˜‡ „‡‡ƒ‘’–‹ƒŽˆ‹–ˆ‘”–Š‡†ƒ–ƒǤ †‡ˆ‡•‡‘ˆ–Š‡‘”‹‰‹ƒŽ•–—†›ǡ–Š‘—‰Šǡ™‡•Š‘—Ž†‡–‹‘–Šƒ––Š‡ ƒƒŽ›•‹•‘ˆ—Ž–‹Ž‡˜‡Ž†ƒ–ƒ‹• ‘•–ƒ–Ž›‹†‡˜‡Ž‘’‡–Ǥ ‘—–‹‰ˆ‘”˜‹‘Žƒ–‹‘‘ˆ‘”ƒŽ‹–›‹

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Š‹‡”ƒ” Š‹ ƒŽŽ›•–”— –—”‡††ƒ–ƒŠƒ•‘Ž›˜‡”›”‡ ‡–Ž›„‡‡„”‘—‰Š––‘ƒ––‡–‹‘ȋ‡”Ž—‹ǡ†‡‘‡”Ƭ †‡‡–ǡʹͲͳ͸Ȍƒ†–Š‡˜‹‘Žƒ–‹‘‹• ‘’Ž‡š–‘ƒ††”‡••Ǥ  ‘ Ž—•‹‘ǡ–Š‡ —””‡–ˆ‹†‹‰•”‡’Ž‹ ƒ–‡†•‘‡„—–‘–ƒŽŽˆ‹†‹‰•„›ƒ”†‹‘‹•‡–ƒŽǤ ȋʹͲͳͳȌǤŠ‡”‡Žƒ–‹‘•Š‹’„‡–™‡‡•–”‡••ƒ†–Š‡‹–‡•‹–›‘ˆ‡‰ƒ–‹˜‡ƒˆˆ‡ –Ȁ’•› Š‘–‹ ‡š’‡”‹‡ ‡• ȋ™Š‡’”‡•‡–Ȍ•‡‡•”‘„—•–ǡ„—––Š‡‘†‡”ƒ–‹‰‡ˆˆ‡ –•‘ˆ‘•–”‡••”‡ƒ –‹˜‹–›Ž‡•••‘Ǥ› —•‹‰–™‘•–ƒ–‹•–‹ ƒŽƒ’’”‘ƒ Š‡•ǡ–Š‹••–—†›Šƒ•ˆ—”–Š‡”‘”‡‹ŽŽ—•–”ƒ–‡†–Š‡‹’‘”–ƒ ‡‘ˆ‡š’Ž‘”‹‰ –Š‡‡ˆˆ‡ –•‘ˆƒ••—’–‹‘˜‹‘Žƒ–‹‘‘—Ž–‹Ž‡˜‡Ž†ƒ–ƒǤ‡–Š‹–Šƒ––Š‡ˆ‹†‹‰•‘ˆ–Š‡’”‡•‡– •–—†›ƒ”‡‘ˆ Ž‹‹ ƒŽ”‡Ž‡˜ƒ ‡Ǥ—Ž–‹’Ž‡ƒ—–Š‘”•Šƒ˜‡ƒ”‰—‡†–Šƒ–‹–ƒ›„‡‹’‘”–ƒ––‘–ƒ‹Ž‘” ‹–‡”˜‡–‹‘•–‘™ƒ”†•–Š‡‘„•‡”˜‡†Š‡‹‰Š–‡‡†‡‘–‹‘ƒŽ”‡ƒ –‹˜‹–›–‘†ƒ‹Ž›•–”‡••‘”• ȋ”‹•–ׄƒŽǦƒ”˜ž‡œ‡–ƒŽǤǡʹͲͳ͸Ǣ˜ƒ‹‡”‘’‡–ƒŽǤǡʹͲͳͺǢ‡‹‹‰Šƒ—•‡–ƒŽǤǡʹͲͳ͸ȌǤ †‡‡†ǡ•–”‡•• •‡‡•”‘„—•–Ž›”‡Žƒ–‡†–‘–Š‡•‡˜‡”‹–›‘ˆ’•› Š‘–‹ ‡š’‡”‹‡ ‡•ƒ†‡‰ƒ–‹˜‡ƒˆˆ‡ –ǡƒ–Ž‡ƒ•–‹ˆ ƒŽ”‡ƒ†›’”‡•‡–ǤŠ‹•ƒ›‡ƒ–Šƒ–‹–‡”˜‡–‹‘•–ƒ”‰‡–‹‰”‡ƒ –‹˜‹–›–‘•–”‡••ƒ”‡‘ˆ„‡‡ˆ‹––‘ ’ƒ–‹‡–•™‹–ŠǤ –‡”˜‡–‹‘••— Šƒ•‡–ƒŽ‹œƒ–‹‘„ƒ•‡†–”‡ƒ–‡–ǡ™Š‹ Š‹•ƒ‹‡†ƒ– ‹’”‘˜‹‰‡‘–‹‘”‡‰—Žƒ–‹‘ǡƒ›„‡ˆ”—‹–ˆ—Ž‹–Š‹•”‡‰ƒ”†ȋ”‡–ǡʹͲͲͻȌǤ ‘™‡˜‡”ǡ–Š‡ —””‡– ”‡•—Ž–•ƒŽ•‘‹ ”‡ƒ•‡— ‡”–ƒ‹–›ƒ„‘—––Š‡’ƒ–Š‘‰‡‹ ‘†‡Ž’—–ˆ‘”–Š„›’”‡˜‹‘—•ƒ”–‹ Ž‡•ǤŠ‡”‡‹• •–‹ŽŽ— ‡”–ƒ‹–›ƒ„‘—–™Š‡–Š‡”–Š‡”‡Žƒ–‹‘„‡–™‡‡•–”‡••ƒ†–Š‡•‡˜‡”‹–›‘ˆ’•› Š‘–‹  ‡š’‡”‹‡ ‡•ƒ†‡‰ƒ–‹˜‡ƒˆˆ‡ – ƒƒ –—ƒŽŽ›„‡ƒ––”‹„—–‡†–‘ Š‹Ž†Š‘‘†ƒ„—•‡ǤŠ‡”‡ˆ‘”‡ǡ ‹–‡”˜‡–‹‘•ƒ‹‡†ƒ–”‡†— ‹‰•–”‡••”‡ƒ –‹˜‹–›ƒ›‘–ƒˆˆ‡ –’•› Š‘–‹ ‡š’‡”‹‡ ‡•ƒ––”‹„—–ƒ„Ž‡ –‘ Š‹Ž†Š‘‘†ƒ„—•‡Ǥ ‘—”˜‹‡™ǡ‹–‹•‹’‘”–ƒ––‘ƒ• ‡”–ƒ‹™Š‡–Š‡”’”‡˜‹‘—•”‡•—Ž–•†‘‘–”‡ˆŽ‡ – ›’‡ ‡””‘”•Ǥ”‡˜‹‘—•ˆ‹†‹‰•‹˜‘Ž˜‹‰•–ƒ†ƒ”†‹š‡†Ǧ‡ˆˆ‡ –•‘†‡Ž•™‹–Š•‹‹Žƒ”‘—– ‘‡• ƒ›‡‡†”‡ǦƒƒŽ›•‹•Ǥƒ•–Ž›ǡˆ—–—”‡”‡•‡ƒ” Š•Š‘—Ž††‡–‡”‹‡™Š‡–Š‡”•— Šƒ••—’–‹‘˜‹‘Žƒ–‹‘• ƒ –—ƒŽŽ›Ž‡ƒ†–‘†‹ˆˆ‡”‡–‹–‡”’”‡–ƒ–‹‘•‹•—ˆˆ‹ ‹‡–Ž›Žƒ”‰‡•ƒ’Ž‡•Ǥ  Ethics statement

‡•‡ƒ” Š™ƒ• ‘†— –‡†ƒ ‘”†‹‰™‹–Š–Š‡’”‘˜‹•‹‘•‘ˆ–Š‡‘”Ž†‡†‹ ƒŽ••‘ ‹ƒ–‹‘ ‡ Žƒ”ƒ–‹‘‘ˆ ‡Ž•‹‹ǤŠ‹••–—†›‹•’ƒ”–‘ˆƒŽƒ”‰‡”•–—†›ˆ‘”™Š‹ Š‡–Š‹ ƒŽƒ’’”‘˜ƒŽ™ƒ•‰‹˜‡„› –Š‡‡†‹ ƒŽ‡•‡ƒ” Š–Š‹ •‘‹––‡‡‘ˆ–Š‡‹˜‡”•‹–› ‘•’‹–ƒŽƒƒ•–”‹ Š–ƒ†ƒƒ•–”‹ Š– ‹˜‡”•‹–›ȋ ͳ͵Ǧ͵ǦͲ͸͸ǤͷȀƒ„ȌǤ”‹––‡‹ˆ‘”‡† ‘•‡–™ƒ•‘„–ƒ‹‡†ˆ”‘ƒŽŽ•—„Œ‡ –•Ǥ Author’s contributions

†‡˜‡Ž‘’‡†–Š‡•–—†› ‘ ‡’–ƒ†™”‘–‡–Š‡ˆ‹”•–†”ƒˆ–Ǥ ™ƒ•ƒŽ•‘”‡•’‘•‹„Ž‡ˆ‘”–‡•–‹‰ƒ† †ƒ–ƒ ‘ŽŽ‡ –‹‘Ǥƒ† ’‡”ˆ‘”‡††ƒ–ƒƒƒŽ›•‹•Ǥǡǡƒ† ’”‘˜‹†‡† ”‹–‹ ƒŽ”‡˜‹•‹‘•ǤŽŽ ƒ—–Š‘”•ƒ’’”‘˜‡‘ˆ–Š‡ˆ‹ƒŽ˜‡”•‹‘‘ˆ–Š‡’ƒ’‡”ˆ‘”•—„‹••‹‘Ǥ

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146807_JonasWeijers_BNW_def.indd 62 28-10-2020 15:08 Reported childhood abuse and stress reactivity in psychosis

Conflicts of interest

 Š‡ƒ—–Š‘”•†‡ Žƒ”‡‘ ‘ˆŽ‹ –•‘ˆ‹–‡”‡•–™‹–Š”‡•’‡ ––‘–Š‡ƒ—–Š‘”•Š‹’‘”–Š‡’—„Ž‹ ƒ–‹‘‘ˆ–Š‹• ƒ”–‹ Ž‡Ǥ Funding

Š‹•™‘””‡ ‡‹˜‡†‘–Š‹”†Ǧ’ƒ”–›ˆ—†‹‰ǡ‡‹–Š‡”†‹†–Š‡ƒ—–Š‘”•Šƒ˜‡ˆ‹ƒ ‹ƒŽ”‡Žƒ–‹‘•Š‹’•™‹–Š ‘‡” ‹ƒŽ‹–‡”‡•–•Ǥ Acknowledgments 

‘‡Ǥ  3 References

†”‡ƒ•‡ǡǤǤǡ Žƒ—ǡǤǡƬ”†–ǡǤȋͳͻͻʹȌǤŠ‡‘’”‡Š‡•‹˜‡••‡••‡–‘ˆ›’–‘•ƒ†Archives of ‹•–‘”›general psychiatry, ȋ Ȍǣ ƒ 49 ‹•–”—‡– ˆ‘” ƒ••‡••‹‰ †‹ƒ‰‘•‹• ƒ† ’•› Š‘’ƒ–Š‘Ž‘‰›Ǥ ȋͺȌǡ͸ͳͷǦ͸ʹ͵Ǥ ‹ˆ—Ž ‘ǡǤǡ”‘™ǡ ǤǤǡƬ ƒ””‹•ǡǤǤȋͳͻͻͶȌǤJournalŠ‹Ž†Š‘‘†š’‡”‹‡ ‡‘ˆƒ”‡ƒ†„—• of Child Psychology and Psychiatry, 35‡ȋȌǣƒ ”‡–”‘•’‡ –‹˜‡ ‹–‡”˜‹‡™ ‡ƒ•—”‡Ǥ ȋͺȌǡ ͳͶͳͻǦ ͳͶ͵ͷǤ ƒ–‡•ǡǤǡ¡ ŠŽ‡”ǡǤǡ‘Ž‡”ǡǤǡJournal of Statistical Software,ƬƒŽ‡”ǡǤȋʹͲͳͶȌǤ ‹––‹‰Ž‹‡ƒ”‹š‡† Ǧ‡ˆˆ‡ –•‘†‡Ž•—•‹‰Ž‡ͶǤ ’”‡’”‹–ƒ”‹˜ǣͳͶͲ͸Ǥͷͺʹ͵Ǥ Journal of clinical Brent, B.psychology, (2009). Mentalization‐based 65 psychodynamic psychotherapy for psychosis. ȋͺȌǡͺͲ͵ǦͺͳͶǤ ”‘™ǡ ǤǤǡ”ƒ‹‰ǡǤǤǡ ƒ””‹•ǡǤǤǡ ƒ†Ž‡›ǡǤǤǡƬ ƒ”˜‡›ǡǤǤȋʹͲͲ͹ȌǤƒŽ‹†‹–›‘ˆ”‡–”‘•’‡ –‹˜‡ ‡ƒ•—”‡•‘ˆ‡ƒ”Ž›ƒŽ–”‡ƒ–‡–ƒ††‡’”‡••‹˜‡‡’‹•‘†‡•—•‹‰–Š‡Š‹Ž†Š‘‘†š’‡”‹‡ ‡‘ˆ Journalƒ”‡ ƒ† of affective „—•‡ ȋȌ disorders, ‹•–”—‡– 103 — Ž‹ˆ‡Ǧ ‘—”•‡ •–—†› ‘ˆ ƒ†—Ž– Š”‘‹  †‡’”‡••‹‘—ʹǤ ȋͳǦ͵Ȍǡʹͳ͹ǦʹʹͶǤ ”‹•–ׄƒŽǦƒ”˜ž‡œǡ Ǥǡ Š‡‹„ƒ—ǡ Ǥǡ ƒŽŽ‡•’Àǡ Ǥǡ ‹–Œƒ˜‹Žƒǡ Ǥǡ ›‹Ǧ ‡”‡›•ǡ Ǥǡ ™ƒ’‹Žǡ ǤǤǡ Ƭ ƒ””ƒ–‡•Ǧ‹†ƒŽǡ Ǥ ȋʹͲͳ͸ȌǤ ’ƒ – ‘ˆ ƒ†˜‡”•‡ Š‹Ž†Š‘‘† ‡š’‡”‹‡ ‡•Focus ‘, 14 ’•› Š‘–‹ ǦŽ‹‡ •›’–‘•ƒ†•–”‡••”‡ƒ –‹˜‹–›‹†ƒ‹Ž›Ž‹ˆ‡‹‘ Ž‹‹ ƒŽ›‘—‰ƒ†—Ž–•Ǥ ȋ͵Ȍǡ͵ͺ͹Ǧ͵ͻͷǤ Žƒ•‡”ǡ ǤǦǤǡƒ•ǡ Ǥǡ‘”–‡‰‹Œ•ǡǤ ǤǡƬ›‹Ǧ ‡”‡›•ǡ ǤȋʹͲͲ͸ȌǤŠ‹Ž†Š‘‘†–”ƒ—ƒƒ†‡‘–‹‘ƒŽJournal of psychosomatic”‡ƒ –‹˜‹–›–‘†ƒ‹Ž›Ž‹ˆ‡•–”‡••‹ƒ†—Ž–ˆ”‡“—‡–ƒ––‡†‡”•‘ˆ‰‡‡”ƒŽ’”ƒ –‹–‹‘‡”•Ǥ research, 6 ͳȋʹȌǡʹʹͻǦʹ͵͸Ǥ

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—”ƒǡǤ Ǥǡ†™ƒ”†•ǡǤ ǤǡStatistics inƬ medicine,—ŽŽ‡”ǡǤǤȋʹͲͳͳȌǤ˜‘‹†‹‰„‹ƒ•‹‹š‡†‘†‡Ž‹ˆ‡”‡ 30 ‡ˆ‘”ˆ‹š‡† ‡ˆˆ‡ –•Ǥ ȋʹʹȌǡ ʹ͸ͻ͸Ǧʹ͹Ͳ͹Ǥ ‘ŽŽ‹’ǡ Ǥǡ ›‹Ǧ ‡”‡›•ǡ Ǥǡ ƒ •ǡ Ǥ (2008). Does the concept of “sensitization” provideSchizophren a plausibleia mechanism bulletin, 34 for the putative Ž‹„‡–™‡‡–Š‡‡˜‹”‘‡–ƒ†• Š‹œ‘’Š”‡‹ƒǫClassification, data analysis, andȋʹȌ dataǡʹʹͲ highways.ǦʹʹͷǤ ‘šǡ ǤȋͳͻͻͺȌǤ—Ž–‹Ž‡˜‡Ž‘†‡Ž‹‰ǣŠ‡ƒ†™Š›Ǥ ‡‹†‡Ž„‡”‰ǣ’”‹‰‡”Ǥ ‘‡ǡ Ǥǡ ¡¡•‡Ž¡‹‡ǡǤǡ‘”’‡Žƒǡ ǤǡƬ‹‡––—‡ǡ ǤȋʹͲͳ͹ȌǤEarly‰‡ƒ–‘•‡–ƒ†–Š‡‘—– ‘‡•‘ˆ intervention in psychiatry, 11 • Šizophrenia: A systematic review and meta‐analysis. ȋ͸Ȍǡ Ͷͷ͵ǦͶ͸ͲǤ ”™‹ǡ ǤǤǡƬ Ž‡ŽŽƒ†ǡ Ǥ ǤȋʹͲͲ͵ȌǤ‡‰ƒ–‹˜‡ ‘•‡“—‡ ‡•‘ˆ†‹ Š‘–‘‹œ‹‰ ‘–‹—‘—•’”‡†‹ –‘”Journal of Marketing Research, 40 ˜ƒ”‹ƒ„Ž‡•Ǥ ȋ͵Ȍǡ͵͸͸Ǧ͵͹ͳǤ ƒ”†‹‘‹•ǡǤǡƒ–ƒ•–‡”ǡǤǡ‡‰‡Ž‡”•ǡǤǡƒ•ǡ ǤǡActaƬ›‹ PsychiatricaǦ ‡”‡›•ǡ ǤȋʹͲͳͳȌǤŠ‹Ž†Š‘‘†–”ƒ—ƒƒ† Scandinavica, 123 ‹ ”‡ƒ•‡†•–”‡•••‡•‹–‹˜‹–›‹’•› Š‘•‹•Ǥ ȋͳȌǡʹͺǦ͵ͷǤ ƒ–ƒ•–‡”ǡ Ǥǡ ƒŽƒ‰‰‹ƒǡ Ǥǡ ƒ”†‹‘‹•ǡ Ǥǡ ƒ •ǡ ǡ Ƭ ›‹Ǧ ‡”‡›•ǡ Ǥ ȋʹͲͳ͵ȌǤ  ”‡ƒ•‡† •–”‡•• ”‡ƒ –‹˜‹–›ǣPsychological ƒ ‡ Šƒ‹• Medicine, •’‡ ‹ˆ‹ ƒŽŽ›43 ƒ••‘ ‹ƒ–‡† ™‹–Š –Š‡ ’‘•‹–‹˜‡ •›’–‘• ‘ˆ ’•› Š‘–‹  †‹•‘”†‡”Ǥ  ȋ͹Ȍǡͳ͵ͺͻǦͳͶͲͲǤ ƒ›ǡ ǤǤǡ ‹•œ„‡‹ǡ ǤǡSchizophrenia ’ˆ‡”ǡ ǤǤ ȋͳͻͺ͹ȌǤ bulletin, Š‡ 13 ’‘•‹–‹˜‡ ƒ† ‡‰ƒ–‹˜‡ •›†”‘‡ • ƒŽ‡ ȋȌ ˆ‘” • Š‹œ‘’Š”‡‹ƒǤ ȋʹȌǡʹ͸ͳǦʹ͹͸Ǥ ƒ–Š‡•‘ǡǤǤǡŠ‡’Š‡”†ǡǤǤǡ‹ Š„‡ ǡǤǤǡƒ—”‡•PsychologicalǡǤǤǡƬƒ”” medicineǡǤ ǤȋʹͲͳ͵ȌǤ, 43 Š‹Ž†Š‘‘†ƒ†˜‡”•‹–› ‹• Š‹œ‘’Š”‡‹ƒǣƒ•›•–‡ƒ–‹ ‡–ƒǦƒƒŽ›•‹•Ǥ ȋʹȌǡʹʹͷǦʹ͵ͺǤ ‘”‰ƒǡ Ǥǡ Ƭ ‹•Š‡”ǡ Ǥ ȋʹͲͲ͹ȌǤ ˜‹”‘‡– ƒ† • Š‹œ‘’Š”‡‹ƒǣSchizophrenia ‡˜‹”‘‡–ƒŽ bulletin 33 ˆƒ –‘”• ‹ • Š‹œ‘’Š”‡‹ƒǣ Š‹Ž†Š‘‘†–”ƒ—ƒ—ƒ ”‹–‹ ƒŽ”‡˜‹‡™Ǥ ǡ ȋͳȌǡ͵ǦͳͲǤ ›‹Ǧ ‡”‡›•ǡ Ǥǡ‡Ž‡•’ƒ—ŽǡǤǡPsychological medicine,Ƭƒ•ǡ ǤȋʹͲͲͷȌǤ‡Šƒ˜‹‘—”ƒŽ•‡•‹–‹œƒ–‹‘–‘†ƒ‹Ž›Ž‹ˆ‡ 35 •–”‡••‹ ’•› Š‘•‹•Ǥ ȋͷȌǡ͹͵͵Ǧ͹ͶͳǤ ›‹Ǧ ‡”‡›•ǡ ǤǡƬ˜ƒ•ǡ ǤȋʹͲͲ͹ȌǤ–”‡••Clinical psychology review,Ǧ”‡ƒ –‹˜‹–›‹’•› Š‘•‹•ǣ‡˜‹†‡ ‡ˆ‘”ƒƒˆˆ‡ –‹˜‡’ƒ–Š™ƒ›27 –‘’•› Š‘•‹•Ǥ  ȋͶȌǡͶͲͻǦͶʹͶǤ Ž•‡ǡǤǤǡƬJourn Šƒˆ‡”ǡ ǤǤȋʹͲͲͳȌǤ–™‘al of the American StatisticalǦ’ƒ”–”ƒ†‘ Association,Ǧ‡ˆˆ‡ –•‘†‡Žˆ‘”•‡‹ ‘–‹—‘—•Ž‘‰‹–—†‹ƒŽ 96 †ƒ–ƒǤ ȋͶͷͶȌǡ͹͵ͲǦ͹ͶͷǤ ’‡  ‹‡ ‡ ‘ŽŽƒ„‘”ƒ–‹‘Ǥ ȋʹͲͳʹȌǤ  ‘’‡ǡPerspectives Žƒ”‰‡Ǧ• ƒŽ‡ǡ on ‘ŽŽƒ„‘”ƒ–‹˜‡ Psychological ‡ˆˆ‘”–Science, –‘ 7 ‡•–‹ƒ–‡ –Š‡ ”‡’”‘†— ‹„‹Ž‹–›‘ˆ’•› Š‘Ž‘‰‹ ƒŽ• ‹‡ ‡Ǥ ȋ͸Ȍǡ͸ͷ͹MixedǦ͸͸ͲǤ-  ‹Š‡‹”‘ǡ ǤǤǡeffectsƬ modelsƒ–‡•ǡǤǤȋʹͲͲʹȌǤ‹‡ƒ”‹š‡† in S and S-Plus Ǧ‡ˆˆ‡ –•‘†‡Ž•ǣ„ƒ•‹  ‘ ‡’–•ƒ†‡šƒ’Ž‡•Ǥ Ǥ‡™‘”ǣ’”‹‰‡”Ǥ

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‡‹‹‰Šƒ—•ǡǤǡ‡’–‘ǡǤ ǤǡƒŽƒ‰‰‹ƒǡǤǡ”ƒ‹‰ǡǤǤǡ ƒ”‡–›ǡǤǡ›‡Œ‹ƒƒǡǤǡǤǤǤǡ ƬƒœœƒǡǤ ȋʹͲͳ͸ȌǤ–”‡•••‡•‹–‹˜‹–›ǡƒ„‡””ƒ–•ƒŽ‹‡ ‡ǡƒ†–Š”‡ƒ–ƒ–‹ ‹’ƒ–‹‘‹‡ƒ”Ž›’•› Š‘•‹•ǣƒSchizophrenia bulletin, 42 ‡š’‡”‹‡ ‡•ƒ’Ž‹‰•–—†›Ǥ ȋ͵Ȍǡ͹ͳʹǦ͹ʹʹǤ ‘›•–‘ǡǤǡŽ–ƒǡǤ ǤǡƬƒ—‡”„”‡‹ǡǤȋʹͲͲ͸ȌǤ‹ Š‘–‘‹œ‹‰ ‘–‹—‘—•’”‡†‹ –‘”•‹—Statistics in medicine, 25 Ž–‹’Ž‡ ”‡‰”‡••‹‘ǣƒ„ƒ†‹†‡ƒǤ ȋͳȌǡͳʹ͹ǦͳͶͳǤ ‡Ž–‡ǡ ǤǤǡActaƬ Psychiatricaƒ–‘”Ǧ ”ƒƒ‡ǡǤȋʹͲͳͶȌǤŠ‹Ž†Š‘‘†–”ƒ—ƒƒ†–Š‡–”‡ƒ–‡–ˆ‘”’•› Š‘–‹ †‹•‘”†‡”Ǥ Scandinavica, 129 ȋ͸ȌǡͶ͹ͻǦͶͺͲǤ  Š‹‡Žœ‡–Šǡ Ǥǡ Ƭ ‘”•–‡‹‡”ǡBehavioral Ǥ ȋEcology,ʹͲͲͺȌǤ ‘ Ž—•‹‘•20 „‡›‘† •—’’‘”–ǣ ‘˜‡” ‘ˆ‹†‡– ‡•–‹ƒ–‡• ‹ ‹š‡†‘†‡Ž•Ǥ ȋʹȌǡͶͳ͸ǦͶʹͲǤ ‹–‘ǡǤǡ‡–ƒŽŽǡǤǤǡŠ‡˜Ž‹ǡǤǡƬ‡ŽŽ™‘‘†ǡǤȋʹͲͳͶȌǤ••‘ ‹ƒ–‹‘•„‡–™‡‡•’‡ ‹ˆ‹ ’•› Š‘–‹ 

•›’–‘•ƒ†•’‡ ‹ˆ‹  Š‹Ž†Š‘‘†ƒ†˜‡”•‹–‹‡•ƒ”‡‡†‹ƒ–‡†„›ƒ––ƒ Š‡–•–›Ž‡•ǣƒƒƒŽ›•‹•Psychiatry research, 217 3 ‘ˆ–Š‡ƒ–‹‘ƒŽ‘‘”„‹†‹–›—”˜‡›Ǥ ȋ͵ȌǡʹͲʹǦʹͲͻǤ –‘‡ǡǤǤǡŠ‹ˆˆƒǡǤǡ Š™ƒ”–œǡ ǤǤǡ”‘†‡”‹ ǡ ǤǤǡBritish Medical Jorunal, 324Ƭ —ˆˆ‘”†ǡǤǤȋʹͲͲʹȌǤƒ–‹‡–‘Ǧ ‘’Ž‹ƒ ‡ ™‹–Š’ƒ’‡”†‹ƒ”‹‡•Ǥ ȋ͹͵Ͷ͹Ȍǡͳͳͻ͵ǦͳͳͻͶǤ ‡”Ž—‹ǡǤǡ†‡‘‡”ǡǤǤǡƬ†‡‡–ǡ ǤǤȋʹͲͳ͸ȌǤ‹ˆˆ‡”‡ ‡•‹‘‡ –‹‘–”‡‰–Š„‡–™‡‡‡–ƒŽ ›’–‘•‹‰Š–‡š’Žƒ‹‡†„›‹ˆˆ‡”‡ ‡•‹ƒ”‹ƒ ‡ǣ‡ƒƒŽ›•‹•‘ˆ‡–™‘”ƒ–ƒ‹†PloS one, 11 ‘–‘ˆ‹”–ƒ‰‹‰Ǥ ȋͳͳȌǤ ƒ‡••‡ǡǤǡ˜ƒ‹‡”‘’ǡǤǡ‡ ‘•–‡”ǡ Ǥǡ‡Ž‡•’ƒ—ŽǡǤǡ‡”‘ǡǤǡ†‡ ‡”–ǡǤǡǤǤǤƬ˜ƒ•ǡ ǤȋʹͲͳ͹ȌǤ •European •‡•‹–‹˜‹–›–‘†ƒ‹Ž›•–”‡••’Psychiatry, 45 ”‡†‹ –‹˜‡‘ˆ‘•‡–‘”’‡”•‹•–‡ ‡‘ˆ’•› Š‘’ƒ–Š‘Ž‘‰›ǫ  ǡͳ͸͹Ǧͳ͹͵Ǥ ƒƒǡǤǤǡ˜ƒ‹‡”‘’ǡǤǡ‹‡ Š–„ƒ—‡”ǡǤǡ‡Ž–Š‘”•–ǡǤǡ˜ƒ‹‡ŽǡǤǡ”—‰‰‡ƒǡǤǡǤǤǤƬ›‹Ǧ ‡”‡›•ǡ ǤȋʹͲͳͷȌǤŠ‹Ž†Š‘‘†ƒ„—•‡ƒ†‡‰Ž‡ –‹”‡Žƒ–‹‘–‘–Š‡’”‡•‡ ‡ƒ†’‡”•‹•–‡ ‡Psychological Medicine 4 ‘ˆ’•› Š‘–‹ ƒ††‡’”‡••‹˜‡•›’–‘ƒ–‘Ž‘‰›Ǥ ǡ ͷȋ͹Ȍǡͳ͵͸͵Ǧͳ͵͹͹Ǥ ˜ƒ‹‡”‘’ǡǤǡ‡ ‡‹ǡǤǡ›‹Ǧ ‡”‡›•ǡ Ǥǡ‘ŽŽ‹’ǡǤǡ‹‡ Š–„ƒ—‡”ǡǤǡ ƒ ‘„•ǡǤǡ‡”‘ǡǤǡŠ‹‡”›ǡǤǡ ˜ƒ•ǡ ǤǡƬ˜ƒ‹‡ŽǡǤȋʹͲͳͺȌǤ–”‡••”‡ƒ –‹˜‹–›Ž‹• Š‹Ž†Š‘‘†–”ƒ—ƒ‡š’‘•—”‡–‘ƒPsychiatry research, 1 ƒ†‹š–—”‡‘ˆ†‡’”‡••‹˜‡ǡƒš‹‡–›ǡƒ†’•› Š‘•‹••›’–‘•Ǥ ȋʹ͸ͲȌǡͶͷͳǦ Ͷͷ͹Ǥ ˜ƒ‹‡ŽǡǤǡ–‡ˆƒ‹•ǡǤǤǡƬ›‹Ǧ ‡”‡›•ǡ ǤȋʹͲͲͺȌǤ•› Š‘•‘ ‹ƒŽ•–”‡••ƒ†’•› Š‘•‹•Ǥ”‡˜‹‡™ Schizophrenia‘ˆ –Š‡ ‡—”‘„‹‘Ž‘‰‹ ƒŽ bulletin, 34 ‡ Šƒ‹•• ƒ† –Š‡ ‡˜‹†‡ ‡ ˆ‘” ‰‡‡Ǧ•–”‡•• ‹–‡”ƒ –‹‘Ǥ ȋ͸ȌǡͳͲͻͷǦͳͳͲͷǤ ƒ”‡•‡ǡ Ǥǡ‡‡–•ǡ Ǥǡ”—‡”ǡǤǡ‹‡˜‡”•‡ǡǤǡƒ–ƒ•–‡”ǡǤǡ‹‡ Š–„ƒ—‡”ǡǤǡǤǤǤƬ‡–ƒŽŽǡǤǤȋʹͲͳʹȌǤ Š‹Ž†Š‘‘† ƒ†˜‡”•‹–‹‡• ‹ ”‡ƒ•‡ –Š‡ ”‹• ‘ˆ ’•› Š‘•‹•ǣSchizophrenia ƒ ‡–ƒ bulletinǦƒƒŽ›•‹•, 38 ‘ˆ ’ƒ–‹‡–Ǧ ‘–”‘Žǡ ’”‘•’‡ –‹˜‡Ǧƒ† ”‘••Ǧ•‡ –‹‘ƒŽ ‘Š‘”–•–—†‹‡•Ǥ ȋͶȌǡ͸͸ͳǦ͸͹ͳǤ

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‡Ž‹‰ǡ Ǥǡ ‘—‘––‡ǡ Ǥǡ ‘–Ǧ‘Ž†‡”ǡ Ǥǡ ˜ƒ •ǡ Ǥǡ Ƭ ˜ƒ †‡” ƒƒ‰ǡ Ǥ ȋʹͲͳPsychological͸ȌǤ Š‹Ž†Š‘‘† medicine, –”ƒ—ƒǡ 46’•› Š‘•‹•Ž‹ƒ„‹Ž‹–›ƒ†•‘ ‹ƒŽ•–”‡••”‡ƒ –‹˜‹–›ǣƒ˜‹”–—ƒŽ”‡ƒŽ‹–›•–—†›Ǥ ȋͳ͸Ȍǡ͵͵͵ͻǦͶͺǤ ‡‹Œ‡”•ǡ Ǥǡ–‡ƒ–‡ǡǤǡ—”‡Ž‹‰•Ǧ‘–‡‘‡ǡǤǡ‹‡ Š–„ƒ—‡”ǡǤǡƒ’ƒƒ”–ǡǤǡƒ–‡ƒǡǤǡƬ‡Ž–‡ǡ ǤǦǤȋʹͲͳ͸ȌǤ‡–ƒŽ‹œƒ–‹‘BMC psychiatryǦ„ƒ•‡†–”‡ƒ–‡–ˆ‘”’•› Š‘–‹ †‹•‘”†‡”ǣ’”‘–‘ ‘Ž‘ˆƒ”ƒ†‘‹œ‡†, 16 ‘–”‘ŽŽ‡†–”‹ƒŽǤ ȋͳͻͳȌǤ Š‹•ƒǡ ǤǤǡ Ƭ  Ž‡ŽŽƒ†ǡ Ǥ Ǥ ȋʹͲͲͷȌǤJournal ‡•‹‰‹‰ǡ of Family –‡•–‹‰ǡ Psychology, ƒ† ‹–‡”’”‡–‹‰ 19 ‹–‡”ƒ –‹‘• ƒ† ‘†‡”ƒ–‘”‡ˆˆ‡ –•‹ˆƒ‹Ž›”‡•‡ƒ” ŠǤ ȋͳȌǡͳͳͳǦͳʹͲǤ                 

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Chapter Four: THE RELATIONSHIPŠ‡”‡Žƒ–‹‘•Š‹’„‡–™‡‡ Š‹Ž†Š‘‘†ƒ„—•‡ ƒ†•‡˜‡”‹–›‘ˆ Schizophrenia’•› Š‘•‹•‹• Research‡†‹ƒ–‡† (2019)„›Ž‘‡Ž‹‡••ǣƒ‡š’‡”‹‡ ‡•ƒ’Ž‹‰•–—†›

LisaBETWEEN Steenkamp1,2,3,4*, Jonas Weijers 1 ,5CHILDHOOD, Jorinde Gerrmann1,2,6,7, Elisabeth Eurelings -Bontekoe2, & Jean- PaulABUSE Selten1,5 AND SEVERITY OF PSYCHOSIS IS MEDIATED BY LONELINESS: AN EXPERIENCE SAMPLING STUDY

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‹˜‹‡”†—‹‡ •–‹–—–‡ˆ‘”‡–ƒŽ ‡ƒŽ–Šƒ”‡ǡ–Š‡‡–Š‡”Žƒ†• ʹ ‡’ƒ”–‡–‘ˆŽ‹‹ ƒŽƒ† ‡ƒŽ–Š•› Š‘Ž‘‰›ǡ‡‹†‡‹˜‡”•‹–›ǡ–Š‡‡–Š‡”Žƒ†• ͵ ‡’ƒ”–‡–‘ˆŠ‹Ž†ƒ††‘Ž‡• ‡–•› Š‹ƒ–”›Ȁ•› Š‘Ž‘‰›ǡ”ƒ•—•‡†‹ ƒŽ‡–‡”Ǧ‘’Š‹ƒhildren’s ‘•’‹–ƒŽǡ‘––‡”†ƒǡ–Š‡‡–Š‡”Žƒ†•Ǥ Ͷ  ‡‡”ƒ–‹‘–—†›‰”‘—’ǡ”ƒ•—•‡†‹ ƒŽ‡–‡”ǡ‘––‡”†ƒǡ–Š‡‡–Š‡”Žƒ†•Ǥ ͷ  Š‘‘Žˆ‘”‡–ƒŽ ‡ƒŽ–Šƒ†‡—”‘• ‹‡ ‡ǡƒƒ•–”‹ Š–‹˜‡”•‹–›ǡ–Š‡‡–Š‡”Žƒ†•Ǥ ͸ ‘—†ƒ–‹‘‡–”—̵Ͷͷǡ–Š‡‡–Š‡”Žƒ†•Ǥ ͹ L.‡’ƒ”–‡–‘ˆ•› Š‹ƒ–”›ǡ‡‹†‡‹˜‡”•‹–›‡†‹ ƒŽ‡–‡”ǡ Steenkamp, J.G. Weijers, J. Gerrmann, –Š‡‡–Š‡”Žƒ†•Ǥ ȗ E.H.M‘””‡•’‘†‹‰ Eurelings-Bontekoe,ƒ—–Š‘”ǣ‹•ƒ–‡‡ƒ’ǡ J.-P.C.J.”Ǥ ‘Ž‡™ƒ–‡”’Ž‡‹ Selten ͶͲǡ͵Ͳͳͷ ‘––‡”†ƒǤ ƒ‹Žƒ††”‡••ǣŽǤ•–‡‡ƒ’̷‡”ƒ•—• ǤŽ

Schizophrenia Research (2019) Chapter Chapter

146807_JonasWeijers_BNW_def.indd 69 28-10-2020 15:08 Chapter Four

Abstract Background.

Š‹••–—†›–‡•–‡†–Š‡Š›’‘–Š‡•‡•–Šƒ–ȋ‹Ȍ–Š‡”‡Žƒ–‹‘•Š‹’„‡–™‡‡ƒŠ‹•–‘”›‘ˆ Š‹Ž†Š‘‘†ƒ„—•‡ƒ†•‡˜‡”‹–›‘ˆ’•› Š‘•‹•‹•‡†‹ƒ–‡†„›Ž‘‡Ž‹‡••Ǣȋ‹‹Ȍ–Š‡”‡Žƒ–‹‘•Š‹’„‡–™‡‡ Ž‘‡Ž‹‡••ƒ†’•› Š‘•‹•‹•‡†‹ƒ–‡†„›™‹–Š‹Ǧ’‡”•‘ˆŽ— –—ƒ–‹‘•‹†‡’”‡••‹˜‡ƒ†ƒš‹‘—• ˆ‡‡Ž‹‰•ǤMethods. ‹ˆ–›Ǧ‹‡‹†‹˜‹†—ƒŽ•™‹–Š‘Ǧƒˆˆ‡ –‹˜‡’•› Š‘–‹ †‹•‘”†‡””ƒ–‡†–Š‡‹–‡•‹–›‘ˆ Ž‘‡Ž‹‡••ǡ’‘•‹–‹˜‡•›’–‘•ǡƒ††‡’”‡••‹˜‡ƒ†ƒš‹‘—•ˆ‡‡Ž‹‰•†—”‹‰”‡’‡ƒ–‡†‘‡–•‹ †ƒ‹Ž›Ž‹ˆ‡ȋš’‡”‹‡ ‡ƒ’Ž‹‰‡–Š‘†ȌǤŠ‹Ž†Š‘‘†ƒ„—•‡™ƒ•ƒ••‡••‡†”‡–”‘•’‡ –‹˜‡Ž›—•‹‰–Š‡ ‘Childhood Experience of Care and Abuse’ interview. ‘–‡•––Š‡‡†‹ƒ–‹‘Š›’‘–Š‡•‡•ǡƒ—Ž–‹Ž‡˜‡Ž •–”— –—”ƒŽ‡“—ƒ–‹‘‘†‡Ž‹‰’ƒ”ƒ†‹‰™ƒ•—•‡†ǤResults.  •’”‡†‹ –‡†ǡ–Š‡”‡Žƒ–‹‘•Š‹’„‡–™‡‡•‡˜‡”‹–›‘ˆ Š‹Ž†Š‘‘†ƒ„—•‡ƒ†’‘•‹–‹˜‡•›’–b = p ‘• ™ƒ•‡†‹ƒ–‡†„›Ž‘‡Ž‹‡••ȋ ͲǤͲͺǡͻͷΨ ȏͲǤͲʹǡͲǤͳ͵Ȑǡ αͲǤͲͲͷȌǤ –—”ǡ–Š‡”‡Žƒ–‹‘•Š‹’ „‡–™‡‡Ž‘‡Ž‹‡••ƒ†’‘•‹–‹˜‡•›’–‘•™ƒ•‡†‹ƒ–‡†„›™‹–Š‹b p b Ǧ’‡”•‘ˆŽ— –—ƒ–‹‘•‹„‘–Š = †‡’”‡••‹˜‡ȋ αͲǤͲͶǡͻͷΨ ȏͲǤͲʹǡͲǤͲ͸Ȑǡ δͲǤͲͲͳȌƒ†ƒš‹‘—•ȋ αͲǤͲʹǡͻͷΨ ȏͲǤͲͳǡͲǤͲ͵Ȑb = ǡ’ ͲǤͲͲʹȌ•›’–‘ƒ–‘Ž‘‰›Ǥ‡’”‡••‹‘™ƒ•ƒ•–”‘‰‡”‡†‹ƒ–‘”–Šƒƒš‹‡–›ȋp ͲǤͲʹǡͻͷΨ ȏͲǤͲͲǡ ͲǤͲͶȐǡConclusionsαͲǤͲʹ͹ȌǤ.  —”ˆ‹†‹‰•Š‹‰ŠŽ‹‰Š––Š‡”‘Ž‡‘ˆ Š‹Ž†Š‘‘†ƒ„—•‡ƒ†Ž‘‡Ž‹‡••‹–Š‡ •‡˜‡”‹–›‘ˆ ’•› Š‘•‹•‹†ƒ‹Ž›Ž‹ˆ‡Ǥ  Keywords: Š‹Ž†Š‘‘†–”ƒ—ƒǢ ‡š’‡”‹‡ ‡•ƒ’Ž‹‰‡–Š‘†Ǣ•‘ ‹ƒŽ†‡ˆ‡ƒ–Ǣ†‡’”‡••‹‘Ǣƒš‹‡–›Ǣ‘Ǧ ƒˆˆ‡ –‹˜‡’•› Š‘–‹ †‹•‘”†‡”Ǥ Introduction

Š‹Ž†Š‘‘†ƒ„—•‡‹•”‡Žƒ–‡†–‘ƒ‹ ”‡ƒ•‡†”‹•ˆ‘”’•› Š‘•‹•ȋ”•‡‡ƒ—Ž–‡–ƒŽǤǡʹͲͳͳǢ‡†ƒŽŽǡ ƒ •‘ǡ —Ž„‡”–ǡƬ ‘””›ǡʹͲͲͺǢƒ–Š‡•‘ǡŠ‡’Š‡”†ǡ‹ Š„‡ ǡƒ—”‡•ǡƬƒ””ǡʹͲͳ͵Ǣƒ”‡•‡ ‡–ƒŽǤǡʹͲͳʹȌǤŠ‡”‡‹•ƒŽ•‘ ‘•‹†‡”ƒ„Ž‡‡˜‹†‡ ‡ˆ‘”ƒ†‘•‡Ǧ”‡•’‘•‡”‡Žƒ–‹‘•Š‹’ǡ‹†‹ ƒ–‹‰–Šƒ– ——Žƒ–‹˜‡‡š’‘•—”‡–‘ƒ„—•‡‹•”‡Žƒ–‡†–‘‹ ”‡ƒ•‡†’•› Š‘•‹•Ž‹‡Ž‹Š‘‘†ȋƒ”‹Ƭ‡ƒ†ǡʹͲͲͺǢ ‘‰†‡ǡƒ’•‘ǡƬ‡ƒ†ǡʹͲͳ͸Ȍƒ†•‡˜‡”‹–›‘ˆ•›’–‘•‘ˆ’•› Š‘•‹•ǡ•— Šƒ•ŠƒŽŽ— ‹ƒ–‹‘•ǡ †‡Ž—•‹‘•ǡƒ†’ƒ”ƒ‘‹ƒ‡ƒ†ǡ˜ƒ•ǡ‘””‹•‘Ƭ‘••ǡʹͲͲͷǢ˜ƒ‹‡”‘’‡–ƒŽǤǡʹͲͳͶȌǤŠ‡•‘ ‹ƒŽ †‡ˆ‡ƒ–Š›’‘–Š‡•‹•’‘•‹–•–Šƒ––Š‹•”‡Žƒ–‹‘•Š‹’ƒ›„‡‡š’Žƒ‹‡†„›–Š‡•‡•‹–‹œƒ–‹‘‘ˆ–Š‡ ‡•‘Ž‹„‹ †‘’ƒ‹‡•›•–‡ȋ‡Ž–‡Ƭƒ–‘”Ǧ ”ƒƒ‡ǡʹͲͲͷǢ‡Ž–‡ǡ˜ƒ†‡”‡ǡ—––‡ǡƬƒ–‘”Ǧ ”ƒƒ‡ǡʹͲͳ͵ȌǤ †‡‡†ǡ–™‘•–—†‹‡•Šƒ˜‡•Š‘™†‘’ƒ‹‡•‡•‹–‹œƒ–‹‘‹’•› Š‘–‹ ƒ†‘Ǧ

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146807_JonasWeijers_BNW_def.indd 70 28-10-2020 15:08 The relationship between childhood abuse, psychosis and loneliness

’•› Š‘–‹ ‹†‹˜‹†—ƒŽ•™Š‘”‡’‘”–‡†ƒŠ‹•–‘”›‘ˆ Š‹Ž†Š‘‘†ƒ„—•‡ȋ‰‡”–‘‡–ƒŽǤǡʹͲͳ͸Ǣ•™ƒŽ†‡–ƒŽǤǡ ʹͲͳͶȌǤ ‘‡Ž‹‡••‹•–Š‘—‰Š––‘”‡’”‡•‡–ƒ ‘•‡“—‡ ‡‘ˆ•‘ ‹ƒŽ†‡ˆ‡ƒ––Šƒ–ƒ›ƒ ‘—–ˆ‘”–Š‡ ’ƒ–Š™ƒ›ˆ”‘ Š‹Ž†Š‘‘†ƒ„—•‡–‘’•› Š‘•‹•ȋŠ‡˜Ž‹ǡ Ž”‘›Ƭ—”’Š›ǡʹͲͳͷǢ˜ƒ‹‡”‘’‡–ƒŽǤǡ ʹͲͳͶȌǤ–—†‹‡•Šƒ˜‡•Š‘™–Šƒ–ƒ„—•‡†—”‹‰ Š‹Ž†Š‘‘†‹•ƒ••‘ ‹ƒ–‡†™‹–Šˆ‡‡Ž‹‰•‘ˆŽ‘‡Ž‹‡••‹ ƒ†—Ž–Š‘‘†ȋ ‹„•‘Ƭ ƒ”–•Š‘”‡ǡͳͻͻ͸Ǣ‡”œƬ ƒǡʹͲͳ͵Ǣ—”’Š›ǡŠ‡˜Ž‹ǡ†ƒ•‘ǡƬ ‘—•–‘ǡ ʹͲͳ͵Ȍƒ†–Šƒ–’ƒ–‹‡–•™‹–Š’•› Š‘•‹•Šƒ˜‡ƒ•‹šǦˆ‘Ž†‹ ”‡ƒ•‡‹ˆ‡‡Ž‹‰•‘ˆŽ‘‡Ž‹‡•• ‘’ƒ”‡†–‘ Š‡ƒŽ–Š›‹†‹˜‹†—ƒŽ•ȋ‡Ž–œ‡”‡–ƒŽǤǡʹͲͳ͵ȌǤ —”–Š‡”‘”‡ǡƒ”‡ ‡–‡–ƒǦƒƒŽ›•‹•†‡‘•–”ƒ–‡†ƒ ”‘„—•–’‘•‹–‹˜‡ƒ••‘ ‹ƒ–‹‘„‡–™‡‡Ž‘‡Ž‹‡••ƒ†•‡˜‡”‹–›‘ˆ’‘•‹–‹˜‡•›’–‘•ȋ‹ ŠƒŽ•ƒǡ Š‘†‡•ǡƒ•‹Ž‘’‘—Ž‘—Ƭ —––‘ǡʹͲͳ͹ȌǤ Š‹Ž‡Ž‘‡Ž‹‡••’”‡˜‹‘—•Ž›™ƒ•ƒ‹Ž›‹–‡”’”‡–‡†–‘„‡ƒ ‘•‡“—‡ ‡‘ˆ’•› Š‘•‹•ǡ ”‡•‡ƒ” Š‡”•ƒ”‡‘™•Š‹ˆ–‹‰–‘™ƒ”†•–Š‡‹†‡ƒ–Šƒ–Ž‘‡Ž‹‡••ƒ›ƒŽ•‘„‡ƒ ƒ—•ƒŽˆƒ –‘”‹–Š‡

†‡˜‡Ž‘’‡–‘ˆ’•› Š‘•‹•ȋ ƒ›‡”Ǧ†‡”•‘Ƭ‘”‰ƒǡʹͲͳ͵Ǣ‹ ŠƒŽ•ƒ‡–ƒŽǤǡʹͲͳ͹Ǣ˜ƒ†‡”‡”ˆǡ 4 ˜ƒ‹‡Žǡ˜ƒ‘š–‡ŽǡƬ˜ƒ•ǡʹͲͳͲȌǤŠ‹•‹••—’’‘”–‡†„›–Š‡ˆ‹†‹‰•–Šƒ–•‘ ‹ƒŽ‹•‘Žƒ–‹‘ ’”‡ ‡†‡•–Š‡‘•‡–‘ˆ’•› Š‘•‹•ȋ ‘ˆˆƒǡʹͲͲ͹Ȍƒ†–Šƒ–’ƒ–‹‡–•–Š‡•‡Ž˜‡•’‡” ‡‹˜‡Ž‘‡Ž‹‡•• ƒ• ƒ—•ƒŽ–‘–Š‡‹”’•› Š‘•‹•”ƒ–Š‡”–Šƒ ‘•‡“—‡–‹ƒŽȋ‰‡”‡›‡”ƬŽ—•ƒǡͳͻͺͺǢƒˆƒ”‡–ƒŽǤǡ ʹͲͲͺȌǤ‡”Šƒ’•†—‡–‘•‡•‹–‹œƒ–‹‘‘ˆ–Š‡‡•‘Ž‹„‹ †‘’ƒ‹‡•›•–‡ǡƒ˜‹ –‹‘ˆ Š‹Ž†Š‘‘† ƒ„—•‡ƒ›„‡ ‘‡‘”‡•‡•‹–‹˜‡–‘•—„•‡“—‡–‡š’‡”‹‡ ‡•‘ˆ•‘ ‹ƒŽ†‡ˆ‡ƒ–ǡ•— Šƒ•Ž‘‡Ž‹‡••ǡ ƒ†”‡ƒ –•™‹–ŠŠ‡‹‰Š–‡‡†’‘•‹–‹˜‡•›’–‘•Ǥ Ž›ƒˆ‡™•–—†‹‡•Šƒ˜‡‡šƒ‹‡†Ž‘‡Ž‹‡••ƒ•ƒ‡†‹ƒ–‹‰ˆƒ –‘”‹–Š‡ƒ••‘ ‹ƒ–‹‘ „‡–™‡‡ Š‹Ž†Š‘‘†ƒ„—•‡ƒ†’•› Š‘•‹•Ǥ‡•–—†›†‡‘•–”ƒ–‡†–Šƒ–Ž‘‡Ž‹‡••‡†‹ƒ–‡†–Š‡ ”‡Žƒ–‹‘•Š‹’„‡–™‡‡ Š‹Ž†Š‘‘†ƒ„—•‡ƒ††‹ƒ‰‘•‡•‘ˆ•‡˜‡”ƒŽ’•› Š‹ƒ–”‹ †‹•‘”†‡”•ǡ‹ Ž—†‹‰ ’•› Š‘•‹•ȋŠ‡˜Ž‹‡–ƒŽǤǡʹͲͳͷȌǤ ’ƒ–‹‡–•™‹–Š•—„Ǧ Ž‹‹ ƒŽ’•› Š‘•‹•ǡŽ‘‡Ž‹‡••™ƒ•ˆ‘—†–‘ ‡†‹ƒ–‡–Š‡”‡Žƒ–‹‘•Š‹’„‡–™‡‡ Š‹Ž†Š‘‘†ƒ„—•‡ƒ†’‘•‹–‹˜‡•›’–‘•ȋ‘›†ƒƬ ‡‡–‡”•ǡ ʹͲͳͷȌǤ –—”ǡ–Š‡”‡Žƒ–‹‘•Š‹’„‡–™‡‡Ž‘‡Ž‹‡••ƒ†’•› Š‘•‹•ƒ›„‡‡š’Žƒ‹‡†„›†‡’”‡••‹˜‡ ƒ†ƒš‹‘—•ˆ‡‡Ž‹‰•ȋ ƒ›ƒǡ ‹ŽŽƒǡ‡‹‹‰‡”ǡ ‘ŽŽ™‹–œ‡”ǡƬ‹ ‘ŽǡʹͲͳ͸Ǣò†‡”ƒǡ ™—‡”‡ǡƒ‡ǡ‘”‰ƒǡƬ—‹’‡”•ǡʹͲͳͶȌǤŠ‹•‹••—’’‘”–‡†„›’”‘•’‡ –‹˜‡•–—†‹‡••Š‘™‹‰–Šƒ– Ž‘‡Ž‹‡••‹•ƒ”‹•ˆƒ –‘”ˆ‘”†‡’”‡••‹˜‡ƒ†ƒš‹‘—••›’–‘ƒ–‘Ž‘‰›ȋƒ ‹‘’’‘ǡ ƒ™Ž‡›ǡƬ Š‹•–‡†ǡʹͲͳͲǢƒ ‹‘’’‘ǡ —‰Š‡•ǡƒ‹–‡ǡ ƒ™Ž‡›ǡƬŠ‹•–‡†ǤʹͲͲ͸Ǣ”ƒ‡”‡–ƒŽǤǡʹͲͳ͵Ǣ‹ǡ ‘†‡„ƒ—‰Šǡ›’Š—”ǡƬ Ž‡‡•‘ǡʹͲͳ͸Ȍƒ†–Šƒ–•›’–‘•‘ˆ’•› Š‘•‹•ƒ”‡’”‡†‹ –‡†„›†‡’”‡••‹˜‡ ƒ†ƒš‹‘—•ˆ‡‡Ž‹‰•ȋ‡Ž‡•’ƒ—Žǡ†‡”‹‡•ǡƬ˜ƒ•ǡʹͲͲʹǢ ‘™Ž‡”‡–ƒŽǤǡʹͲͳͳǢ ”‡‡ƒ‡–ƒŽǤǡʹͲͲͷǢ ¡ˆ‡”‡–ƒŽǤǡʹͲͲͷǢ”ƒ‡”‡–ƒŽǤǡʹͲͳͶǢ–ƒ”–—’ǡ ”‡‡ƒǡƬ ƒ”‡–›ǡʹͲͲ͹ȌǤ

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146807_JonasWeijers_BNW_def.indd 71 28-10-2020 15:08 Chapter Four

‡”‡ǡ™‡–‡•––Š‡Š›’‘–Š‡•‡•ȋ‹Ȍ–Šƒ–Ž‘‡Ž‹‡••‹’ƒ–‹‡–•™‹–Š‘Ǧƒˆˆ‡ –‹˜‡’•› Š‘–‹  †‹•‘”†‡”‡†‹ƒ–‡•–Š‡”‡Žƒ–‹‘•Š‹’„‡–™‡‡ƒŠ‹•–‘”›‘ˆ Š‹Ž†Š‘‘†ƒ„—•‡ƒ†•‡˜‡”‹–›‘ˆ’•› Š‘•‹•Ǣ ȋ‹‹Ȍ–Šƒ––Š‡”‡Žƒ–‹‘•Š‹’„‡–™‡‡Ž‘‡Ž‹‡••ƒ†’•› Š‘•‹•‹•‡†‹ƒ–‡†„›™‹–Š‹Ǧ’‡”•‘ ˆŽ— –—ƒ–‹‘•‹†‡’”‡••‹˜‡ƒ†ƒš‹‘—•ˆ‡‡Ž‹‰•Ǥ ‡‡Ž‹‰••— Šƒ•Ž‘‡Ž‹‡••ǡˆ‡ƒ”ǡ‘”•ƒ†‡••ƒ”‡„›†‡ˆ‹‹–‹‘‘‡–ƒ”›•–ƒ–‡ǦŽ‹‡ ‡š’‡”‹‡ ‡•–Š‡ˆŽ— –—ƒ–‹‰ƒ–—”‡‘ˆ™Š‹ Š ƒ‘–„‡ˆ—ŽŽ› ƒ’–—”‡†„›•–—†›‹‰„‡–™‡‡Ǧ’‡”•‘ †ƒ–ƒǤ‡–Š‡”‡ˆ‘”‡‡’Ž‘›‡†–Š‡š’‡”‹‡ ‡ƒ’Ž‹‰‡–Š‘†ȋȌǡƒ‹–‡•‹˜‡”‡’‡ƒ–‡†Ǧ ‡ƒ•—”‡•†‹ƒ”›–‡ Š‹“—‡–Šƒ–ƒŽŽ‘™•ˆ‘”–Š‡‹˜‡•–‹‰ƒ–‹‘‘ˆ’•› Š‘’ƒ–Š‘Ž‘‰›‹†ƒ‹Ž›Ž‹ˆ‡ ȋ ‡–‡”ǡ Š‹†–ǡƬ•‹•œ‡–‹ŠƒŽ›‹ǡʹͲͲ͹Ǣ›‹Ǧ ‡”‡›•ǡ‡Ž‡•’ƒ—ŽǡƬƒ•ǡʹͲͲͷȌǤ Material and Methods Subjects.

Š‹••–—†›‹•’ƒ”–‘ˆƒŽƒ”‰‡””‡•‡ƒ” Š’”‘Œ‡ –ǡ•‡‡‡‹Œ‡”•‡–ƒŽǤǡʹͲͳ͸ˆ‘”™Š‹ ŠͻͲ ’ƒ–‹‡–•™‹–Šƒ‘Ǧƒˆˆ‡ –‹˜‡’•› Š‘–‹ †‹•‘”†‡”ȋȌ™‡”‡”‡ ”—‹–‡†ˆ”‘ ‘—‹–›–”‡ƒ–‡– –‡ƒ•‹–Š‡‡–Š‡”Žƒ†•ȋ‡‹†‡ǡ‘‘”Š‘—–ǡ‘‡–‡”‡‡”ǡƒ†‡‹•–ȌǤŽŽ•—„Œ‡ –•‰ƒ˜‡™”‹––‡ ‹ˆ‘”‡† ‘•‡––‘’ƒ”–‹ ‹’ƒ–‡Ǥ‹ƒ‰‘•‡•‘ˆ•—„Œ‡ –•‹ Ž—†‡†• Š‹œ‘’Š”‡‹ƒǡ• Š‹œ‘ƒˆˆ‡ –‹˜‡ †‹•‘”†‡”ǡ• Š‹œ‘’Š”‡‹ˆ‘”†‹•‘”†‡”ǡ„”‹‡ˆ’•› Š‘–‹ †‹•‘”†‡”ǡ†‡Ž—•‹‘ƒŽ†‹•‘”†‡”ǡƒ†’•› Š‘–‹  †‹•‘”†‡”‘–‘–Š‡”™‹•‡•’‡ ‹ˆ‹‡†ȋȌǤ‹ƒ‰‘•‡•™‡”‡‡•–ƒ„Ž‹•Š‡†„›’•› Š‹ƒ–”‹•–•’”‹‘”–‘ ’ƒ”–‹ ‹’ƒ–‹‘ƒ†™‡”‡ ‘ˆ‹”‡†„›”‡•‡ƒ” Š‡”•—•‹‰–Š‡‘’”‡Š‡•‹˜‡••‡••‡–‘ˆ ›’–‘•ƒ† ‹•–‘”›ȋ†”‡ƒ•‡ǡ Žƒ—Ƭ”†–ǡͳͻͻʹȌǤ ‡‹ Ž—†‡†•—„Œ‡ –•‘ˆƒ–Ž‡ƒ•–ͳͺ›‡ƒ”•‘Ž†™Š‘™‡”‡ˆŽ—‡–‹–Š‡—– ŠŽƒ‰—ƒ‰‡ǤŠ‡ ˆ‹”•––”‡ƒ–‡–ˆ‘”’•› Š‘•‹•™ƒ•”‡“—‹”‡†–‘Šƒ˜‡•–ƒ”–‡†„‡–™‡‡͸‘–Š•ƒ†ͳͲ›‡ƒ”•ƒ‰‘Ǥ š Ž—•‹‘ ”‹–‡”‹ƒ™‡”‡ȋͳȌ‹ŽŽ‹–‡”ƒ ›ǡȋʹȌ‹–‡ŽŽ‡ –—ƒŽ†‹•ƒ„‹Ž‹–›ǡƒ†ȋ͵Ȍ•—„•–ƒ ‡ƒ††‹ –‹‘–Šƒ– ‡ ‡••‹–ƒ–‡††‡–‘š‹ˆ‹ ƒ–‹‘ǤDesign.  Š‡’”‡•‡–•–—†›—•‡†–Š‡ǡƒ‹–‡•‹˜‡†‹ƒ”›‡–Š‘†‹™Š‹ Š•—„Œ‡ –•ƒ”‡ ”‡’‡ƒ–‡†Ž›ƒ•‡†–‘ˆ‹ŽŽ‘—–“—‡•–‹‘ƒ‹”‡•‹–Š‡‹”†ƒ‹Ž›Ž‹ˆ‡Ǥ‡—•‡†ƒ‡Ž‡ –”‘‹ †‡˜‹ ‡ȋ–Š‡ ‘PsyMate’)–‘ ‘ŽŽ‡ ––Š‡”‡•’‘•‡•Ǥ—„Œ‡ –•™‡”‡’”‘’–‡†„›ƒ•‹‰ƒŽ–‡–‹‡•ƒ†ƒ›–‘ˆ‹ŽŽ‘—– ȋ‹†‡–‹ ƒŽȌ“—‡•–‹‘ƒ‹”‡•‘–Š‡•›ƒ–‡ˆ‘”ƒ—’–‘•‹š†ƒ›•Ǥ”‡˜‹‘—•”‡•‡ƒ” ŠŠƒ•†‡‘•–”ƒ–‡† –Š‡ˆ‡ƒ•‹„‹Ž‹–›ǡ”‡Ž‹ƒ„‹Ž‹–›ǡƒ†˜ƒŽ‹†‹–›‘ˆ‹‹†‹˜‹†—ƒŽ•™‹–Š’•› Š‘–‹ †‹•‘”†‡”•ȋ‡Ž‡•’ƒ—Žǡ†‡ ”‹‡•ǡƬMaterials˜ƒ•ǡʹͲͲʹǢ. ‹Š›‡–ƒŽǤǡʹͲͲ͸ǢŠ‡™‹••‡‡–ƒŽǤǡʹͲͳͳȌǤ Childhood Experience of Care and Abuse (CECA):

We used the ‘Childhood Experience of Care and Abuse’ (CECA) interview to measure childhood abuse retrospectively ȋ‹ˆ—Ž ‘ǡ”‘™ǡƬ ƒ””‹•ǡ ͳͻͻͶȌǤŠ‡‹•ƒ•‡‹Ǧ•–”— –—”‡†‹–‡”˜‹‡™–Šƒ–ƒ••‡••‡•–Š‡•‡˜‡”‹–›‘ˆ Š‹Ž†Š‘‘†ƒ„—•‡

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146807_JonasWeijers_BNW_def.indd 72 28-10-2020 15:08 The relationship between childhood abuse, psychosis and loneliness

„‡ˆ‘”‡–Š‡ƒ‰‡‘ˆͳ͹›‡ƒ”•ǤŠ‡‹ Ž—†‡•ˆ‘—”–›’‡•‘ˆ Š‹Ž†Š‘‘†ƒ„—•‡ǣ’ƒ”‡–ƒŽ ‘ˆŽ‹ –ǡ ’•› Š‘Ž‘‰‹ ƒŽƒ„—•‡ǡ•‡š—ƒŽƒ„—•‡ǡƒ†’Š›•‹ ƒŽƒ„—•‡Ǥ„—•‡™ƒ•ƒ••‡••‡†‘„‘–Šˆ”‡“—‡ ›ƒ† ‹–‡•‹–›Ǥ ”‡“—‡ ›™ƒ•”ƒ–‡†‘ƒˆ‹˜‡Ǧ’‘‹–‹‡”–Ǧ• ƒŽ‡ǣ‡˜‡”ȋͲȌǡ”ƒ”‡Ž›ȋͳȌǡ‹ ‹†‡–ƒŽŽ›ȋʹȌǡ ”‡‰—Žƒ”Ž›ȋ͵Ȍǡƒ†‘ˆ–‡ȋͶȌǤ –‡•‹–›™ƒ•”ƒ–‡†‘ƒˆ‘—”Ǧ’‘‹–‹‡”–• ƒŽ‡ǣ‘‡ȋͲȌǡ•‘‡ȋͳȌǡ ‘†‡”ƒ–‡ȋʹȌǡƒ†ƒ”‡†ȋ͵Ȍǡ™‹–Š–Š‡‡š ‡’–‹‘‘ˆ’ƒ”‡–ƒŽ ‘ˆŽ‹ –ǡ™Š‹ Š™ƒ•• ‘”‡†‘ƒˆ‹˜‡Ǧ ’‘‹–• ƒŽ‡–Šƒ–ƒŽ•‘‹ Ž—†‡†˜‹‘Ž‡ ‡ȋͶȌǤŠ‡•‡˜‡”‹–›‘ˆ‡ƒ Š–›’‡‘ˆƒ„—•‡™ƒ• ƒŽ —Žƒ–‡†„› —Ž–‹’Ž›‹‰ˆ”‡“—‡ ›™‹–Š‹–‡•‹–›ǤŠ‡•—‘ˆ–Š‡•‡˜‡”‹–›• ‘”‡•ˆ‘”–Š‡ˆ‘—”–›’‡•‘ˆƒ„—•‡ ”‡•—Ž–•‹ƒ’‘••‹„Ž‡–‘–ƒŽ• ‘”‡”ƒ‰‹‰ˆ”‘Ͳ–‘ͷʹǤŠ‡’‘••‹„Ž‡• ‘”‡•ˆ‘”’•› Š‘Ž‘‰‹ ƒŽƒ„—•‡ǡ •‡š—ƒŽƒ„—•‡ǡƒ†’Š›•‹ ƒŽƒ„—•‡”ƒ‰‡ˆ”‘Ͳ–‘ͳʹƒ†ˆ‘”’ƒ”‡–ƒŽ ‘ˆŽ‹ –ˆ”‘Ͳ–‘ͳ͸Ǥ ‘”‘—” ƒƒŽ›•‡•ǡ–Š‡–‘–ƒŽ•‡˜‡”‹–›• ‘”‡™ƒ•†‹˜‹†‡†„›ˆ‹˜‡‹‘”†‡”–‘ƒ˜‘‹†‘˜‡”Ž›•ƒŽŽ ‘‡ˆˆ‹ ‹‡–•Ǥ Š—•ǡƒ‘‡Ǧ—‹–‹ ”‡ƒ•‡‹–Š‡”‡• ƒŽ‡†•‡˜‡”‹–›• ‘”‡”‡•‡„Ž‡•ƒˆ‹˜‡Ǧ—‹–‹ ”‡ƒ•‡‹–Š‡ƒ –—ƒŽ •‡˜‡”‹–›• ‘”‡ǤESM measures:

ŽŽ‹–‡•™‡”‡”ƒ–‡†‘ƒ͹Ǧ’‘‹–‹‡”–• ƒŽ‡ǤŠ‡•‡˜‡”‹–›‘ˆ’‘•‹–‹˜‡ 4 •›’–‘• ‘•‹•–‡†‘ˆ–Š‡ƒ˜‡”ƒ‰‡• ‘”‡‘ˆ•‡˜‡‹–‡•–Šƒ–ƒ••‡••‡†˜ƒ”‹‘—•’‘•‹–‹˜‡•›’–‘• ȋŠ‡ƒ”‹‰˜‘‹ ‡•ǡˆ‡‡Ž‹‰—”‡ƒŽǡˆ‡‡Ž‹‰•—•’‹ ‹‘—•ǡ„‡‹‰ƒˆ”ƒ‹†–‘†‘•‘‡–Š‹‰— ‘–”‘ŽŽ‡†ǡˆ‡‡Ž‹‰ that others want to hurt him/her, feeling disliked, and thinking that one’s –Š‘—‰Š–•ƒ”‡„‡‹‰ ‘–”‘ŽŽ‡†„›‘–Š‡”•ȌǤ‡’”‡••‹˜‡ƒ†ƒš‹‘—•ˆ‡‡Ž‹‰•™‡”‡ƒ••‡••‡†„›–Š‡single items “I feel down” and “I feel anxious”. Loneliness was assessed by the single item “I feel lonely”, which is a ‘‘ƒ’’”‘ƒ Š‹•–—†‹‡•–‘Ž‘‡Ž‹‡••ȋ‘›†ƒƬ ‡‡–‡”•ǡʹͲͳͷǢ‘‘ǡͳͻͺ͹Ǣò†‡”ƒ‡– ƒŽǤǡʹͲͳͶȌƒ†‹• ‘’ƒ”ƒ„Ž‡–‘‘”‡ ‘’”‡Š‡•‹˜‡‡ƒ•—”‡•‘ˆŽ‘‡Ž‹‡••‹‡•–ƒ„Ž‹•Š‹‰–Š‡ ”‡Žƒ–‹‘•Š‹’™‹–Š’‘•‹–‹˜‡•›’–‘•ȋ‹ ŠƒŽ•ƒǡŠ‘†‡•ǡƒ•‹Ž‘’‘—Ž‘—ǡƬ —––‘ǡʹͲͳ͹ȌǤƒ Š ˜ƒ”‹ƒ„Ž‡Šƒ†ƒ’‘••‹„Ž‡• ‘”‡”ƒ‰‹‰ˆ”‘ͳStatistical Analyses. Ǧ͹Ǥ –ƒ–‹•–‹ ƒŽƒƒŽ›•‡•™‡”‡’‡”ˆ‘”‡†—•‹‰’Ž—•ȋ˜‡”•‹‘ͺȌǤŽŽ–‡•–• ™‡”‡ʹǦ–ƒ‹Ž‡†™‹–ŠƒƒŽ’ŠƒαǤͲͷǤŠ‡†ƒ–ƒŠƒ˜‡ƒ—Ž–‹Ž‡˜‡Ž•–”— –—”‡ǣ—Ž–‹’Ž‡‘„•‡”˜ƒ–‹‘• ȋ‡˜‡ŽͳȌƒ”‡‡•–‡†™‹–Š‹•—„Œ‡ –•ȋ‡˜‡ŽʹȌǤŠ‹Ž†Š‘‘†ƒ„—•‡™ƒ•ƒ••‡••‡†ƒ–‡˜‡Žʹ™Š‹Ž‡–Š‡ ”‡ƒ‹‹‰˜ƒ”‹ƒ„Ž‡•™‡”‡ƒ••‡••‡†ƒ–‡˜‡Žͳȋ‘„•‡”˜ƒ–‹‘•ȌǤ”ƒ†‹–‹‘ƒŽ‡–Š‘†•ˆ‘” ƒ••‡••‹‰‡†‹ƒ–‹‘ƒ”‡–Š‡”‡ˆ‘”‡‹ƒ’’”‘’”‹ƒ–‡ǡ’”‹ƒ”‹Ž›„‡ ƒ—•‡–Š‡ƒ••—’–‹‘‘ˆ•–ƒ–‹•–‹ ƒŽ ‹†‡’‡†‡ ‡‘ˆ”‡•‹†—ƒŽ•‹•˜‹‘Žƒ–‡†ǡ”‡•—Ž–‹‰‹—†‡”‡•–‹ƒ–‡†•–ƒ†ƒ”†‡””‘”•ƒ†‹ˆŽƒ–‡† ›’‡ ‡””‘”•Ǥ ‘”†‡”–‘–ƒ‡‹–‘ƒ ‘—––Š‡—Ž–‹Ž‡˜‡Ž•–”— –—”‡‘ˆ–Š‡†ƒ–ƒǡ™‡—•‡†ƒ—Ž–‹Ž‡˜‡Ž •–”— –—”ƒŽ‡“—ƒ–‹‘‘†‡Ž‹‰ȋȌ’ƒ”ƒ†‹‰ȋ”‡ƒ Š‡”ǡ›’Š—”ǡƬŠƒ‰ǡʹͲͳͲȌǤ†˜ƒ–ƒ‰‡•‘ˆ ƒ”‡–Š‡ƒ„‹Ž‹–›–‘•‡’ƒ”ƒ–‡„‡–™‡‡Ǧƒ†™‹–Š‹Ǧ•—„Œ‡ –‡ˆˆ‡ –•ǡ‘”‡“—‹”‡†ƒ••—’–‹‘‘ˆ ‘”ƒŽ‹–›ǡ ƒ†–Š‡—•‡‘ˆ”‘„—•–ƒš‹—Ž‹‡Ž‹Š‘‘†‡•–‹ƒ–‹‘–Šƒ– ƒƒ ‘‘†ƒ–‡—„ƒŽƒ ‡† Ž—•–‡”•Ǥ

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–”ƒ Žƒ•• ‘””‡Žƒ–‹‘•ȋ •Ȍ™‡”‡ ƒŽ —Žƒ–‡†–‘†‡–‡”‹‡‡Ž‹‰‹„‹Ž‹–›ˆ‘”–Š‡’”‘’‘•‡† ‡†‹ƒ–‹‘ƒŽ‘†‡Ž•ǤŠ‡ ”‡•‡„Ž‡•–Š‡’”‘’‘”–‹‘‘ˆ–Š‡„‡–™‡‡Ǧ•—„Œ‡ –˜ƒ”‹ƒ ‡”‡Žƒ–‹˜‡–‘ –Š‡–‘–ƒŽ˜ƒ”‹ƒ ‡ǤʹǦͳǦͳ‘†‡Ž™‹–Š”ƒ†‘•Ž‘’‡•ȋ”‡ƒ Š‡”‡–ƒŽǤǡʹͲͳͲȌ™ƒ•–‡•–‡†–‘ ‹˜‡•–‹‰ƒ–‡™Š‡–Š‡”Ž‘‡Ž‹‡••‡†‹ƒ–‡•–Š‡”‡Žƒ–‹‘•Š‹’„‡–™‡‡ Š‹Ž†Š‘‘†ƒ„—•‡ƒ†’‘•‹–‹˜‡ •›’–‘•ȋ•‡‡ ‹‰—”‡ͳȌǤ‡š–ǡ–™‘ͳǦͳǦͳ‘†‡Ž•™‹–Š”ƒ†‘•Ž‘’‡•ȋ”‡ƒ Š‡”‡–ƒŽǤǡʹͲͳͲȌ™‡”‡ –‡•–‡†–‘‹˜‡•–‹‰ƒ–‡™Š‡–Š‡”†‡’”‡••‹˜‡ƒ†ƒš‹‘—•ˆ‡‡Ž‹‰•‡†‹ƒ–‡–Š‡”‡Žƒ–‹‘•Š‹’„‡–™‡‡ Ž‘‡Ž‹‡••ƒ†’‘•‹–‹˜‡•›’–‘•ǤŠ‡Ž‘™‡”Ž‡˜‡Ž‡†‹ƒ–‹‘‘†‡Ž•ƒŽŽ‘™ˆ‘”–Š‡‹˜‡•–‹‰ƒ–‹‘‘ˆ „‘–Š„‡–™‡‡Ǧƒ†™‹–Š‹Ǧ•—„Œ‡ –‡ˆˆ‡ –•„‡ ƒ—•‡ƒŽŽ˜ƒ”‹ƒ„Ž‡•™‡”‡ƒ••‡••‡†ƒ–‡˜‡Žͳȋ ‘„•‡”˜ƒ–‹‘•ȌǤŠ‡„‡–™‡‡Ǧ•—„Œ‡ –Ž‡˜‡Ž”‡ˆŽ‡ –•–Š‡ƒ˜‡”ƒ‰‡‘ˆ•›’–‘•„‡–™‡‡‹†‹˜‹†—ƒŽ• ™Š‹Ž‡–Š‡™‹–Š‹Ǧ•—„Œ‡ –Ž‡˜‡Ž”‡•‡„Ž‡•–Š‡ˆŽ— –—ƒ–‹‘•‘ˆ•›’–‘•™‹–Š‹‹†‹˜‹†—ƒŽ•Ǥ ‡’”‡••‹˜‡ƒ†ƒš‹‘—•ˆ‡‡Ž‹‰•™‡”‡ƒŽ•‘–‡•–‡†‹ƒͳǦȋͳǦͳȌǦͳ—Ž–‹’Ž‡‡†‹ƒ–‘”‘†‡Žȋ”‡ƒ Š‡” ‡–ƒŽǤǡʹͲͳͲȌȋ•‡‡ ‹‰—”‡ʹȌ‹‘”†‡”–‘ƒ••‡••‹†‡’‡†‡ ‡ƒ† ‘’ƒ”‡–Š‡•–”‡‰–Š‘ˆ–Š‡ ‡†‹ƒ–‹‰‡ˆˆ‡ –•Ǥ 

Figure 1.

Level 2: Subjects  Childhood abuse X c’ 

Level 1: ESM observations a

 b w Positive Loneliness M symptoms Y  bb 



Figure 1. 

 ŽŽ—•–”ƒ–‹‘‘ˆ–Š‡ʹǦͳǦͳ—Ž–‹Ž‡˜‡Ž‡†‹ƒ–‹‘‘†‡Ž’”‡†‹ –‹‰’‘•‹–‹˜‡•›’–‘•ˆ”‘ Š‹Ž†Š‘‘† ƒ„—•‡˜‹ƒŽ‘‡Ž‹‡••Ǥዐ†‡’‡†‡–˜ƒ”‹ƒ„Ž‡ǡᏇ†‹ƒ–‘”ǡᆇ’‡†‡–˜ƒ”‹ƒ„Ž‡Ǣƒα„‡–™‡‡Ǧ•—„Œ‡ – ™ „ ‡ˆˆ‡ –’ƒ–Š ƒǢc’ᄇ–™‡‡Ǧ•—„Œ‡ –†‹”‡ –‡ˆˆ‡ –Ǣ„ α™‹–Š‹Ǧ•—„Œ‡ –‡ˆˆ‡ –’ƒ–Š„Ǣ„ ᄇ–™‡‡Ǧ•—„Œ‡ –‡ˆˆ‡ – ’ƒ–Š„Ǥ Figure 2

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Level 2: Subjects  Level 1: ESM observations  Feeling down ab M bb  a b w c ’ w w Positive Loneliness X c ’ symptoms Y a b b  w w ab Feeling bb  anxious M

Figure 2.

 ŽŽ—•–”ƒ–‹‘‘ˆ–Š‡ͳǦȋͳǦͳȌǦͳ—Ž–‹Ž‡˜‡Ž‡†‹ƒ–‹‘‘†‡Ž’”‡†‹ –‹‰’‘•‹–‹˜‡•›’–‘•ˆ”‘X M Y Ž‘‡Ž‹‡••˜‹ƒ†‡’”‡••‹˜‡ƒ†ƒš‹‘—•ˆ‡‡Ž‹‰•Ǥab a cb’ ዐ†‡’‡†‡–˜ƒ”‹ƒ„Ž‡ǡ Ꮗ†‹ƒ–‘”ǡcw’ ᆇ’‡†‡– bw b bb b

˜ƒ”‹ƒ„Ž‡Ǣ ᄇ–™‡‡Ǧ•—„Œ‡ –‡ˆˆ‡ –’ƒ–Š Ǣ ᄇ–™‡‡Ǧ•—„Œ‡ –†‹”‡ –‡ˆˆ‡ –Ǣ α™‹–Š‹Ǧ•—„Œ‡ –†‹”‡ – 4  ‡ˆˆ‡ –ǢResults α™‹–Š‹Ǧ•—„Œ‡ –‡ˆˆ‡ –’ƒ–Š Ǣ ᄇ–™‡‡Ǧ•—„Œ‡ –‡ˆˆ‡ –’ƒ–Š Ǥ Sample.

ˆ–Š‡ͻͲ•—„Œ‡ –•”‡ ”—‹–‡†ǡͻ•—„Œ‡ –•™‡”‡‡š Ž—†‡†„‡ ƒ—•‡–Š‡›”‡ˆ—•‡†‘” ˆƒ‹Ž‡†–‘ˆ‹ŽŽ‘—–ƒ›•›ƒ–‡“—‡•–‹‘ƒ‹”‡ƒ†ʹͳ•—„Œ‡ –•™‡”‡‡š Ž—†‡†„‡ ƒ—•‡–Š‡›ˆ‹ŽŽ‡†‘—– ˆ‡™‡”–ŠƒʹͲ•›ƒ–‡“—‡•–‹‘ƒ‹”‡•ǡ•‹‹Žƒ”–‘’”‹‘”•–—†‹‡•ȋ Žƒ•‡”ǡƒ•ǡ‘”–‡‰‹Œ•Ƭ›‹Ǧ ‡”‡›•ǡʹͲͲ͸Ǣƒ”†‹‘‹•ǡ‡‰‡Ž‡”•ǡƒ•ǡƬ›‹Ǧ ‡”‡›•ǡʹͲͳͳȌǤ ƒ††‹–‹‘ǡ‘‡•—„Œ‡ –™ƒ• ‡š Ž—†‡†„‡ ƒ—•‡•Š‡”‡ˆ—•‡†–‘ƒ•™‡”“—‡•–‹‘•ƒ„‘—–•‡š—ƒŽƒ„—•‡ǤŠ‡”‡ˆ‘”‡ǡ–Š‡ˆ‹ƒŽ•ƒ’Ž‡ ‘•‹•–‡†‘ˆͷͻ•—„Œ‡ –•Ǥ Š‡”‡™‡”‡•‘‡‹••‹‰˜ƒŽ—‡•ˆ‘”–Š‡˜ƒ”‹ƒ„Ž‡•Ž‘‡Ž‹‡••ȋʹͲ‹••‹‰ǢͳǤͲΨȌǡ †‡’”‡••‹‘ȋʹͻ‹••‹‰ǢͳǤͷΨȌǡƒš‹‡–›ȋͳͺ‹••‹‰ǢͲǤͻΨȌǡƒ†’‘•‹–‹˜‡•›’–‘•ȋ͵ͳ‹••‹‰Ǣ ͳǤ͸ΨȌǤ‡‡š Ž—†‡†‘„•‡”˜ƒ–‹‘•–Šƒ–Šƒ†‹••‹‰˜ƒŽ—‡•‘ƒ–Ž‡ƒ•–‘‡˜ƒ”‹ƒ„Ž‡Ǥˆ–‡” ‡š Ž—†‹‰͵ͳ‘„•‡”˜ƒ–‹‘•ǡ–Š‡ˆ‹ƒŽ†ƒ–ƒ•ƒ’Ž‡ ‘•‹•–‡†‘ˆͳͺͻ͸ȋͳͻʹ͹–͵ͳαͳͺͻ͸Ȍ ‘„•‡”˜ƒ–‹‘•Ǥ ƒ„Ž‡ͳ•Š‘™•–Š‡ Šƒ”ƒ –‡”‹•–‹ •‘ˆ–Š‡•–—†›•ƒ’Ž‡Ǥ –‘–ƒŽǡͶ͵•—„Œ‡ –•ȋ͹ʹǤͻΨȌ”‡’‘”–‡† •‘‡–›’‡‘ˆ Š‹Ž†Š‘‘†ƒ„—•‡Ǣ͵Ͷ•—„Œ‡ –•ȋͷ͹Ǥ͸ΨȌ‡š’‡”‹‡ ‡†’ƒ”‡–ƒŽ†‹• ‘”†ǡͳͷ•—„Œ‡ –• ȋʹͷǤͶΨȌ‡š’‡”‹‡ ‡†’Š›•‹ ƒŽƒ„—•‡ǡͳͷ•—„Œ‡ –•ȋʹͷǤͶΨȌ‡š’‡”‹‡ ‡†’•› Š‘Ž‘‰‹ ƒŽƒ„—•‡ǡƒ†͹ subjects (11.9%) experienced sexual abuse. Table 2 depicts the means, standard deviations, ICC’s, ƒ†‹–‡” ‘””‡Žƒ–‹‘•ˆ‘”ƒŽŽ•–—†›˜ƒ”‹ƒ„Ž‡•Ǥ Table 1. 

Šƒ”ƒ –‡”‹•–‹ •‘ˆ–Š‡•–—†›•ƒ’Ž‡ȋαͷͻȌǤ

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146807_JonasWeijers_BNW_def.indd 75 28-10-2020 15:08 Chapter Four

M SD n ‰‡ǡ ȋ Ȍǡ”ƒ‰‡  n     ͵ͳǤͺȋͻǤͶȌǡͳͻǦͷ͹ ‡šǡ ‡ȋΨȌ      ͵Ͷȋͷ͹Ǥ͸ΨȌ  Ǧ †‹ƒ‰‘•‹•ǡ ȋΨȌ   Š‹œ‘’Š”‡‹ƒ      ͵Ͷȋͷ͹Ǥ͸ΨȌ  •› Š‘–‹ ‹•‘”†‡”    ͳͲȋͳ͸ǤͻΨȌ   Š‹œ‘ƒˆˆ‡ –‹˜‡‹•‘”†‡”    ͳͲȋͳ͸ǤͻΨȌ  ”‹‡ˆ•› Š‘–‹ ‹•‘”†‡”  M SD  ͵ȋͷǤͳΨȌ  ‡Ž—•‹‘ƒŽ‹•‘”†‡”M SD    ʹȋ͵ǤͶΨȌ ‡ƒ”••‹ ‡‘•‡–‘ˆ’•› Š‘–‹ †‹•‘”†‡”ǡ ȋ Ȍǡ”ƒ‰‡ ͷǤ͸ȋͶǤͳȌǡͳǦʹʹ  Š‹Ž†Š‘‘†ƒ„—•‡•‡˜‡”‹–›ǡ ȋ Ȍǡ”ƒ‰‡   ͳͲǤͳȋͳͳǤ͵ȌǡͲǦͶ͵   ƒ”‡–ƒŽ†‹• ‘”†     ͷǤͶȋͷǤͻȌǡͲǦͳ͸  Š›•‹ ƒŽƒ„—•‡     ͳǤ͹ȋ͵ǤͷȌǡͲǦͳʹ Note. •› Š‘Ž‘‰‹ ƒŽƒ„—•‡     ͳǤͻȋ͵Ǥ͹ȌǡͲǦͳʹ  ‡š—ƒŽƒ„—•‡      ͲǤ͵ȋͲǤͺȌǡͲǦ͵ ‘••‹„Ž‡”ƒ‰‡•ˆ‘” Š‹Ž†Š‘‘†ƒ„—•‡• ‘”‡•ǣ–‘–ƒŽͲǦͷʹǡ’ƒ”‡–ƒŽ†‹• ‘”†ͲǦͳ͸ǡ’Š›•‹ ƒŽƒ„—•‡ͲǦͳʹǡ ’•› Š‘Ž‘‰‹ ƒŽƒ„—•‡ͲǦͳʹǡƒ†•‡š—ƒŽƒ„—•‡ͲǦͳʹǤ     Table 2.  Šƒ”ƒ –‡”‹•–‹ •ǡ‹–”ƒ Žƒ•• ‘””‡Žƒ–‹‘ ‘‡ˆˆ‹ ‹‡–•ǡƒ†‹–‡” ‘””‡Žƒ–‹‘•‘ˆ–Š‡•–—†›

˜ƒ”‹ƒ„Ž‡•Ǥ ‘•‹–‹˜‡ ‡’”‡••‹˜‡ š‹‘—• ƒ”‹ƒ„Ž‡  ‡ƒȋȌǡ”ƒ‰‡ ‘‡Ž‹‡•• •›’–‘• ˆ‡‡Ž‹‰• ˆ‡‡Ž‹‰• Š‹Ž†Š‘‘† Ȁƒ ʹǤͲͳȋʹǤʹͶȌǡͲǦͺǤ͸ ͲǤ͵ʹ ͲǤʹͺ ͲǤͶͲ ͲǤʹ͸ ƒ„—•‡ ͲǤͶ ‘‡Ž‹‡•• ʹǤ͵͸ȋͳǤͷͻȌǡͳǦ͹ Ǧ ͲǤ͹ͳ ͲǤ͹͸ ͲǤ͸͹ ͳ ‘•‹–‹˜‡ ͲǤ͹ ͳǤͺʹȋͲǤͻͻȌǡͳǦ͸Ǥ͵ ͲǤʹʹ Ǧ ͲǤ͸ͺ ͲǤ͹͵ •›’–‘• ͹ ‡’”‡••‹˜ ͲǤͷ ʹǤͶͳȋͳǤͷ͹ȌǡͳǦ͹ ͲǤ͵͵ ͲǤ͵͸ Ǧ ͲǤͺͳ ‡ˆ‡‡Ž‹‰• Ͳ š‹‘—• ͲǤͷ Note. ͳǤͻͳȋͳǤ͵͵ȌǡͳNǦ ͹ ͲǤʹͶ ͲǤ͵Ͳ ͲǤ͵ʹ Ǧ ˆ‡‡Ž‹‰• N = ʹ Š‡™‹–Š‹Ǧ•—„Œ‡ – ‘””‡Žƒ–‹‘•ȋ αͳͺͻ͸Ȍƒ”‡†‹•’Žƒ›‡†„‡Ž‘™–Š‡†‹ƒ‰‘ƒŽǤŠ‡„‡–™‡‡Ǧ•—„Œ‡ – ‘””‡Žƒ–‹‘•ȋ ͷͻȌƒ”‡†‹•’Žƒ›‡†ƒ„‘˜‡–Š‡†‹ƒ‰‘ƒŽǤ ዐ–”ƒ Žƒ•• ‘””‡Žƒ–‹‘ ‘‡ˆˆ‹ ‹‡–Ǥ‘–ƒŽ Š‹Ž†Š‘‘†ƒ„—•‡• ‘”‡•™‡”‡†‹˜‹†‡†„›ͷ‹‘”†‡”–‘ƒ˜‘‹†‘˜‡”Ž›•ƒŽŽ ‘‡ˆˆ‹ ‹‡–•Ǥ‘••‹„Ž‡”ƒ‰‡ˆ‘” Š‹Ž†Š‘‘†ƒ„—•‡• ‘”‡‹•ͲǦͳͲǤͶǢˆ‘”˜ƒ”‹ƒ„Ž‡•ͳǦ͹Ǥ 

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146807_JonasWeijers_BNW_def.indd 76 28-10-2020 15:08 The relationship between childhood abuse, psychosis and loneliness

The mediating role of loneliness.

Š‡ ˆ‘”–Š‡‘—– ‘‡˜ƒ”‹ƒ„Ž‡’‘•‹–‹˜‡•›’–‘• ‹†‹ ƒ–‡†–Šƒ–͹͹Ǥ͵Ψ‘ˆ–Š‡˜ƒ”‹ƒ ‡‹’‘•‹–‹˜‡•›’–‘•™ƒ•ƒ––”‹„—–ƒ„Ž‡–‘„‡–™‡‡Ǧ•—„Œ‡ – †‹ˆˆ‡”‡ ‡•ǡ’”‘˜‹†‹‰•—’’‘”–ˆ‘”–Š‡‹˜‡•–‹‰ƒ–‹‘‘ˆ–Š‡ʹǦͳǦͳ‘†‡Žƒ†„‡–™‡‡Ǧ•—„Œ‡ – ‡†‹ƒ–‹‘ƒŽ‡ˆˆ‡ –•Ǥa—„Œ‡ –•™Š‘‡š’‡”‹‡ ‡†‘”‡p •‡˜‡”‡ Š‹Ž†Š‘‘†ƒ„—•‡”‡’‘”–‡†Š‹‰Š‡” Ž‡˜‡Ž•‘ˆŽ‘‡Ž‹‡••ȋ αͲǤͳͷǡͻͷΨ ȏͲǤͲͷǡͲǤʹͶȐǡ αͲǤͲͲʹȌǤbb  –—”ǡ•—„Œ‡ –•™‹–ŠŠ‹‰Š‡”p Ž‡˜‡Ž• ‘ˆŽ‘‡Ž‹‡••”‡’‘”–‡†‘”‡•‡˜‡”‡’‘•‹–‹˜‡•›’–‘•ȋ αͲǤͷͶǡͻͷΨ ȏͲǤ͵͹ǡͲǤ͹ʹȐǡ δ ͲǤͲͲͳȌǤ‘”‡‘˜‡”ǡ™‹–Š‹bw Ǧ•—„Œ‡ –Ž‡˜‡Ž•‘ˆŽ‘‡Ž‹‡••p ™‡”‡’‘•‹–‹˜‡Ž›”‡Žƒ–‡†–‘•‡˜‡”‹–›‘ˆ ’‘•‹–‹˜‡•›’–‘•ȋ αͲǤͲͺǡͻͷΨ ȏͲǤͲͷǡͲǤͳʹȐǡ δͲǤͲͲͳȌǤ–‡•–‘ˆ‡†‹ƒ–‹‘”‡˜‡ƒŽ‡† ab = ‡˜‹†‡ ‡‘ˆƒ‹†‹”‡ –‡ˆˆ‡ –p ‘ˆ Š‹Ž†Š‘‘†ƒ„—•‡‘’‘•‹–‹˜‡•›’–‘•–Š”‘—‰ŠŽ‘‡Ž‹‡••ȋ ͲǤͲͺǡͻͷΨ ȏͲǤͲʹǡͲǤͳ͵Ȑǡ αͲǤͲͲͷȌǤŠ‹Ž‡ ‘–”‘ŽŽ‹‰ˆ‘”–Š‡‹†‹”‡ –c’ ‡ˆˆ‡ –ǡ–Š‡†‹”‡ –‡ˆˆ‡ –‘ˆp Š‹Ž†Š‘‘†ƒ„—•‡‘’‘•‹–‹˜‡•›’–‘•™ƒ•‘Ž‘‰‡”’”‡•‡–ȋ αǦͲǤͲͳǡͻͷΨ ȏǦͲǤͳͳǡͲǤͲͻȐǡ αͲǤͺʹͶȌǤThe mediating role of depressive and anxious symptomatology. Š‡”‡•—Ž–•‘ˆ–Š‡ ‡†‹ƒ–‹‘‘†‡Ž•ˆ‘”†‡’”‡••‹˜‡ƒ†ƒš‹‘—••›’–‘ƒ–‘Ž‘‰›ƒ”‡†‹•’Žƒ›‡†‹ƒ„Ž‡͵ǤŠ‡  4 ˆ‘”–Š‡‹†‡’‡†‡–˜ƒ”‹ƒ„Ž‡Ž‘‡Ž‹‡••‹†‹ ƒ–‡†–Šƒ–ͶͳǤʹΨ‘ˆ–Š‡˜ƒ”‹ƒ ‡‹Ž‘‡Ž‹‡••™ƒ• ƒ––”‹„—–ƒ„Ž‡–‘„‡–™‡‡Ǧ•—„Œ‡ –†‹ˆˆ‡”‡ ‡•ƒ†ͷͺǤͺΨ–‘™‹–Š‹Ǧ•—„Œ‡ –†‹ˆˆ‡”‡ ‡•ǡ’”‘˜‹†‹‰ •—’’‘”–ˆ‘”–Š‡‹˜‡•–‹‰ƒ–‹‘‘ˆƒͳǦͳǦͳ—Ž–‹Ž‡˜‡Ž‡†‹ƒ–‹‘‘†‡Žƒ†„‘–Š™‹–Š‹Ǧƒ† „‡–™‡‡Table 3.Ǧ•—„Œ‡ –‡†‹ƒ–‹‘ƒŽ‡ˆˆ‡ –•Ǥ

—Ž–‹Ž‡˜‡Ž‡†‹ƒ–‹‘‘†‡Ž•’”‡†‹ –‹‰’‘•‹–‹˜‡•›’–‘•ˆ”‘Ž‘‡Ž‹‡••˜‹ƒ †‡’”‡••‹˜‡ƒ†ƒš‹‘—••›’–‘ƒ–‘Ž‘‰›Ǥ SE SE  ‡’”‡••‹‘ƒ•‡†‹ƒ–‘”  š‹‡–›ƒ•‡†‹ƒ–‘”  ͻͷΨ   •–‹ƒ–‡ ͻͷΨ   Within-subject level •–‹ƒ–‡   aw        bw ƒ–Šcw’ ͲǤ͵Ͳȗȗȗ ͲǤͲͶ ͲǤʹʹǡͲǤ͵͹  ͲǤͳͻȗȗȗ ͲǤͲ͵ ͲǤͳʹǡͲǤʹ͸ ƒ–Šabw ͲǤͳ͵ȗȗȗ ͲǤͲʹ ͲǤͳͲǡͲǤͳ͹  ͲǤͳʹȗȗȗ ͲǤͲ͵ ͲǤͲ͸ǡͲǤͳ͹ ƒ–Š  ͲǤͲͶȗȗ ͲǤͲʹ ͲǤͲͳǡͲǤͲ͹  ͲǤͲ͸ȗȗȗ ͲǤͲʹ ͲǤͲ͵ǡͲǤͳͲ

ƒ–Š abw1/w2ȋዐ†‹”‡ – ͲǤͲͶȗȗȗ ͲǤͲͳ ͲǤͲʹǡͲǤͲ͸  ͲǤͲʹȗȗ ͲǤͲͳ ͲǤͲͳǡͲǤͲ͵ ‡ˆˆ‡ –Ȍ ƒ–Š ‹ͳǦȋͳǦͳȌǦ ͲǤͲͶȗȗȗ ͲǤͲͳ ͲǤͲʹǡͲǤͲͷ  ͲǤͲʹȗ ͲǤͲͳ ͲǤͲͲǡͲǤͲ͵ Betweenͳ‘†‡Ž-subject level   ab        bb ƒ–Š  ͲǤͺͳȗȗȗ ͲǤͳʹ ͲǤͷ͹ǡͳǤͲͷ  ͲǤ͸ʹȗȗȗ ͲǤͳͳͺ ͲǤ͵ͻǡͲǤͺͷ ƒ–Šcb’ ͲǤͳͷ ͲǤͳͻ ǦͲǤʹʹǡ  ͲǤ͵ͺ ͲǤʹ͹͸ ǦͲǤͳ͹ǡͲǤͻʹ abb ͲǤͷ͸ ƒ–Š  ͲǤ͵Ͳȗ ͲǤͳ͵ ͲǤͲͷǡͲǤͷͷ  ͲǤʹ͸ ͲǤͳͷͶ ǦͲǤͲͶǡͲǤͷ͸

ƒ–Š abb1/b2ȋዐ†‹”‡ – ͲǤͳʹ ͲǤͳ͸ ǦͲǤͳͻǡ  ͲǤʹ͵ ͲǤͳͺͳ ǦͲǤͳʹǡͲǤͷͻ ‡ˆˆ‡ –Ȍ ͲǤͶͶ Note.ƒ–Š ȋዐ†‹”‡ – ͲǤͲʹ ͲǤͳʹ ǦͲǤʹʹǡ ab a w ͲǤͳͷ ͲǤͳʹͳ→  ǦͲǤͲͻǡͲǤ͵ͻbb bw‡ˆˆ‡ –Ȍ‹ͳǦȋͳ→ǦͳȌǦͳ‘†‡Ž cb’ cw’ ͲǤʹ͸ → p  p p Š‡‘†‡Ž•ƒ”‡”ƒ†‘‹–‡” ‡’–ƒ†•Ž‘’‡‘†‡Ž•Ǣƒ–Š Ȁ αŽ‘‡Ž‹‡•• ‡†‹ƒ–‘”Ǣƒ–Š Ȁ Ꮗ†‹ƒ–‘” ’‘•‹–‹˜‡•›’–‘•Ǣƒ–Š Ȁ αŽ‘‡Ž‹‡•• ’‘•‹–‹˜‡•›’–‘•Ǥ ȗ δǤͲͷǤȗȗ δǤͲͳǤ ȗȗȗ δǤͲͲͳǤ

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146807_JonasWeijers_BNW_def.indd 77 28-10-2020 15:08 Chapter Four

Within-subject effects.

p  ‹‰Š‡”Ž‡˜‡Ž•‘ˆŽ‘‡Ž‹‡••™‡”‡”‡Žƒ–‡†–‘‘”‡†‡’”‡••‹˜‡ƒ†aw ƒš‹‘—•ˆ‡‡Ž‹‰•ȋ •δͲǤͲͲͳǢ•‡‡ƒ„Ž‡͵ǡ’ƒ–Š ȌǤ –—”ǡ‘”‡†‡’”‡••‹˜‡ƒ†ƒš‹‘—•ˆ‡‡Ž‹‰•p bw ™‡”‡”‡Žƒ–‡†–‘‘”‡•‡˜‡”‡’‘•‹–‹˜‡•›’–‘•ȋ •δͲǤͲͲͳǡ•‡‡ƒ„Ž‡͵ǡ’ƒ–Š ȌǤ‡•–•‘ˆ ‡†‹ƒ–‹‘”‡˜‡ƒŽ‡†‹†‹”‡ –™‹–Š‹abw Ǧ•—„Œ‡ –‡ˆˆ‡ –•‘ˆŽ‘‡Ž‹‡••‘’‘•‹–‹˜‡•›’–‘•–Š”‘—‰Šp abw †‡’”‡••‹˜‡ˆ‡‡Ž‹‰•ȋp αͲǤͲͶǡͻͷΨ ȏͲǤͲʹǡͲǤͲ͸Ȑǡ δͲǤͲͲͳȌǡƒ†ƒš‹‘—•ˆ‡‡Ž‹‰•ȋ αͲǤͲʹǡ ’ ͻͷΨ ȏͲǤͲͳǡͲǤͲ͵Ȑǡ αͲǤͲͲʹȌǤŠ‡”‡™‡”‡•–‹ŽŽ™‹–Š‹Ǧ•—„Œ‡ –†‹”‡ –‡ˆˆ‡ –•‘ˆŽ‘‡Ž‹‡••‘cw ’ ’‘•‹–‹˜‡•›’–‘•™Š‹Ž‡ ‘–”‘ŽŽ‹‰ˆ‘”–Š‡‹†‹”‡ –‡ˆˆ‡ –‘ˆ†‡’”‡••‹˜‡ˆ‡‡Ž‹‰•ȋp cw p αͲǤͲͶǡ ͻͷΨ ȏͲǤͲͳǡͲǤͲ͹Ȑǡ αͲǤͲͲͷȌƒ†ƒš‹‘—•ˆ‡‡Ž‹‰•ȋ αͲǤͲ͸ǡͻͷΨ ȏͲǤͲ͵ǡͲǤͳͲȐǡ δͲǤͲͲͳȌǤ ƒŽ›œ‹‰†‡’”‡••‹˜‡ƒ†ƒš‹‘—•ˆ‡‡Ž‹‰•‹ƒ—Ž–‹’Ž‡‡†‹ƒ–‘”‘†‡Ž”‡˜‡ƒŽ‡†–Šƒ–„‘–Šabw1 p abw2 †‡’”‡••‹˜‡ˆ‡‡Ž‹‰•ȋ αͲǤͲͶǡͻͷΨ ȏͲǤͲʹǡͲǤͲͷȐǡp δͲǤͲͲͳȌƒ†ƒš‹‘—•ˆ‡‡Ž‹‰•ȋ α ͲǤͲʹǡͻͷΨ ȏͲǤͲͲǡͲǤͲ͵Ȑǡ αͲǤͲͳʹȌ™‡”‡‹†‡’‡†‡–‡†‹ƒ–‘”•‹–Š‡”‡Žƒ–‹‘•Š‹’„‡–™‡‡abw1 abw2  Ž‘‡Ž‹‡••ƒ†’‘•‹–‹˜‡•›’–‘•Ǥ‡’”‡••‹‘™ƒ•ƒ•–”‘‰‡”‡†‹ƒ–‘”–Šƒƒš‹‡–›ȋp Ǧ αͲǤͲʹǡͻͷΨ ȏͲǤͲͲǡͲǤͲͶȐǡBetween-subject effects.αͲǤͲʹ͹ȌǤ ƒ˜‡”ƒ‰‡ǡ•—„Œ‡ –•™‹–ŠŠ‹‰Š‡”Ž‡˜‡Ž•‘ˆŽ‘‡Ž‹‡••”‡’‘”–‡†p ab ‘”‡†‡’”‡••‹˜‡ƒ†ƒš‹‘—•ˆ‡‡Ž‹‰•ȋ •δͲǤͲͲͳǢ•‡‡ƒ„Ž‡͵ǡ’ƒ–Š ȌǤ –—”ǡ•—„Œ‡ –•™‹–Š ”‡Žƒ–‹˜‡Ž›‘”‡†‡’”‡••‹˜‡ƒ†ƒš‹‘—•ˆ‡‡Ž‹‰•”‡’‘”–‡†‘”‡•‡˜‡”‡’‘•‹–‹˜‡•›’–‘•ǡ„—–p bb –Š‹•†‹†‘–”‡ƒ Š•‹‰‹ˆ‹ ƒ ‡ȋ •εͲǤͲͷǢ•‡‡ƒ„Ž‡͵ǡ’ƒ–Š ȌǤˆ‘”ƒŽ–‡•–‘ˆ‡†‹ƒ–‹‘ •Š‘™‡†‘•‹‰‹ˆ‹ ƒ–„‡–™‡‡Ǧ•—„Œ‡ –‹†‹”‡ –‡ˆˆ‡ –‘ˆŽ‘‡Ž‹‡••‘’‘•‹–‹˜‡•›’–‘•p abb –Š”‘—‰Š†‡’”‡••‹˜‡‘”ƒš‹‘—•ˆ‡‡Ž‹‰•ȋ •εͲǤͲͷǢ•‡‡ƒ„Ž‡͵ǡ’ƒ–Š ȌǤ Discussion

Š‡’”‡•‡–•–—†›ƒ‹‡†–‘‹†‡–‹ˆ›‡†‹ƒ–‹‘ƒŽ’ƒ–Š™ƒ›•–‘†ƒ‹Ž›Ž‹ˆ‡’‘•‹–‹˜‡•›’–‘• ‹‹†‹˜‹†—ƒŽ•™‹–ŠǤ—”ˆ‹†‹‰•†‡‘•–”ƒ–‡–Šƒ––Š‡•‡˜‡”‹–›‘ˆ Š‹Ž†Š‘‘†ƒ„—•‡™ƒ• ƒ••‘ ‹ƒ–‡†™‹–Š‹ ”‡ƒ•‡†Ž‡˜‡Ž•‘ˆŽ‘‡Ž‹‡••ƒ†’‘•‹–‹˜‡•›’–‘•Ǥ•Š›’‘–Š‡•‹œ‡†ǡ Ž‘‡Ž‹‡••‡†‹ƒ–‡†–Š‡”‡Žƒ–‹‘•Š‹’„‡–™‡‡ Š‹Ž†Š‘‘†ƒ„—•‡ƒ†’‘•‹–‹˜‡•›’–‘•Ǥ ƒ††‹–‹‘ǡ–‘–Š‡„‡•–‘ˆ‘—”‘™Ž‡†‰‡ǡ–Š‹•‹•–Š‡ˆ‹”•–•–—†›–‘”‡˜‡ƒŽ–Šƒ–™‹–Š‹Ǧ’‡”•‘ ˆŽ— –—ƒ–‹‘•‹†‡’”‡••‹˜‡ƒ†ƒš‹‘—••›’–‘ƒ–‘Ž‘‰›‡†‹ƒ–‡–Š‡”‡Žƒ–‹‘•Š‹’„‡–™‡‡ Ž‘‡Ž‹‡••ƒ†’‘•‹–‹˜‡•›’–‘•Ǥ‘”‡•’‡ ‹ˆ‹ ƒŽŽ›ǡ™Š‡‹†‹˜‹†—ƒŽ•™‡”‡Ž‘‡Ž‹‡”–Šƒ–Š‡‹” ƒ˜‡”ƒ‰‡Ž‡˜‡Ž‘ˆŽ‘‡Ž‹‡••ǡ–Š‡›–‡†‡†–‘”‡’‘”–‘”‡•‡˜‡”‡’‘•‹–‹˜‡•›’–‘•–Š”‘—‰Š ‹ ”‡ƒ•‡††‡’”‡••‹˜‡ƒ†ƒš‹‘—•ˆ‡‡Ž‹‰•ȋ–Š‡™‹–Š‹Ǧ•—„Œ‡ –‹†‹”‡ –‡ˆˆ‡ –•ȌǤ‡’”‡••‹‘™ƒ• ƒ•‹‰‹ˆ‹ ƒ–Ž›•–”‘‰‡”‡†‹ƒ–‘”–Šƒƒš‹‡–›Ǥ ‘™‡˜‡”ǡ‹†‹˜‹†—ƒŽ•™Š‘•Š‘™‡†ƒ„‘˜‡ƒ˜‡”ƒ‰‡ Ž‡˜‡Ž•‘ˆŽ‘‡Ž‹‡••‹‰‡‡”ƒŽ†‹†‘–ƒ’’‡ƒ”–‘•Š‘™ƒ„‘˜‡ƒ˜‡”ƒ‰‡Ž‡˜‡Ž•‘ˆ’‘•‹–‹˜‡•›’–‘• –Š”‘—‰Š†‡’”‡••‹˜‡‘”ƒš‹‘—•ˆ‡‡Ž‹‰•ȋ–Š‡„‡–™‡‡Comparison to previous findings. Ǧ•—„Œ‡ –‹†‹”‡ –‡ˆˆ‡ –•ȌǤ —”ˆ‹†‹‰•ƒ”‡‹Ž‹‡™‹–Š’”‹‘””‡•‡ƒ” Š †‡‘•–”ƒ–‹‰–Šƒ–Ž‘‡Ž‹‡••‡†‹ƒ–‡•–Š‡”‡Žƒ–‹‘•Š‹’„‡–™‡‡ Š‹Ž†Š‘‘†ƒ„—•‡ƒ†ƒ

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146807_JonasWeijers_BNW_def.indd 78 28-10-2020 15:08 The relationship between childhood abuse, psychosis and loneliness

†‹ƒ‰‘•‹•‘ˆ’•› Š‘•‹•ȋŠ‡˜Ž‹‡–ƒŽǤǡʹͲͳͷȌƒ†•—„Ǧ Ž‹‹ ƒŽ’•› Š‘–‹ ‡š’‡”‹‡ ‡•ȋ‘›†ƒƬ  ‡‡–‡”•ǡʹͲͳͷȌǤŠ‡ˆ‹†‹‰••—’’‘”–ƒ‡‡”‰‹‰ ‘•‡•—•–Šƒ–‹†‹˜‹†—ƒŽ•™‹–ŠƒŠ‹•–‘”› ‘ˆƒ„—•‡Šƒ˜‡ƒ‹ ”‡ƒ•‡†”‹•–‘†‡˜‡Ž‘’’•› Š‘•‹•ȋ”•‡‡ƒ—Ž–‡–ƒŽǤǡʹͲͳͳǢ‡†ƒŽŽ‡–ƒŽǤǡ ʹͲͲͺǢƒ–Š‡•‘ǡŠ‡’Š‡”†ǡ‹ Š„‡ ǡƒ—”‡•ǡƬƒ””ǡʹͲͳ͵Ǣƒ”‡•‡‡–ƒŽǤǡʹͲͳʹȌƒ†ƒ”‡’”‘‡ –‘„‡ ‘‡Ž‘‡Ž›‹ƒ†—Ž–Š‘‘†ȋ ‹„•‘Ƭ ƒ”–•Š‘”‡ǡͳͻͻ͸Ǣ‡”œƬ ƒǡʹͲͳ͵Ǣ—”’Š›‡–ƒŽǤǡ ʹͲͳ͵Ȍǡƒ† ‘ˆ‹”–Š‡”‡ ‡–Ž›‡•–ƒ„Ž‹•Š‡†’‘•‹–‹˜‡ƒ••‘ ‹ƒ–‹‘„‡–™‡‡Ž‘‡Ž‹‡••ƒ† ’•› Š‘–‹ •›’–‘•ȋ‹ ŠƒŽ•ƒ‡–ƒŽǤǡʹͲͳ͹ȌǤ ’‘”–ƒ–Ž›ǡ‘—”•–—†›‡š–‡†•’”‡˜‹‘—•ˆ‹†‹‰• „›‹†‡–‹ˆ›‹‰Ž‘‡Ž‹‡••ƒ•ƒ‡†‹ƒ–‹‰ˆƒ –‘”‹–Š‡ ‘–‡š–‘ˆ†ƒ‹Ž›Ž‹ˆ‡Ǥ —””‡•—Ž–•ƒŽ•‘•—’’‘”–’”‡˜‹‘—•ˆ‹†‹‰•™Š‹ Š•—‰‰‡•–‡†–Šƒ–Ž‘‡Ž‹‡••ƒˆˆ‡ –• ’•› Š‘•‹•–Š”‘—‰Š†‡’”‡••‹‘ƒ†ƒš‹‡–›ȋ ƒ›ƒ‡–ƒŽǤǡʹͲͳ͸Ǣò†‡”ƒ‡–ƒŽǤǡʹͲͳͶȌǤ ‘™‡˜‡”ǡ –Š‹•‡ˆˆ‡ –™ƒ•‘–ˆ‘—†‘ƒ„‡–™‡‡Ǧ’‡”•‘Ž‡˜‡Žǡ™Š‹ Š‹•Ž‹‡Ž›†—‡–‘”‡†— ‡†’‘™‡”„› ”‡Ž›‹‰‘‡ƒ•›’–‘Ž‡˜‡Ž•ǤŠ‡Ž‘™ƒ —”ƒ ›‹˜‘Ž˜‡†‹„‡–™‡‡Ǧ’‡”•‘‡ƒ•—”‡‡–• ƒ››‹‡Ž†‹š‡†”‡•—Ž–•‘” ‘ ‡ƒŽ‡ˆˆ‡ –•ǡ™Š‡”‡ƒ•™‹–Š‹Ǧ’‡”•‘ƒƒŽ›•‡•–ƒ‡‹–‘ƒ ‘—– ˆŽ— –—ƒ–‹‘•ƒ†‹†‹˜‹†—ƒŽ†‹ˆˆ‡”‡ ‡•ǡ”‡˜‡ƒŽ‹‰•—„–Ž‡—†‡”Ž›‹‰’ƒ––‡”•ȋ‘Ž‡ƒƒ”Ƭ 4 ƒ’„‡ŽŽǡʹͲͲͻȌǤ‡„‡Ž‹‡˜‡–Šƒ––Š‡™‹–Š‹Ǧ’‡”•‘ƒ’’”‘ƒ Š‹•‘”‡ƒ’’”‘’”‹ƒ–‡™Š‡ •–—†›‹‰•›’–‘•‘”‡‘–‹‘•ǡƒ•–Š‡•‡ƒ”‡„›†‡ˆ‹‹–‹‘‘‡–ƒ”›ˆŽ— –—ƒ–‹‰‡š’‡”‹‡ ‡•Ǥ ˆƒ –ǡ–Š‡”‡‹•ƒ‰”‘™‹‰”‡ ‘‰‹–‹‘ˆ‘”–Š‡‹’‘”–ƒ ‡‘ˆ™‹–Š‹Ǧ’‡”•‘†ƒ–ƒ‹–Š‡ˆ‹‡Ž†‘ˆ ’•› Š‘Ž‘‰›ǡ‡•’‡ ‹ƒŽŽ›„‡ ƒ—•‡‘•–’•› Š‘Ž‘‰‹ ƒŽ–Š‡‘”‹‡•’‘•–—Žƒ–‡‹–”ƒ‹†‹˜‹†—ƒŽ’”‘ ‡••‡• ȋ‘ŽŽ‹•ǡʹͲͲ͸Ǣ—””ƒƬƒ—‡”ǡʹͲͳͳǢ ƒƒ‡”ǡʹͲͳʹǢ‘Ž‡ƒƒ”ǡʹͲͲͶȌrelative Ǥ•‹‰ƒ™‹–Š‹Ǧ’‡”•‘ ƒ’’”‘ƒ Šǡ™‡™‡”‡ƒ„Ž‡–‘†‡–‡ –ƒ ‡ˆˆ‡ –‘ˆŽ‘‡Ž‹‡••––Š‡‡ˆˆ‡ ––Šƒ–‘ —””‡†™Š‡ ’‡‘’Ž‡•–ƒ”–ed to feel more lonely than their “baseline” ––Šƒ–™‘—Ž†‘–Šƒ˜‡„‡‡”‡˜‡ƒŽ‡† —•‹‰ƒ„‡–™‡‡Ǧ’‡”•‘ƒ’’”‘ƒ ŠǤ —””‡•—Ž–•’”‘˜‹†‡•—’’‘”–ˆ‘”–Š‡•‘ ‹ƒŽ†‡ˆ‡ƒ–Š›’‘–Š‡•‹•‘ˆ’•› Š‘•‹•ƒ‡–‹‘Ž‘‰›ȋ‡Ž–‡‡–ƒŽǤǡ ʹͲͳ͵ȌǤ ˜‡•–‹‰ƒ–‹‰Ž‘‡Ž‹‡••‹–Š‡ ‘–‡š–‘ˆ†‘’ƒ‹‡•‡•‹–‹œƒ–‹‘ƒ›„‡ƒˆ”—‹–ˆ—Ž˜‡—‡ ˆ‘”ˆ—–—”‡”‡•‡ƒ” Šǡƒ•˜ƒ”‹‘—•‘–Š‡”•‘ ‹ƒŽƒ†˜‡”•‹–‹‡•ǡ‹ Ž—†‹‰ Š‹Ž†Š‘‘†ƒ„—•‡ȋ‰‡”–‘‡–ƒŽǤǡ ʹͲͳ͸ȌǡŠ‡ƒ”‹‰‹’ƒ‹”‡–ȋ ‡˜‘†‡‡–ƒŽǤǡʹͲͳͶȌǡƒ†‹‰”ƒ–‹‘ȋ‰‡”–‘‡–ƒŽǤǡʹͲͳ͹ȌŠƒ˜‡ „‡‡”‡Žƒ–‡†–‘ƒ•‡•‹–‹œ‡†‡•‘Ž‹„‹ †‘’ƒ‹‡•›•–‡Ǥ‹‡™‹•‡ǡƒ•’”‡†‹ –‡†„›–Š‡•‘ ‹ƒŽ †‡ˆ‡ƒ–Š›’‘–Š‡•‹•ǡ–Š‡ ‘–”‹„—–‹‘‘ˆŽ‘‡Ž‹‡••–‘’•› Š‘•‹•ƒ›„‹‘Ž‘‰‹ ƒŽŽ›„‡‡š’Žƒ‹‡†„› –Š‡•‡•‹–‹œƒ–‹‘‘ˆ–Š‡‡•‘Ž‹„‹ †‘’ƒ‹‡•›•–‡Strengths and limitations. ȋ ‘™‡•Ƭ—””ƒ›ǡʹͲͳͶȌǤ Š‡ƒ‹•–”‡‰–Š‘ˆ‘—”•–—†›‹•–Š‡—•‡‘ˆ‘‡–ƒ”›ƒ† ‡ ‘Ž‘‰‹ ƒŽŽ›˜ƒŽ‹††ƒ–ƒǤ‡ƒ•—”‹‰•›’–‘•ƒ•–Š‡›‘ —”‹†ƒ‹Ž›Ž‹ˆ‡ ‹” —˜‡–•”‡ ƒŽŽ„‹ƒ• ƒ†‹’”‘˜‡•‰‡‡”ƒŽ‹œƒ„‹Ž‹–›ȋ›‹Ǧ ‡”‡›•‡–ƒŽǤǡʹͲͲͻȌǤ‘–Š‡”•–”‡‰–Š‹•–Š‡—•‡‘ˆǡ ƒ•–ƒ–‡Ǧ‘ˆǦ–Š‡Ǧƒ”–ˆ”ƒ‡™‘”ˆ‘”ƒ••‡••‹‰—Ž–‹Ž‡˜‡Ž‡†‹ƒ–‹‘ȋ”‡ƒ Š‡”‡–ƒŽǤǡʹͲͳͲȌǤŠ‹• ƒŽŽ‘™‡†—•–‘•‡’ƒ”ƒ–‡„‡–™‡‡Ǧƒ†™‹–Š‹Ǧ’‡”•‘‡†‹ƒ–‡†‡ˆˆ‡ –•‹ƒ”‘„—•–ƒ†—„‹ƒ•‡† ƒ‡”Ǥƒ”–‹ —Žƒ”Ž›‘—”ˆ‘ —•‘™‹–Š‹Ǧ’‡”•‘’”‘ ‡••‡•‹•ƒ’‘™‡”ˆ—Žƒ††‹–‹‘–‘–›’‹ ƒŽ

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146807_JonasWeijers_BNW_def.indd 79 28-10-2020 15:08 Chapter Four

„‡–™‡‡Ǧ’‡”•‘”‡•‡ƒ” Š’ƒ”ƒ†‹‰•ƒ•™‡™‡”‡ƒ„Ž‡–‘ƒ••‡••Š‘™—†‡”Ž›‹‰’”‘ ‡••‡• —ˆ‘Ž†™‹–Š‹‹†‹˜‹†—ƒŽ•Ǥ ‡˜‡”ƒŽ’‘–‡–‹ƒŽŽ‹‹–ƒ–‹‘•ƒŽ•‘‡‡†–‘„‡ ‘•‹†‡”‡†Ǥ ‹”•–ǡ‘—”•–—†›†‡’‡†‡†‘ ”‡–”‘•’‡ –‹˜‡”‡ ƒŽŽ‘ˆ Š‹Ž†Š‘‘†ƒ„—•‡ǡƒ‹‰‹–•—• ‡’–‹„Ž‡–‘”‡ ƒŽŽ„‹ƒ•ȋ‡™„—”›‡–ƒŽǤǡ ʹͲͳͺȌǤ‡ ƒ—•‡‘ˆ–Š‹•ǡ•‘‡”‡•‡ƒ” Š‡”•†‹•’—–‡–Š‡ ƒ—•ƒŽ”‘Ž‡‘ˆ Š‹Ž†Š‘‘†ƒ„—•‡‹’•› Š‘•‹• ȋ—••‡”Ƭ‹†‘ǡʹͲͳʹȌǤ ‘™‡˜‡”ǡ‹–•‡‡•”ƒ–Š‡”—Ž‹‡Ž›–Šƒ–”‡ ƒŽŽ„‹ƒ•ƒŽ‘‡™‘—Ž†‡š’Žƒ‹ –Š‡”‘„—•–ƒ••‘ ‹ƒ–‹‘„‡–™‡‡ Š‹Ž†Š‘‘†ƒ„—•‡ƒ†’•› Š‘•‹•ȋ—–ƒŒƒ”‡–ƒŽǤǡʹͲͳͲǢ‡ŽŽ‡Š‡”‡– ƒŽǤǡʹͲͳ͵Ǣ‘”‰ƒƬGayer‐Anderson, 2016; Varese et al., 2012)Ǥ‡ ‘†ǡ–Š‡ ”‘••Ǧ•‡ –‹‘ƒŽ ƒ–—”‡‘ˆ‘—”ƒƒŽ›•‡•’”‡ Ž—†‡•–‹‡‘”†‡”‹‰‘ˆ–Š‡˜ƒ”‹ƒ„Ž‡•ǤŠ‹•‡ƒ•–Šƒ–‹– ƒ‘–„‡ ‘ Ž—†‡†–Šƒ–ǡˆ‘”‡šƒ’Ž‡ǡŽ‘‡Ž‹‡••Ž‡ƒ†•–‘ˆ—–—”‡‹ ”‡ƒ•‡•‘ˆ’‘•‹–‹˜‡•›’–‘•ǤŠ‹”†ǡ –Š‡’”‡•‡–•–—†›‡’Ž‘›‡†•‡ŽˆǦreport instruments. Their validity depends upon the patients’ ƒ„‹Ž‹–›–‘ƒ —”ƒ–‡Ž›‹†‡–‹ˆ›ƒ†”‡’‘”–‡š’‡”‹‡ ‡•ǤŽƒ ‘ˆƒ™ƒ”‡‡••ƒ†’‘‘”‹•‹‰Š–ƒ› Šƒ˜‡‹ˆŽ—‡ ‡†–Š‡˜ƒŽ‹†‹–›‘ˆ•‡ŽˆǦ”‡’‘”–• ‘”‡•‹•‘‡’ƒ–‹‡–•ȋ‡ŽŽǡ ‹•œ†‘ǡ‹ Šƒ”†•‘ǡ ›•ƒ‡”ǡConclusion.Ƭ”›•‘ǡʹͲͲ͹Ȍ Ǥ Š‡ˆ‹†‹‰•‘ˆ–Š‡’”‡•‡–•–—†›•–”‘‰Ž›•—‰‰‡•–ȋ‹Ȍ–Šƒ–Ž‘‡Ž‹‡•• ‡†‹ƒ–‡•–Š‡”‡Žƒ–‹‘•Š‹’„‡–™‡‡ Š‹Ž†Š‘‘†ƒ„—•‡ƒ†•‡˜‡”‹–›‘ˆ’‘•‹–‹˜‡•›’–‘•‹ ’ƒ–‹‡–•™‹–ŠǢȋ‹‹Ȍ–Šƒ––Š‡”‡Žƒ–‹‘•Š‹’„‡–™‡‡Ž‘‡Ž‹‡••ƒ†’‘•‹–‹˜‡•›’–‘•‹• ‡†‹ƒ–‡†„›™‹–Š‹Ǧ’‡”•‘ˆŽ— –—ƒ–‹‘•‹†‡’”‡••‹˜‡ƒ†ƒš‹‘—••›’–‘ƒ–‘Ž‘‰›Ǥ References

†”‡ƒ•‡ǡǤǤǡ Žƒ—ǡǤǡƬ”†–ǡǤȋͳͻͻʹȌǤŠ‡‘’”‡Š‡•‹˜‡••‡••‡–‘ˆ›’–‘• ƒ† ‹•–‘”›ȋ Ȍǣƒ‹•–”—‡–ˆ‘”ƒ••‡••‹‰†‹ƒ‰‘•‹•ƒ†’•› Š‘’ƒ–Š‘Ž‘‰›ǤArchives of general psychiatry, 49 ȋͺȌǡ͸ͳͷǦ͸ʹ͵Ǥ ‰‡”‡›‡”ǡǤǤǡƬŽ—•ƒǡǤȋͳͻͺͺEuropeanȌǤŠ‡ ƒ—•‡•‘ˆˆ— –‹‘ƒŽ’•› Š‘•‡•ƒ••‡‡„› Archives of Psychiatry and Clinical Neuroscience , ’ƒ–‹‡–•ƒ†–Š‡‹””‡Žƒ–‹˜‡•Ǥ238 ȋͳȌǡͶ͹ǦͷͶǤ ”•‡‡ƒ—Ž–ǡǤǡƒ‘ǡǤǡ ‹•Š‡”ǡ ǤǤǡ‘Žƒ œ›ǡ Ǥǡ‘ˆˆ‹––ǡǤǤǡƬƒ•’‹ǡǤȋʹͲͳͳȌǤŠ‹Ž†Š‘‘† –”ƒ—ƒƒ† Š‹Ž†”‡̵•‡‡”‰‹‰’•› Š‘–‹ •›’–‘•American Journal of Psychiatryǣƒ‰‡‡–‹ ƒŽŽ›•‡•‹–‹˜‡, 168 Ž‘‰‹–—†‹ƒŽ ‘Š‘”–•–—†›Ǥ ȋͳȌǡ͸ͷǦ͹ʹǤ ‡ŽŽǡǤǡ ‹•œ†‘ǡ Ǥǡ‹ Šƒ”†•‘ǡǤǡ›•ƒ‡”ǡǤǡƬ”›•‘ǡ ǤȋʹͲͲ͹ȌǤ”‡•‡ŽˆǦ”‡’‘”–•˜ƒŽ‹†ˆ‘” • Š‹œ‘’Š”‡‹ƒ’ƒ–‹‡–•™‹–Š’‘‘”‹•‹‰Š–ǫ‡Žƒ–‹‘•Š‹’‘Psychiatry researchˆ—ƒ™ƒ”‡‡••‘ˆ‹ŽŽ‡••–‘, 151 ’•› Š‘Ž‘‰‹ ƒŽ•‡ŽˆǦ”‡’‘”–‹•–”—‡–•Ǥ ȋͳȌǡ͵͹ǦͶ͸Ǥ ‡†ƒŽŽǡǤǡ ƒ •‘ǡ Ǥ Ǥǡ —Ž„‡”–ǡǤǤǡƬ ‘””›ǡǤǤȋʹͲͲͺȌǤŠ‹Ž†Š‘‘†–”ƒ—ƒƒ†’•› Š‘–‹ Schizophrenia bulletin, 34 †‹•‘”†‡”•ǣƒ•›•–‡ƒ–‹ ǡ ”‹–‹ ƒŽ”‡˜‹‡™‘ˆ–Š‡‡˜‹†‡ ‡Ǥ ȋ͵Ȍǡ ͷ͸ͺǦͷ͹ͻǤ

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146807_JonasWeijers_BNW_def.indd 80 28-10-2020 15:08 The relationship between childhood abuse, psychosis and loneliness

‹ˆ—Ž ‘ǡǤǡ”‘™ǡ ǤǤǡƬ ƒ””‹•ǡǤǤȋͳͻͻͶJournalȌǤŠ‹Ž†Š‘‘†š’‡”‹‡ ‡‘ˆƒ”‡ƒ†„—•‡ȋȌǣ of Child Psychology and Psychiatry, 35 ƒ”‡–”‘•’‡ –‹˜‡‹–‡”˜‹‡™‡ƒ•—”‡Ǥ ȋͺȌǡ ͳͶͳͻǦͳͶ͵ͷǤ ‘›†ƒǡǤǡƬ ‡‡–‡”•ǡǤȋʹͲͳͷPsychiatryȌǤŠ‹Ž†Š‘‘†ƒŽ–”‡ƒ–‡–ƒ†•‘ ‹ƒŽˆ— –‹‘‹‰‹ƒ†—Ž–•™‹–Š research, 226 •—„Ǧ Ž‹‹ ƒŽ’•› Š‘•‹•Ǥ ȋͳȌǡ͵͹͸Ǧ͵ͺʹǤ ƒ ‹‘’’‘ǡ ǤǤǡ ƒ™Ž‡›ǡǤǤǡƬŠ‹•–‡†ǡǤǤȋʹͲͳͲȌǤ‡” ‡‹˜‡†•‘ ‹ƒŽ‹•‘Žƒ–‹‘ƒ‡•‡•ƒ†ǣͷǦ ›‡ƒ” ”‘••ǦŽƒ‰‰‡†ƒƒŽ›•‡•‘ˆŽ‘‡Ž‹‡••ƒ††‡’”‡••‹˜‡•›’–‘ƒ–‘Ž‘‰›‹–Š‡Š‹ ƒ‰‘ ‡ƒŽ–Šǡ‰‹‰ǡƒ†‘ ‹ƒŽ‡Žƒ–‹‘•–—†›Ǥ•› Š‘Ž‘‰›ƒ†ƒ‰‹‰ʹͷȋʹȌǡͶͷ͵Ǥ ƒ ‹‘’’‘ǡ ǤǤǡ —‰Š‡•ǡǤǤǡƒ‹–‡ǡǤ Ǥǡ ƒ™Ž‡›ǡǤǤƬŠ‹•–‡†ǡǤǤȋʹͲͲ͸ȌǤ‘‡Ž‹‡••ƒ•ƒ Psychology•’‡ ‹ˆ‹ ”‹•ˆƒ –‘”ˆ‘”†‡’”‡ and aging, 21 ••‹˜‡•›’–‘•ǣ ”‘••Ǧ•‡ –‹‘ƒŽƒ†Ž‘‰‹–—†‹ƒŽƒƒŽ›•‡•Ǥ ȋͳȌǡͳͶͲǤ ‘ŽŽ‹•ǡǤǤȋʹͲͲ͸ȌǤƒŽ›•‹•‘ˆŽ‘‰‹–—†‹ƒŽ†ƒ–ƒǣŠ‡‹–‡‰”ƒ–‹‘‘ˆ–Š‡‘”‡–‹ ƒŽ‘†‡Žǡ –‡’‘”ƒŽ†‡•‹‰ǡƒ†•–ƒ–‹•–‹ ƒŽ‘†‡ŽǤ—ƒŽ‡˜‹‡™‘ˆ•› Š‘Ž‘‰›ǡͷ͹ǡͷͲͷǦͷʹͺǤ —””ƒǡǤ ǤǡƬƒ—‡”ǡǤ ǤȋʹͲͳͳȌǤŠ‡†‹•ƒ‰‰”‡‰ƒ–‹‘‘ˆ™‹–Š‹Annual reviewǦ ’‡”•‘ƒ†„‡–™‡‡of psychology, 62 Ǧ’‡”•‘ 4 ‡ˆˆ‡ –•‹Ž‘‰‹–—†‹ƒŽ‘†‡Ž•‘ˆ Šƒ‰‡Ǥ ǡͷͺ͵Ǧ͸ͳͻǤ —–ƒŒƒ”ǡǤǤǡ—ŽŽ‡ǡǤǤǡ‰Ž‘ˆˆǡ ǤǤǡŠ‘ƒ•ǡǤǤǡ‡ŽŽ•ǡǤǤǡƬ’ƒ–ƒ”‘ǡ ǤȋʹͲͳͲȌǤ  Š‹œ‘’Š”‡‹ƒƒ†‘–Š‡”’•› Š‘–‹ †‹•‘”†‡”•‹ƒ ‘Š‘”–‘ˆ•‡š—ƒŽŽ›ƒ„—•‡† Š‹Ž†”‡ǤArchives of general psychiatry, 67 ȋͳͳȌǡͳͳͳͶǦͳͳͳͻǤ ‡Ž‡•’ƒ—ŽǡǤǡ†‡”‹‡•ǡǤǡƬ˜ƒ•ǡ ǤSocialȋʹͲͲʹ psychiatryȌǤ‡–‡”‹ƒ–•‘ˆ‘ —””‡ ‡ƒ†”‡ ‘˜‡”›ˆ”‘ and psychiatric epidemiology, 37 ŠƒŽŽ— ‹ƒ–‹‘•‹†ƒ‹Ž›Ž‹ˆ‡Ǥ ȋ͵Ȍǡͻ͹ǦͳͲͶǤ ‰‡”–‘ǡǤǡ ‘™‡•ǡǤǤǡ ‘—Ž‡ǡǤǡ ‡œ‹‡ǡǤǡƒŽƒ‰‰‹ƒǡǤǤǡƒ‰„›ǡǤǤǡ•‡‰ǡ ǤǦ Ǥǡ Ž‘‘ˆ‹‡Ž†ǡǤǤǡ‡ǡǤǡƬŠƒ––ƒ Šƒ”››ƒǡǤȋʹͲͳ͹ȌǤŽ‡˜ƒ–‡†–”‹ƒ–ƒŽ‘’ƒ‹‡ — –‹‘‹ ‹‰”ƒ–•ƒ†Š‡‹”Š‹Ž†”‡ǣ‹•‡ Šƒ‹•ˆ‘”•› Š‘•‹•ǤSchizophrenia bulletin 43 ȋʹȌǡʹͻ͵Ǧ͵ͲͳǤ ‰‡”–‘ǡǤǡƒŽƒ‰‰‹ƒǡǤǤǡ ‘™‡•ǡǤǤǡƒ›ǡ ǤǡŠƒ††‘ ǡǤǤǡŽŽ‡ǡǤǡ‹–‘Ǧ”‘™ǡǤǤǡ Ž‘‘ˆ‹‡Ž†ǡǤǤǡŠƒ––ƒ Šƒ”››ƒǡǤǡƬŠ‹Ž ‘––ǡ ǤȋʹͲͳ͸SchizophreniaȌǤ†˜‡”•‹–›‹ Š‹Ž†Š‘‘†Ž‹‡†–‘ research, 176 ‡Ž‡˜ƒ–‡†•–”‹ƒ–ƒŽ†‘’ƒ‹‡ˆ— –‹‘‹ƒ†—Ž–Š‘‘†Ǥ ȋʹȌǡͳ͹ͳǦ ͳ͹͸Ǥ ‘™Ž‡”ǡǤǡ ‘†‰‡‹•ǡ Ǥǡ ƒ”‡–›ǡǤǡ ”‡‡ƒǡǤǡ—‹’‡”•ǡǤǡ—ǡ Ǥǡ‹–ŠǡǤǡƬ‡„„‹‰–‘ǡ ǤǤȋʹͲͳͳȌǤ‡‰ƒ–‹˜‡ ‘‰‹–‹‘ǡ†‡’”‡••‡†‘‘†ǡƒ†’ƒ”ƒ‘‹ƒǣƒŽ‘‰‹–—†‹ƒŽ’ƒ–Š™ƒ›Schizophrenia bulletin ƒƒŽ›•‹•—•‹‰•–”— –—”ƒŽ‡“—ƒ–‹‘‘†‡Ž‹‰Ǥ ǡ•„”ͲͳͻǤ ”‡‡ƒǡǤǡ ƒ”‡–›ǡǤǤǡ‡„„‹‰–‘ǡǤǡŽƒ–‡”ǡǤǡ—‹’‡”•ǡǤǡ ‘™Ž‡”ǡǤǡ ”‡‡ǡǤǡ ‘”†ƒǡ Ǥǡ ƒ›ǡǤǡƬ—ǡ ǤȋʹͲͲͷThe JournalȌǤŠ‡’•› Š‘Ž‘‰›‘ˆ’‡”•‡ —–‘”›‹†‡ƒ–‹‘ ǣƒ˜‹”–—ƒŽ”‡ƒŽ‹–› of nervous and mental disease, 193 ‡š’‡”‹‡–ƒŽ•–—†›Ǥ ȋͷȌǡ͵ͲͻǦ͵ͳͷǤ ƒ›‡”Ǧ†‡”•‘ǡǤǡƬ‘”‰ƒǡǤȋEpidemiologyʹͲͳ͵Ȍ Ǥ‘ ‹ƒŽ‡–™‘”•ǡ•—’’‘”–ƒ†‡ƒ”Ž›’•› Š‘•‹•ǣƒand Psychiatric Sciences, 22 •›•–‡ƒ–‹ ”‡˜‹‡™Ǥ ȋͲʹȌǡͳ͵ͳǦͳͶ͸Ǥ

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‡˜‘†‡ǡǤǡ‘‘‹Œǡ Ǥǡ˜ƒ†‡”‹ǡǤǡ ‡‹Œ–‡ŽǡǤǡ˜ƒ•ǡ ǤǡƬ‡Ž–‡ǡ ǤǦǤȋʹͲͳͶȌǤ  ”‡ƒ•‡† ”‡Ž‡ƒ•‡‘ˆ†‘’ƒ‹‡‹–Š‡•–”‹ƒ–ƒ‘ˆ›‘—‰ƒ†—Ž–•™‹–ŠŠ‡ƒ”‹‰‹’ƒ‹”‡–ƒ†‹–•JAMA psychiatry, 71 ”‡Ž‡˜ƒ ‡ˆ‘”–Š‡•‘ ‹ƒŽ†‡ˆ‡ƒ–Š›’‘–Š‡•‹•‘ˆ• Š‹œ‘’Š”‡‹ƒǤ ȋͳʹȌǡ ͳ͵͸ͶǦͳ͵͹ʹǤ ‹„•‘ǡǤǤǡƬ ƒ”–•Š‘”‡ǡǤǤȋChildͳͻͻ͸ AbuseȌǤŠ‹Ž†Š‘‘†•‡š—ƒŽƒ„—•‡ƒ†ƒ†—Ž–Ž‘‡Ž‹‡••ƒ & Neglect, 20 † ‡–™‘”‘”‹‡–ƒ–‹‘Ǥ ȋͳͳȌǡͳͲͺ͹ǦͳͲͻ͵Ǥ Žƒ•‡”ǡ ǤǦǤǡƒ•ǡ Ǥǡ‘”–‡‰‹Œ•ǡǤ ǤǡƬ›‹Ǧ ‡”‡›•ǡ ǤȋʹͲͲ͸ȌǤŠ‹Ž†Š‘‘†–”ƒ—ƒƒ† ‡‘–‹‘ƒŽ”‡ƒ –‹˜‹–›–‘†ƒ‹Ž›Ž‹ˆ‡•–”‡••‹ƒ†—Ž–ˆ”‡“—‡–ƒ––‡†‡”•‘ˆ‰‡‡”ƒŽJournal of psychosomatic research, 61 ’”ƒ –‹–‹‘‡”•Ǥ ȋʹȌǡʹʹͻǦʹ͵͸Ǥ ¡ˆ‡”ǡ Ǥǡƒ—”‡”ǡǤǡ”‡†Ž‡”ǡ Ǥǡƒ†‡” ‡‹†‡ǡǤǡ Š‹†–ǡǤǡƬڐ‡ ‡ǡǤȋʹͲͲͷȌǤ  Š‹œ‘’Š”‡‹ƒƒ††‡’”‡••‹‘ǣ ŠƒŽŽ‡‰‹‰–Š‡’ƒ”ƒ†‹‰‘ˆ–™‘•‡’ƒ”ƒ–‡†‹•‡ƒ•‡•Schizophrenia —ƒ ‘–”‘ŽŽ‡†•–—†›‘ˆ• Š‹œ‘’Š”‡‹ƒǡ†‡’”‡••‹‘ƒ†Š‡ƒŽ–Š› ‘–”‘Ž•Ǥresearch, 77 ȋͳȌǡͳͳǦʹͶǤ ƒƒ‡”ǡǤȋHandbookʹͲͳʹ ofȌ. Whyresearch researchers methods shouldfor studying think daily“within lifeǦ’‡”•on”: A paradigmatic rationale. ExperienceǡͶ͵Ǧ͸ͳǤ sampling method: ‡–‡”ǡ ǤǤǡ Š‹†–ǡ ǤǤǡMeasuring the qualityƬ •‹•œ‡–‹ŠƒŽ›‹ǡǤȋof everyday life. ʹͲͲ͹ȌǤ Š‘—•ƒ†ƒ‡•ǡǣ ƒ‰‡Ǥ ‘ˆˆƒǡSchizophreniaǤǤȋʹͲͲ͹ȌǤ•‘ ‹ƒŽ†‡ƒˆˆ‡”‡–ƒ–‹‘Š›’‘–Š‡•‹•ˆ‘”‹†— –‹‘‘ˆƒ –‹˜‡• Š‹œ‘’Š”‡‹ƒǤ bulletin, 33 ȋͷȌǡͳͲ͸͸ǦͳͲ͹ͲǤ ‘™‡•ǡǤǤǡƬThe—””ƒ›ǡǤǤ Lancet, 383ȋʹͲͳͶȌǤ Š‹œ‘’Š”‡‹ƒǣƒ‹–‡‰”ƒ–‡†•‘ ‹‘†‡˜‡Ž‘’‡–ƒŽǦ ‘‰‹–‹˜‡ ‘†‡ŽǤ ȋͻͻʹͻȌǡͳ͸͹͹Ǧͳ͸ͺ͹Ǥ ƒ›ƒǡǤǤǡ ‹ŽŽƒǡǤǤǡ‡‹‹‰‡”ǡǤǤǡ ‘ŽŽ™‹–œ‡”ǡǤǡƬ‹ ‘ŽǡǤǤCognitiveȋʹͲͳ͸ TherapyȌǤ‘‡Ž‹‡••ƒ† and Research, ’•› Š‘–‹ •›’–‘•ǣŠ‡‡†‹ƒ–‹‰”‘Ž‡‘ˆ†‡’”‡••‹‘Ǥ  ͳǦͳͳǤ ‡ŽŽ‡Š‡”ǡ Ǥǡ‡‡Ž‡›ǡ Ǥǡ‘” ‘”ƒǡǤǡƒ•ƒ›ǡ Ǥǡƒ••‡”ƒǡǤǡƒ”Ž‹ǡǤǡƒ” Š‹ƒ’‘‡ǡǤǡ ‘˜‡ǡ Ǥǡƒ••‡”ƒǡǤǡƬƒ‘ǡǤȋʹͲͳ͵ȌǤŠ‹Ž†Š‘‘†–”ƒ—ƒƒ†’•› Š‘•‹•‹ƒAmerican Journal of ’”‘•’‡ –‹˜‡ ‘Š‘”–•–—†›ǣ ƒ—•‡ǡ‡ˆˆ‡ –ǡPsychiatry, 170 ƒ††‹”‡ –‹‘ƒŽ‹–›Ǥ ȋ͹Ȍǡ͹͵ͶǦ͹ͶͳǤ ‹Š›ǡǤǡ‡Ž‡•’ƒ—ŽǡǤǡ‘” ‘”ƒǡǤǡŠǡ ǤǡƒŽ‡ǡǤǡƬƒŽƒ•’‹ƒǡǤȋʹͲͲ͸ȌǤ‘’—–‡”‹œ‡† ‡š’‡”‹‡ ‡•ƒ’Ž‹‰‡–Š‘†ȋ Ȍǣƒ••‡••‹‰ˆ‡ƒ•‹„‹Ž‹–›ƒ†˜ƒŽ‹†‹–›ƒ‘‰Journal of psychiatric research, 40 ‹†‹˜‹†—ƒŽ•™‹–Š• Š‹œ‘’Š”‡‹ƒǤ ȋ͵ȌǡʹʹͳǦʹ͵ͲǤ ”ƒ‡”ǡ Ǥǡ‹‘•ǡǤ Ǥǡ‹‰ƒǡ ǤǤǡ‘ŽŽ‹’ǡǤǡ ƒ ‘„•ǡǤǡ‡”‘ǡǤǡŠ‹‡”›ǡǤǡ˜ƒ•ǡ Ǥǡ›‹Ǧ ‡”‡›•ǡ ǤǡƬ‹ Š‡”•ǡǤȋʹͲͳ͵ȌǤ‹‡ǦŽƒ‰‰‡†‘‡–Ǧ–‘Ǧ‘‡–‹–‡”’Žƒ›„‡–™‡‡ Schizophrenia‡‰ƒ–‹˜‡ƒˆˆ‡ –ƒ†’ƒ”ƒ‘‹ƒǣ‡™‹•‹‰Š–•‹–Š‡ƒˆˆ‡ –‹˜‡’ƒ–Š™ƒ›–‘ bulletin, 40 ’•› Š‘•‹•Ǥ ȋʹȌǡʹ͹ͺǦʹͺ͸Ǥ

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”ƒ‡”ǡ Ǥǡ‹‘•ǡǤ Ǥǡ‹‰ƒǡ ǤǤǡ‘ŽŽ‹’ǡǤǡ ƒ ‘„•ǡǤǡ‡”‘ǡǤǡŠ‹‡”›ǡǤǡ˜ƒ•ǡ Ǥǡ›‹Ǧ ‡”‡›•ǡ ǤǡƬ‹ Š‡”•ǡǤȋʹͲͳͶȌǤ‹‡ǦŽƒ‰‰‡†‘‡–Ǧ–‘Ǧ‘‡–‹–‡”’Žƒ›„‡–™‡‡ Schizophrenia‡‰ƒ–‹˜‡ƒˆˆ‡ –ƒ bulletin†’ƒ”ƒ‘‹ƒǣ‡™‹•‹‰Š–•‹–Š‡ƒˆˆ‡ –‹˜‡’ƒ–Š™ƒ›–‘’•› Š‘•‹•Ǥ, 40 ȋʹȌǡʹ͹ͺǦʹͺ͸Ǥ ƒ”†‹‘‹•ǡǤǡƒ–ƒ•–‡”ǡǤǡ‡‰‡Ž‡”•ǡǤǡƒ•ǡ ǤǡƬ›‹Acta PsychiatrǦ ‡”‡›•ǡ Ǥȋica ScandʹͲͳͳinavica,ȌǤŠ‹Ž†Š‘‘†–”ƒ—ƒ 123 ƒ†‹ ”‡ƒ•‡†•–”‡•••‡•‹–‹˜‹–›‹’•› Š‘•‹•Ǥ ȋͳȌǡʹͺǦ ͵ͷǤ ƒ”‹ǡǤǡƬ‡ƒ†ǡ ǤȋJournalʹͲͲͺȌǤŠ‹Ž†Š‘‘†–”ƒ—ƒƒ†’•› Š‘•‹•ǣ‡˜‹†‡ ‡ǡ’ƒ–Š™ƒ›•ǡƒ† of postgraduate medicine, 54 ‹’Ž‹ ƒ–‹‘•Ǥ ȋͶȌǡʹͺ͹Ǥ ‹ǡǤ Ǥǡ‘†‡„ƒ—‰ŠǡǤǤǡ›’Š—”ǡǤ ǤǡJournal of abnormalƬ Ž‡‡•‘ǡ Ǥ Ǥ psychologyȋʹͲͳ͸, Ȍ125Ǥ‘‡Ž‹‡••‘˜‡”–‹‡ǣŠ‡ ”— ‹ƒŽ ”‘Ž‡‘ˆ•‘ ‹ƒŽƒš‹‡–›Ǥ ȋͷȌǡ͸ʹͲǤ ‘‰†‡ǡǤǡƒ’•‘ǡǤǡEpidemiologyƬ‡ƒ†ǡ ǤȋʹͲͳ͸ and psychiatricȌǤŠ‹Ž†Š‘‘†ƒ†˜‡”•‹–›ƒ†’•› Š‘•‹•ǣ‰‡‡”ƒŽ sciences, 25 ‹•‡†‘” •’‡ ‹ˆ‹ ‡ˆˆ‡ –•ǫ ȋͲͶȌǡ͵ͶͻǦ͵ͷͻǤ ƒ–Š‡•‘ǡǤǡŠ‡’Š‡”†ǡǤǡ‹ Š„‡ ǡǤǡƒ—”‡•ǡǤǡPsychologicalƬƒ””ǡǤȋ ʹͲͳ͵medicineȌǤŠ‹Ž†Š‘‘†ƒ†˜‡”•‹–›‹, 43 4 • Š‹œ‘’Š”‡‹ƒǣƒ•›•–‡ƒ–‹ ‡–ƒǦƒƒŽ›•‹•Ǥ ȋʹȌǡʹʹͷǤ ‡Ž–œ‡”ǡ Ǥǡ‡„„‹‰–‘ǡǤǡ‡‹•ǡǤǤǡ ‡‹•ǡǤǡ ƒ—•ǡǤǡSocial PsychiatryƬ”—‰ŠƒǡǤǤȋ and PsychiatricʹͲͳ͵ȌǤ ‡‡Ž‹‰• ‘ˆŽ‘‡Ž‹‡••ƒ‘‰ƒ†—Ž–•™‹–Š‡–ƒŽ†‹•‘”†‡”ǤEpidemiology, 48 ȋͳȌǡͷǦͳ͵Ǥ ‡”œǡǤǦǤǡƬ ƒǡǤȋʹͲͳ͵ȌǤŠ‡Ž‘‰”‡ƒ Š‘ˆ Š‹Ž†Š‘‘†ǤŠ‹Ž†Š‘‘†‡š’‡”‹‡ ‡•‹ˆŽ—‡ ‡ Ž‘•‡Advances in life course research, 18 ”‡Žƒ–‹‘•Š‹’•ƒ†Ž‘‡Ž‹‡••ƒ ”‘••Ž‹ˆ‡Ǥ ȋ͵ȌǡʹͳʹǦʹʹʹǤ ‹ ŠƒŽ•ƒǡǤǤǤǡŠ‘†‡•ǡǤǡƒ•‹Ž‘’‘—Ž‘—ǡǤǡSchizophrenia Ƭbulletin. —––‘ǡǤȋ ʹͲͳ͹ȌǤ‘‡Ž‹‡••‹•› Š‘•‹•ǣ ‡–ƒǦƒƒŽ›–‹ ƒŽ‡˜‹‡™Ǥ ‘Ž‡ƒƒ”ǡǤǤȋʹͲͲͶȌǤƒ‹ˆ‡•–‘‘’•› Š‘Ž‘‰›ƒ•‹†‹‘‰”ƒ’Š‹ • ‹‡ ‡ǣ”‹‰‹‰–Š‡’‡”•‘Measurement, 2 „ƒ ‹–‘• ‹‡–‹ˆ‹ ’•› Š‘Ž‘‰›ǡ–Š‹•–‹‡ˆ‘”‡˜‡”Ǥ ȋͶȌǡʹͲͳǦʹͳͺǤ ‘Ž‡ƒƒ”ǡǤǤǡCurrentƬ directiƒ’„‡ŽŽǡǤ Ǥȋons in psychologicalʹͲͲͻȌǤŠ‡‡™’‡”•‘ science, 18 Ǧ•’‡ ‹ˆ‹ ’ƒ”ƒ†‹‰‹’•› Š‘Ž‘‰›Ǥ ȋʹȌǡͳͳʹǦͳͳ͹Ǥ ‘”‰ƒǡǤǡƬ ƒ›‡”‐†‡”•‘ǡǤWorldȋʹͲͳ͸ PsychiatryȌǤŠ‹Ž†Š‘‘†ƒ†˜‡”•‹–‹‡•ƒ†’•› Š‘•‹•ǣ‡˜‹†‡ ‡ǡ, 15 ŠƒŽŽ‡‰‡•ǡ‹’Ž‹ ƒ–‹‘•Ǥ ȋʹȌǡͻ͵ǦͳͲʹǤ —”’Š›ǡ ǤǡŠ‡˜Ž‹ǡǤǡ†ƒ•‘ǡ ǤǡƬ ‘—•–‘ǡ ǤǤȋʹͲͳ͵ȌǤ ”‘•‡š—ƒŽƒ„—•‡–‘’•› Š‘•‹•ǣƒ ’‹Ž‘–•–—†›‡š’Ž‘”‹‰–Š‡•‘ ‹ƒŽ†‡ƒˆˆ‡”‡–ƒ–‹‘Š›’‘–Š‡•‹•ƒ†–Š‡‡†‹ƒ–‹‰”‘Ž‡‘ˆPsychosis, 5 ƒ˜‘‹†ƒ ‡Ǥ ȋͳȌǡ͵͸ǦͶ͹Ǥ ›‹Ǧ ‡”‡›•ǡ Ǥǡ‡Ž‡•’ƒ—ŽǡǤǡCurrentƬ˜ƒ•ǡ Ǥ Opinionȋ inʹͲͲ͵ Psychiatry,ȌǤŠ‡‡š’‡”‹‡ ‡•ƒ’Ž‹‰‡–Š‘†‹ 16 ’•› Š‘•‹•”‡•‡ƒ” ŠǤ ǡ͵͵Ǧ͵ͺǤ ›‹Ǧ ‡”‡›•ǡ Ǥǡ‘”• Š‘–ǡǤǡ‘ŽŽ‹’ǡǤǡƒ–ƒ•–‡”ǡ Ǥǡ‡Ž‡•’ƒ—ŽǡǤǡƬ˜ƒ•ǡ ǤȋʹͲͲͻȌǤ š’‡”‹‡ ‡•ƒ’Ž‹‰”‡•‡ƒ” Š‹’•› Š‘’ƒ–Š‘Ž‘‰›ǣ‘’‡‹‰–Š‡„Žƒ „‘š‘ˆ†ƒ‹Ž›Ž‹ˆ‡ǤPsychological medicine, 39 ȋͻȌǡͳͷ͵͵Ǥ

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‡™„—”›ǡ ǤǤǡ”•‡‡ƒ—Ž–ǡǤǡ‘ˆˆ‹––ǡǤǤǡƒ•’‹ǡǤǡƒ‡•‡ǡǤǡƒŽ†™‹ǡ ǤǤǡƬ ‹•Š‡”ǡ ǤǤ ȋʹͲͳͺȌǤ‡ƒ•—”‹‰ Š‹Ž†Š‘‘†ƒŽ–”‡ƒ–‡––‘’”‡†‹ –‡ƒ”Ž›Ǧƒ†—Ž–’•› Š‘’ƒ–Š‘Ž‘‰›ǣJournal of ‘’ƒ”‹•‘‘ˆ’”‘•’‡ –‹˜‡‹ˆ‘”ƒ–psychiatric research, 96 Ǧ”‡’‘”–•ƒ†”‡–”‘•’‡ –‹˜‡•‡ŽˆǦ”‡’‘”–•Ǥ ǡͷ͹Ǧ͸ͶǤ •™ƒŽ†ǡǤǤǡƒ†ǡ ǤǤǡ—™ƒ„ƒ”ƒǡ Ǥǡ‘‰ǡǤ ǤǡŠ—ǡǤǡƬ”ƒ•‹ ǡ ǤǤȋʹͲͳͶȌǤ ‹•–‘”›‘ˆ Š‹Ž†Š‘‘†ƒ†˜‡”•‹–›‹•’‘•‹–‹˜‡Ž›ƒ••‘ ‹ƒ–‡†™‹–Š˜‡–”ƒŽ•–”‹ƒ–ƒŽ†‘’ƒ‹‡”‡•’‘•‡•–‘ Psychopharmacology, 231 ƒ’Š‡–ƒ‹‡Ǥ ȋͳʹȌǡʹͶͳ͹ǦʹͶ͵͵Ǥ ”‡ƒ Š‡”ǡǤ Ǥǡ›’Š—”ǡǤ ǤǡƬŠƒ‰ǡǤȋPsychologicalʹͲͳͲȌǤ‰‡‡”ƒŽ—Ž–‹Ž‡˜‡Žˆ”ƒ‡™‘”ˆ‘” methods, 15 ƒ••‡••‹‰—Ž–‹Ž‡˜‡Ž‡†‹ƒ–‹‘Ǥ ȋ͵ȌǡʹͲͻǤ ‡ƒ†ǡ Ǥǡ˜ƒ•ǡ Ǥǡ‘””‹•‘ǡǤǤǡƬ‘••ǡǤǤȋʹͲͲͷȌǤŠ‹Ž†Š‘‘†–”ƒ—ƒǡ’•› Š‘•‹•ƒ†Acta • Š‹œ‘’Š”‡‹ƒǣƒŽ‹–‡”ƒ–—”‡”‡˜‹‡™™‹–Š–Š‡‘”‡–‹ ƒŽƒ† Ž‹‹ ƒŽ‹’Ž‹ ƒ–‹‘•ǤPsychiatrica Scandinavica, 112 ȋͷȌǡ͵͵ͲǦ͵ͷͲǤ ‘‘ǡǤǤȋͳͻͺ͹ȌǤ‘ ‹ƒŽ•—’’‘”–˜‡”•—• ‘’ƒ‹‘•Š‹’ǣˆˆ‡ –•‘Ž‹ˆ‡•–”‡••ǡŽ‘‡Ž‹‡••ǡƒJournal of personality and social psychology, 52 † ‡˜ƒŽ—ƒ–‹‘•„›‘–Š‡”•Ǥ ȋ͸Ȍǡͳͳ͵ʹǤThe British ‡Ž–‡ǡ ǤJournalǦǤǡƬƒ–‘” of PsychiatryǦ ”ƒƒ‡ǡǤȋ, 187ʹͲͲͷȌǤ‘ ‹ƒŽ†‡ˆ‡ƒ–ǣ”‹•ˆƒ –‘”ˆ‘”• Š‹œ‘’Š”‡‹ƒǫ ȋʹȌǡͳͲͳǦͳͲʹǤ ‡Ž–‡ǡ ǤǦǤǡ˜ƒ†‡”‡ǡǤǡ—––‡ǡǤǤǡSchizophreniaƬƒ–‘”Ǧ ”ƒƒ‡ǡǤȋ bulletin, 39ʹͲͳ͵ȌǤŠ‡•‘ ‹ƒŽ†‡ˆ‡ƒ–Š›’‘–Š‡•‹• ‘ˆ• Š‹œ‘’Š”‡‹ƒǣƒ—’†ƒ–‡Ǥ ȋ͸ȌǡͳͳͺͲǦͳͳͺ͸Ǥ Š‡˜Ž‹ǡǤǡ Ž”‘›ǡǤǡƬ—”’Š›ǡ ǤȋʹͲͳͷȌǤ‘‡Ž‹‡••‡†‹ƒ–‡•–Š‡”‡Žƒ–‹‘•Š‹’„‡–™‡‡ Š‹Ž†Š‘‘†–”ƒ—ƒƒ†ƒ†—Ž–’•› Š‘’ƒ–Š‘Ž‘‰›ǣ‡˜‹†‡ ‡ˆ”‘–Š‡ƒ†—Ž–’•› Š‹ƒ–”‹ Social psychiatry and psychiatric epidemiology, 50 ‘”„‹†‹–›•—”˜‡›Ǥ ȋͶȌǡͷͻͳǦ͸ͲͳǤ –ƒ”–—’ǡ Ǥǡ ”‡‡ƒǡǤǡƬ ƒ”‡–›ǡǤǤȋʹͲͲ͹ȌǤ‡”•‡ —–‘”›†‡Ž—•‹‘•ƒ† ƒ–ƒ•–”‘’Š‹ ™‘””›‹Behaviour ’•› Š‘•‹•ǣ†‡˜‡Ž‘’‹‰–Š‡—†‡”•–ƒ†‹‰‘ˆ†‡Ž—•‹‘†‹•–”‡••ƒ†’‡”•‹•–‡ ‡Ǥresearch and therapy, 45 ȋ͵Ȍǡͷʹ͵Ǧͷ͵͹Ǥ ò†‡”ƒǡǤǡ™—‡”‡ǡ Ǥǡƒ‡ǡ Ǥǡ‘”‰ƒǡǤǡƬ—‹’‡”•ǡǤȋʹͲͳͶȌǤ‘ ‹ƒŽ‡–™‘”•ƒ†Social •—’’‘”–‹ˆ‹”•–psychiatry and psychiatricǦ‡’‹•‘†‡’•› Š‘•‹•ǣ‡š’Ž‘”‹‰–Š‡”‘Ž‡‘ˆŽ‘‡Ž‹‡••ƒ†ƒš‹‡–›Ǥ epidemiology, 49 ȋ͵Ȍǡ͵ͷͻǦ͵͸͸Ǥ —••‡”ǡǤǡƬ‹†‘ǡǤǤȋSchizophreniaʹͲͳʹȌǤ–‹ŽŽ•‡ƒ” Š‹‰ˆ‘”Ž‘•––”—–Š•ƒ„‘—––Š‡„‹––‡”•‘””‘™•‘ˆ bulletin, 38 Š‹Ž†Š‘‘†Ǥ ȋͶȌǡ͸͹ʹǦ͸͹ͷǤ Š‡™‹••‡ǡǤǡ‡–ƒŽŽǡǤǤǡ‘”• Š‘–ǡǤǡ ǡǤǤǡ˜ƒ‹‡”‘’ǡǤǡ˜ƒ•ǡ ǤǡƬ›‹Ǧ ‡”‡›•ǡ Ǥ BrȋʹͲͳͳitishȌ ǤJournal‘–‹‘•ǡ•‡Žˆ of ClinicalǦ‡•–‡‡ǡƒ†’ƒ”ƒ Psychology, 50 ‘‹†‡’‹•‘†‡•ǣƒ‡š’‡”‹‡ ‡•ƒ’Ž‹‰•–—†›Ǥ ȋʹȌǡͳ͹ͺǦͳͻͷǤ ˜ƒ†‡”‡”ˆǡǤǡ˜ƒ‹‡ŽǡǤǡ˜ƒ‘š–‡ŽǡǤǡƬ˜ƒ•ǡ ǤȋʹͲͳͲȌǤ˜‹†‡ ‡–Šƒ––Š‡‹’ƒ –‘ˆ Š‡ƒ”‹‰‹’ƒ‹”‡–‘’•› Š‘•‹•”‹•‹•‘†‡”ƒ–‡†„›–Š‡Schizophrenia research, 122 Ž‡˜‡Ž‘ˆ ‘’Ž‡š‹–›‘ˆ–Š‡ •‘ ‹ƒŽ‡˜‹”‘‡–Ǥ ȋͳȌǡͳͻ͵ǦͳͻͺǤ

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146807_JonasWeijers_BNW_def.indd 84 28-10-2020 15:08 The relationship between childhood abuse, psychosis and loneliness

˜ƒ‹‡”‘’ǡǤǡƒ–ƒ•–‡”ǡǤǡ‡‡–•ǡ Ǥǡ —–Š‡”ǡǤǡ˜ƒ‡Ž•–ǡǤǡ†‡ ”ƒƒˆǡǤǡ–‡ ƒ˜‡ǡǤǡ˜ƒ ‘”••‡Žƒ‡”ǡǤǡƒǡǤǡƬ›‹Ǧ ‡”‡›•ǡ ǤȋʹͲͳͶȌǤ•› Š‘’ƒ–Š‘Ž‘‰‹ ƒŽ‡ Šƒ‹•• Ž‹‹‰ Š‹Ž†Š‘‘†–”ƒ—ƒ–‹ ‡š’‡”‹‡ ‡•–‘”‹•‘ˆ’•› Š‘–‹ •›’–‘•ǣƒƒŽ›•‹•‘ˆƒSchizophrenia bulletin, 40 Žƒ”‰‡ǡ”‡’”‡•‡–ƒ–‹˜‡’‘’—Žƒ–‹‘Ǧ„ƒ•‡†•ƒ’Ž‡Ǥ ȋʹȌǡͳʹ͵Ǧͳ͵ͲǤ ƒ”‡•‡ǡ Ǥǡ‡‡–•ǡ Ǥǡ”—‡”ǡǤǡ‹‡˜‡”•‡ǡǤǡƒ–ƒ•–‡”ǡǤǡ‹‡ Š–„ƒ—‡”ǡǤǡ‡ƒ†ǡ Ǥǡ˜ƒ•ǡ ǤǡƬ ‡–ƒŽŽǡǤǤȋʹͲͳʹȌǤŠ‹Ž†Š‘‘†ƒ†˜‡”•‹–‹‡•‹ ”‡ƒ•‡–Š‡”‹•‘ˆ’•› Š‘•‹•ǣƒ‡–ƒǦ ƒƒŽ›•‹•‘ˆ’ƒ–‹‡–Schizophrenia bulletin,Ǧ ‘–”‘Žǡ’”‘•’‡ –‹˜‡Ǧƒ† ”‘••Ǧ•‡ –‹‘ƒŽ ‘Š‘”–•–—†‹‡•Ǥ •„•ͲͷͲǤ ‡‹Œ‡”•ǡ Ǥǡ–‡ƒ–‡ǡǤǡ—”‡Ž‹‰•Ǧ‘–‡‘‡ǡǤǡ‹‡ Š–„ƒ—‡”ǡǤǡƒ’ƒƒ”–ǡǤǡƒ–‡ƒǡǤǡƬ ‡Ž–‡ǡ ǤǦǤȋʹͲͳ͸ȌǤ‡–ƒŽ‹œƒ–‹‘BMC Ǧpsychiatry„ƒ•‡†–”‡ƒ–‡–ˆ‘”’•› Š‘–‹ †‹•‘”†‡”ǣ’”‘–‘ ‘Ž‘ˆƒ, 16 ”ƒ†‘‹œ‡† ‘–”‘ŽŽ‡†–”‹ƒŽǤ ȋͳȌǡͳͻͳǤ ƒˆƒ”ǡǤǤǡ›‡†ǡǤǡ‡Š•‡‡ǡǤǡ ‘™ƒ‹ǡǤǤǡƒ“ƒ”ǡǤǡ—„ƒ‹”ǡǤǡ‘—•ƒˆǡǤǡ—„ƒ‹”‹ǡǤ ǤǡƬ ƒ“˜‹ǡ ǤȋʹͲͲͺȌǤ‡” ‡’–‹‘•ƒ„‘—––Š‡ ƒ—•‡‘ˆ• Š‹œ‘’Š”‡‹ƒƒ†–Š‡•—„•‡“—‡–Š‡Ž’BMC •‡‡‹‰„‡Šƒ˜‹‘”‹ƒƒ‹•–ƒ‹’‘’—Žƒ–‹‘psychiatry, 8 –”‡•—Ž–•‘ˆƒ ”‘••Ǧ•‡ –‹‘ƒŽ•—”˜‡›Ǥ 4 ȋͳȌǡͷ͸Ǥ  





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146807_JonasWeijers_BNW_def.indd 86 28-10-2020 15:08

Chapter Five:

‡–ƒŽ‹œ‹‰‹’ƒ‹”‡–ƒ•ƒ‡†‹ƒ–‘”„‡–™‡‡”‡’‘”–‡† Psychiatry Research (2018) Š‹Ž†Š‘‘†ƒ„—•‡ƒ†‘—– ‘‡‹‘ƒˆˆ‡ –‹˜‡’•› Š‘–‹ †‹•‘”†‡”Ǥ J.G.MENTALIZING Weijers1,2,*, P. Fonagy3, E. Eurelings-Bontekoe 4, F. Termorshuizen1, W. Viechtbauer2, J.P. Selten1,2. IMPAIRMENT AS A

MEDIATOR BETWEEN REPORTED CHILDHOOD ABUSE AND OUTCOME IN NONAFFECTIVE PSYCHOTIC DISORDER 5

J.G. Weijers, P. Fonagy, E.H.M. Eurelings-Bontekoe, ͳ F. Termorshuizen,ʹ‹˜‹‡”†—‹‡ •–‹–—–‡ˆ‘”‡–ƒŽ ‡ƒŽ–Šƒ”‡ǡ–Š‡‡–Š‡”Žƒ†•Ǥ W.V. Viechtbauer, J.-P.C.J. Selten  ͵ Š‘‘Žˆ‘”‡–ƒŽ ‡ƒŽ–Šƒ†‡—”‘• ‹‡ ‡ǡƒƒ•–”‹ Š–‹˜‡”•‹–›ǡ–Š‡‡–Š‡”Žƒ†•Ǥ ‡•‡ƒ” Š‡’ƒ”–‡–‘ˆŽ‹‹ ƒŽǡ†— ƒ–‹‘ƒŽǡƒ† ‡ƒŽ–Š•› Š‘Ž‘‰›ǡ‹˜‡”•‹–›‘ŽŽ‡‰‡ Ͷ‘†‘ǡ‹–‡†‹‰†‘Ǥ ‡’ƒ”–‡–‘ˆŽ‹‹ ƒŽ•› Š‘Ž‘‰›ǡ ‡ƒŽ–Šǡƒ†‡—”‘’•› Š‘Ž‘‰›ǡ‡‹†‡‹˜‡”•‹–›ǡ–Š‡ Psychiatry‡–Š‡”Žƒ†•Ǥ Research (2018) Chapter Chapter ȗ‘””‡•’‘†‹‰ƒ—–Š‘”ǣ ‘ƒ•‡‹Œ‡”•ǡ‡ƒ‹Žƒ††”‡••ǣŒǤ™‡‹Œ‡”•̷”‹˜‹‡”†—‹‡ǤŽ

146807_JonasWeijers_BNW_def.indd 87 28-10-2020 15:08 Chapter Five

Abstract

‡’‘”–‡† Š‹Ž†Š‘‘†ƒ„—•‡Šƒ•„‡‡Ž‹‡†–‘–Š‡•‡˜‡”‹–›‘ˆ Ž‹‹ ƒŽ•›’–‘•ƒ†•‘ ‹ƒŽ †›•ˆ— –‹‘‹‘Ǧƒˆˆ‡ –‹˜‡’•› Š‘–‹ †‹•‘”†‡”Ǥ ’ƒ‹”‡†‡–ƒŽ‹œ‹‰ƒ„‹Ž‹–›ƒ›„‡‘‡‘ˆ–Š‡ ‡ Šƒ‹••ƒ ‘—–‹‰ˆ‘”–Š‹•‡ˆˆ‡ –ǤŠ‹••–—†›‡šƒ‹‡†™Š‡–Š‡”‹’ƒ‹”‡†‡–ƒŽ‹œ‹‰ ‡†‹ƒ–‡•–Š‡‡ˆˆ‡ –‘ˆ”‡’‘”–‡† Š‹Ž†Š‘‘†ƒ„—•‡‘’‘•‹–‹˜‡•›’–‘•ǡ‡‰ƒ–‹˜‡•›’–‘•ǡƒ† •‘ ‹ƒŽ†›•ˆ— –‹‘Ǥ ‹‰Š–›Ǧ•‡˜‡’ƒ–‹‡–•™‹–Š‘Ǧƒˆˆ‡ –‹˜‡’•› Š‘–‹ †‹•‘”†‡”™‡”‡‡šƒ‹‡†Ǥ ‡’‘”–‡† Š‹Ž†Š‘‘†ƒ„—•‡™ƒ•‡ƒ•—”‡†—•‹‰–Š‡Š‹Ž†Š‘‘†š’‡”‹‡ ‡‘ˆƒ”‡ƒ†„—•‡ ‹–‡”˜‹‡™Ǥ††‹–‹‘ƒŽŽ›ǡ–Š‡‘ ‹ƒŽ — –‹‘‹‰ ƒŽ‡ƒ†–Š‡‘•‹–‹˜‡ƒ†‡‰ƒ–‹˜‡›†”‘‡  ƒŽ‡™‡”‡—•‡†ǤŠ‡ ‹–‹‰ƒ•™ƒ•—•‡†–‘‡ƒ•—”‡‡–ƒŽ‹œ‹‰‹’ƒ‹”‡–Ǥ‡’‘”–‡† Š‹Ž†Š‘‘†ƒ„—•‡™ƒ••‹‰‹ˆ‹ ƒ–Ž›”‡Žƒ–‡†–‘–Š‡•‡˜‡”‹–›‘ˆ’‘•‹–‹˜‡ƒ†‡‰ƒ–‹˜‡•›’–‘•ǡ‘– –‘•‘ ‹ƒŽ†›•ˆ— –‹‘Ǥ‡’‘”–‡† Š‹Ž†Š‘‘†ƒ„—•‡™ƒ•ƒŽ•‘”‡Žƒ–‡†–‘‡–ƒŽ‹œ‹‰‹’ƒ‹”‡–Ǥ ‡–ƒŽ‹œ‹‰‹’ƒ‹”‡–™ƒ•”‡Žƒ–‡†–‘‡‰ƒ–‹˜‡•›’–‘•ǡ„—–‘––‘’‘•‹–‹˜‡•›’–‘•‘” •‘ ‹ƒŽ†›•ˆ— –‹‘Ǥ‡–ƒŽ‹œ‹‰‹’ƒ‹”‡–ƒ ‘—–‡†ˆ‘”ͶͲΨ‘ˆ–Š‡ƒ••‘ ‹ƒ–‹‘„‡–™‡‡ ”‡’‘”–‡† Š‹Ž†Š‘‘†ƒ„—•‡ƒ†‡‰ƒ–‹˜‡•›’–‘•ǡ‹†‹ ƒ–‹‰’ƒ”–‹ƒŽ‡†‹ƒ–‹‘Ǥ•‡•‹–‹˜‹–› ƒƒŽ›•‹•”‡˜‡ƒŽ‡†–Šƒ––Š‡‡†‹ƒ–‹‰‡ˆˆ‡ –™ƒ•‘Ž›‘„•‡”˜‡†‹–Š‘•‡™Š‘”‡’‘”–‡†ˆƒ‹”Ž› •‡˜‡”‡ Š‹Ž†Š‘‘†ƒ„—•‡Ǥ  Keywords.

‡–ƒŽ‹œƒ–‹‘Ǣ’•› Š‘•‹•Ǣ’‘•‹–‹˜‡•›’–‘•Ǣ‡‰ƒ–‹˜‡•›’–‘•Ǣ•‘ ‹ƒŽˆ— –‹‘‹‰Ǥ Introduction

ƒ–‹‡–•™‹–Š‘Ǧƒˆˆ‡ –‹˜‡’•› Š‘–‹ †‹•‘”†‡”ƒ”‡ƒŽ‘•––Š”‡‡–‹‡•ƒ•Ž‹‡Ž›ƒ•‘Ǧ ’•› Š‹ƒ–”‹  ‘–”‘Ž•–‘”‡’‘”–ƒŠ‹•–‘”›‘ˆƒ„—•‡‹ Š‹Ž†Š‘‘†ȋƒ”‡•‡‡–ƒŽǤǡʹͲͳʹȌǤ‘”‡‘˜‡”ǡ ”‡’‘”–‡† Š‹Ž†Š‘‘†ƒ„—•‡‹•ƒ••‘ ‹ƒ–‡†™‹–Š–Š‡•‡˜‡”‹–›‘ˆ’‘•‹–‹˜‡ƒ†‡‰ƒ–‹˜‡•›’–‘• ȋ‘‰†‡ǡƒ’•‘ǡƬ‡ƒ†ǡʹͲͳͷǢ Š‡‡Žǡ’ƒ—Ž†‹‰ǡ‹‹ŽŽ‘ǡƬ‹Ž˜‡”•–‡‹ǡʹͲͲͷǢ’ƒ—™‡ǡ ”ƒ„„‡†ƒǡ‹‡„ǡ‹–– Š‡Ƭƒ•ǡʹͲͲ͸Ǣƒƒ‡–ƒŽǤǡʹͲͳͷȌǡƒ†–Š‡”‡‹••‘‡‡˜‹†‡ ‡ ˆ‘”ƒƒ••‘ ‹ƒ–‹‘™‹–Š•‘ ‹ƒŽ†›•ˆ— –‹‘ƒ•™‡ŽŽȋŽƒ‡†ƒ‡–ƒŽǤǡʹͲͳͷǢ–ƒ‹‡–ƒŽǤǡʹͲͳ͵ȌǤ ‘™‡˜‡”ǡŽ‹––Ž‡‹•‘™ƒ„‘—––Š‡—†‡”Ž›‹‰‡ Šƒ‹••Ǥ‡ ‡–Ž›ǡ‹–Šƒ•„‡‡’”‘’‘•‡†–Šƒ– ‘‡•— Š‡ Šƒ‹•‹•ƒ‹’ƒ‹”‡†ƒ„‹Ž‹–›–‘‡–ƒŽ‹œ‡ȋ˜ƒ•‡–ƒŽǤǡʹͲͳͲȌǤ‡–ƒŽ‹œ‹‰Šƒ• been defined as the capacity to understand one’s own and others’ behaviour in terms of mental •–ƒ–‡•ǡ•— Šƒ•‹–‡–‹‘•ǡ™‹•Š‡•ǡ„‡Ž‹‡ˆ•ǡƒ†‡‘–‹‘•ȋƒ–‡ƒƬ ‘ƒ‰›ǡʹͲͳʹȌǤƒ–‹‡–• ™‹–Š‘Ǧƒˆˆ‡ –‹˜‡’•› Š‘–‹ †‹•‘”†‡”Šƒ˜‡„‡‡•Š‘™–‘’‡”ˆ‘”’‘‘”Ž›‘†‹ˆˆ‡”‡– dimensions of mentalizing, such as ‘theory of mind’ (i.e. the ability to infer mental states from other’s behavior; ’”‘‰ǡ Š‘–Š‘”•–ǡ‘•ǡ ‘šǡƬƒ‰‡Žƒ†ǡʹͲͲ͹Ȍǡ‹†‡–‹ˆ›‹‰ƒ† describing their own emotional states (O’Driscoll, Laing Ƭƒ•‘ǡʹͲͳͶȌƒ†recognizing others’ ‡‘–‹‘ƒŽ•–ƒ–‡•ȋ”±‡ƒ—ǡʹͲͲ͸ȌǤ

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‘•–—†›–‘†ƒ–‡Šƒ•‡šƒ‹‡†–Š‡’‘••‹„Ž‡‡†‹ƒ–‹‰”‘Ž‡‘ˆ‹’ƒ‹”‡†‡–ƒŽ‹œ‹‰‹ –Š‡”‡Žƒ–‹‘„‡–™‡‡”‡’‘”–‡† Š‹Ž†Š‘‘†ƒ„—•‡ƒ†–Š‡‘—– ‘‡‘ˆ‘Ǧƒˆˆ‡ –‹˜‡’•› Š‘–‹  †‹•‘”†‡”ǡ‡˜‡–Š‘—‰Š‹–‹•ƒ’Žƒ—•‹„Ž‡—†‡”Ž›‹‰‡ Šƒ‹•Ǥ„—•‡‹ Š‹Ž†Š‘‘†Šƒ•„‡‡ ”‡Žƒ–‡†–‘‹’ƒ‹”‡†‘”†‡Žƒ›‡††‡˜‡Ž‘’‡–‘ˆ‡–ƒŽ‹œ‹‰ȋ‹ Š‡––‹ǡ‘‰‘• Šǡƒ—‰Šƒǡ‘–Šǡ Ƭ”— ‡ǡʹͲͲ͵Ǣ‡ƒ”•Ƭ ‹•Š‡”ǡʹͲͲͷǢ•‹‡–ƒŽǤǡʹͲͳͷȌƒ†’‘‘”—†‡”•–ƒ†‹‰‘” †‹• ”‹‹ƒ–‹‘‘ˆ‡‘–‹‘•ȋ‘‰‘• Šǡ‹ Š‡––‹Ƭ„‡”ǡͳͻͻͷǢƒ”ƒ•ǡƒ Š•ǦŽ–‡”ǡƬ‹„‘”†›ǡ ͳͻͻ͸ǢŠ‹’ƒƬ‡ƒǡͳͻͻͻǢ‘ŽŽƒ‡–ƒŽǤǡʹͲͲͲǢ†™ƒ”†•ǡŠ‹’ƒƬ”‘™ǡʹͲͲͷȌǤ ƒ”‡–ƒŽƒ„—•‡‹• ‘•‹†‡”‡†–‘„‡’ƒ”–‹ —Žƒ”Ž›†‡–”‹‡–ƒŽ–‘–Š‡†‡˜‡Ž‘’‡–‘ˆ ‡–ƒŽ‹œ‹‰ǡ„‡ ƒ—•‡–Š‡‰”‘—†™‘”‘ˆ‡–ƒŽ‹œ‹‰‹•Žƒ‹†–Š”‘—‰Š†ƒ›Ǧ–‘Ǧ†ƒ›‹–‡”ƒ –‹‘• ™‹–Š’”‹ƒ”› ƒ”‡‰‹˜‡”•ȋ ‘ƒ‰›ǡ ‡”‰‡Ž›ǡƬ —”‹•–ǡʹͲͲͶȌ. By labelling the child’s mental stƒ–‡•ǡ ƒ”‡‰‹˜‡”•Š‡Ž’–Š‡ Š‹Ž†—†‡”•–ƒ†Š‹•ȀŠ‡”‘™‡–ƒŽ•–ƒ–‡•ȋ‹ǡʹͲͳͷȌǡ™Š‹ Šƒ›„‡ ˜‹‡™‡†ƒ•ƒ’”‡”‡“—‹•‹–‡ˆ‘”–Š‡ƒ„‹Ž‹–›–‘‹ˆ‡”–Š‡‡–ƒŽ•–ƒ–‡•‘ˆ‘–Š‡”•ȋ”ò‡ǡʹͲͲͷȌǤ  ‘–”ƒ•–ǡ’ƒ”‡–ƒŽƒ„—•‡ ƒ„‡˜‹‡™‡†ƒ•”‡ˆŽ‡ –‹‰ƒ‹ƒ„‹Ž‹–›‘–Š‡’ƒ”–‘ˆ–Š‡ ƒ”‡‰‹˜‡”–‘ ‡–ƒŽ‹œ‡–Š‡‹‡”‡š’‡”‹‡ ‡•‘ˆ–Š‡ Š‹Ž†ǡ–Š‡”‡„›†‡’”‹˜‹‰–Š‡ Š‹Ž†‘ˆƒ‰‘‘†”‘Ž‡‘†‡Žˆ‘” ‡–ƒŽ‹œ‹‰ȋ‹ǡʹͲͳͷȌǤ††‹–‹‘ƒŽŽ›ǡ’ƒ”‡–ƒŽƒ„—•‡Šƒ•„‡‡ƒ”‰—‡†–‘‹’‡†‡‡–ƒŽ‹œ‹‰ „›‹†— ‹‰ƒŽ‡••‡‡†‘–‹˜ƒ–‹‘–‘‡–ƒŽ‹œ‡‹–Š‡ Š‹Ž†ǡ‘”‡˜‡’Š‘„‹ ƒ˜‘‹†ƒ ‡‘ˆ 5 mentalizing, because reflecting on a caregiver’s malevolent or uncaring mental states is ‘˜‡”™Š‡Ž‹‰Ž›’ƒ‹ˆ—ŽȋŠ‹‡•ƒƬ ‘ƒ‰›ǡʹͲͳͶȌǤ ‘–Š‡”Ž‹‡‘ˆ”‡•‡ƒ” Š•—‰‰‡•–•–Šƒ–ƒ‹’ƒ‹”‡†ƒ„‹Ž‹–›–‘”‡’”‡•‡–‡–ƒŽ•–ƒ–‡• ƒ› ‘–”‹„—–‡–‘–Š‡•‡˜‡”‹–›‘ˆ’‘•‹–‹˜‡ƒ†‡‰ƒ–‹˜‡•›’–‘•‹‘Ǧƒˆˆ‡ –‹˜‡’•› Š‘–‹  †‹•‘”†‡”ȋ ”‹–ŠǡʹͲͲͶȌǤ ‘”‹•–ƒ ‡ǡƒ‹ƒ„‹Ž‹–›–‘‹†‡–‹ˆ›one’s own intentions may contribute to the experience that one’s actions are caused or influenced by an outside force (i.e., †‡Ž—•‹‘•‘ˆ ‘–”‘ŽȌǤ‘”‡‘˜‡”ǡ˜‡”„ƒŽŠƒŽŽ— ‹ƒ–‹‘•ƒ†–Š‡‡š’‡”‹‡ ‡‘ˆ–Š‘—‰Š–‹•‡”–‹‘ ‘—Ž†ƒ”‰—ƒ„Ž›„‡˜‹‡™‡†ƒ•–Š‡incorrect representation of one’s own thoughts. D‡Ž—•‹‘•‘ˆ persecution and reference, by definition, involve the misrepresentation of another person’s ‹–‡–‹‘•Ǥ‘ ‡”‹‰‡‰ƒ–‹˜‡•›’–‘•ǡ–Š‡‹ƒ„‹Ž‹–›–‘”‡’”‡•‡–™Šƒ–‘–Š‡”•–Š‹ǡ‹–‡†ǡ ‘”†‡•‹”‡‹•Ž‹‡Ž›–‘ ‘’Ž‹ ƒ–‡•‘ ‹ƒŽ‹–‡”ƒ –‹‘•ǡ‹–—”‹ ”‡ƒ•‹‰–Š‡–‡†‡ ›–‘™‹–Š†”ƒ™ ˆ”‘•— Š•‹–—ƒ–‹‘•Ǥ‹‹Žƒ”Ž›ǡ–Š‡‹ƒ„‹Ž‹–›–‘—•‡‰‡•–—”‡•ǡˆƒ ‹ƒŽ‡š’”‡••‹‘•ǡƒ†–‘‡‘ˆ˜‘‹ ‡ –‘‡š’”‡••‡‘–‹‘•– ‘‘Ž›”‡ˆ‡””ed to as ‘flattened affect’ –ƒ›„‡‡šƒ ‡”„ƒ–‡†„›ƒ ‹ƒ„‹Ž‹–›–‘—†‡”•–ƒ†–Š‡’ƒ”–‹ —Žƒ”‡–ƒŽ•–ƒ–‡• ‘˜‡›‡†„›•— Š ‘—‹ ƒ–‹‘ƒŽ —‡•Ǥ Lastly, failing to identify one’s own goals may contribute to avolition. ƒ”–‹ƒŽ•—’’‘”–ˆ‘”–Š‹•–Š‡‘”› ‘‡•ˆ”‘ƒ—„‡”‘ˆ•–—†‹‡•–Šƒ–Šƒ˜‡ ‘•‹•–‡–Ž› ƒ••‘ ‹ƒ–‡†‹’ƒ‹”‡†‡–ƒŽ‹œ‹‰ƒ„‹Ž‹–›™‹–Š‡‰ƒ–‹˜‡•›’–‘•ȋ‘‘†›ǡ ږœǡ ‘Š•–‘‡ǡ ”‹–Šǡ Ƭ™‡•ǡͳͻͻͺǢ ”‡‹‰ǡ”›•‘ǡƬ‡ŽŽǡʹͲͲͶǢ‡”‰‹‡–ƒŽǤǡʹͲͲ͹Ȍƒ†•‘ ‹ƒŽ†›•ˆ— –‹‘ȋ‘—–—”‡ ‡–ƒŽǤǡʹͲͲ͸Ǣ ‡––‡–ƒŽǤǡʹͲͳͳȌǤ ‘™‡˜‡”ǡ•—’’‘”–ˆ‘”ƒƒ••‘ ‹ƒ–‹‘„‡–™‡‡‹’ƒ‹”‡† ‡–ƒŽ‹œ‹‰ƒ„‹Ž‹–›ƒ†’‘•‹–‹˜‡•›’–‘•‹•™‡ƒ‡”Ǥ‘‡•–—†‹‡•Šƒ˜‡ˆ‘—†•— Šƒ

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ƒ••‘ ‹ƒ–‹‘ȋ‘” ‘”ƒǡ‡” ‡”ǡƬ ”‹–ŠǡͳͻͻͷǢ ”‹–ŠƬ‘” ‘”ƒǡͳͻͻ͸Ȍǡ„—–ƒƒŒ‘”‹–›‘ˆ ”‡˜‹‡™‡†•–—†‹‡•ˆƒ‹Ž‡†–‘†‘•‘ȋ ƒ”‡–›Ƭ ”‡‡ƒǡͳͻͻͻȌǤ ‡†‘‘–’”‡•—‡–Šƒ–‹’ƒ‹”‡†‡–ƒŽ‹œ‹‰‹•–Š‡•‘Ž‡‡ Šƒ‹•™Š‡”‡„› Š‹Ž†Š‘‘† ƒ„—•‡ ƒƒˆˆ‡ –’•› Š‘’ƒ–Š‘Ž‘‰›‘ˆƒ†—Ž–’ƒ–‹‡–•Ǥˆ‡™‡ Šƒ‹••Šƒ˜‡ƒŽ”‡ƒ†›„‡‡ •—‰‰‡•–‡†ǡ‹ Ž—†‹‰†‘’ƒ‹‡•‡•‹–‹œƒ–‹‘ȋ‡Ž–‡ǡ˜ƒ†‡”‡ǡ—––‡ǡƬƒ–‘”Ǧ ”ƒƒ‡ǡǤ ʹͲͳ͵Ȍǡ‹•‡ —”‡ƒ––ƒ Š‡–ȋ‡ƒ†Ƭ —Ž‡›ǡʹͲͳͲȌǡ’‘‘”‡”‡‘–‹‘ƒŽ”‡‰—Žƒ–‹‘ȋ‹ ‘Žǡ ƒ”‹ǡƬ ƒ›ƒǡʹͲͳ͹ȌǡŠ‹‰Š‡”‡‘–‹‘ƒŽ”‡ƒ –‹˜‹–›–‘•–”‡••ȋƒ”†‹‘‹•ǡƒ–ƒ•–‡”ǡ‡‰‡Ž‡”•ǡƒ •ǡ& Myin‐Germeys, ʹͲͳͳȌǡƒ† ‘‰‹–‹˜‡‹’ƒ‹”‡–ȋ ”ƒ–Ƭ‡ ǡʹͲͲͻȌǤ— Š’ƒ–Š™ƒ›• ‹–‡”ƒ –™‹–Š‹’ƒ‹”‡†‡–ƒŽ‹œ‹‰Ǥ ‘”‡šƒ’Ž‡ǡƒ‹•‡ —”‡ƒ––ƒ Š‡–•–›Ž‡Šƒ•„‡‡”‡Žƒ–‡† –‘‡–ƒŽ‹œ‹‰‹’ƒ‹”‡–‹ƒ•ƒ’Ž‡‘ˆ’ƒ–‹‡–•™‹–Š’•› Š‘–‹ †‹•‘”†‡”ȋƒ „‡–Š‡–ƒŽǤǡ ʹͲͳͳȌǤ––ƒ Š‡–Ǧ”‡Žƒ–‡†•–”‡••Šƒ•ƒŽ•‘„‡‡‹’Ž‹ ƒ–‡†‹’‘‘”‡”’‡”ˆ‘”ƒ ‡‘ ‡–ƒŽ‹œ‹‰–ƒ••ȋ‘Ž–‡‡–ƒŽǤǡʹͲͳ͵ȌǤ –Š‡ —””‡–•–—†›ǡ™‡‡š’Ž‘”‡†ȏͳȐ™Š‡–Š‡””‡’‘”–‡† Š‹Ž†Š‘‘†ƒ„—•‡‹•”‡Žƒ–‡†–‘ –Š‡•‡˜‡”‹–›‘ˆ’‘•‹–‹˜‡ƒ†‡‰ƒ–‹˜‡•›’–‘•ƒ†–Š‡Ž‡˜‡Ž‘ˆ•‘ ‹ƒŽ†›•ˆ— –‹‘ǢȏʹȐ™Š‡–Š‡” ”‡’‘”–‡† Š‹Ž†Š‘‘†ƒ„—•‡‹•”‡Žƒ–‡†–‘‡–ƒŽ‹œ‹‰‹’ƒ‹”‡–Ǣȏ͵Ȑ™Š‡–Š‡”‡–ƒŽ‹œ‹‰ ‹’ƒ‹”‡–‹•”‡Žƒ–‡†–‘–Š‡•‡˜‡”‹–›‘ˆ’‘•‹–‹˜‡•›’–‘•ǡ‡‰ƒ–‹˜‡•›’–‘•ǡƒ†Ž‡˜‡Ž‘ˆ •‘ ‹ƒŽ†›•ˆ— –‹‘Ǣƒ†ȏͶȐ™Š‡–Š‡”‹’ƒ‹”‡†‡–ƒŽ‹œ‹‰‡š’Žƒ‹•ƒ–Ž‡ƒ•–’ƒ”–‘ˆ–Š‡ ƒ••‘ ‹ƒ–‹‘ „‡–™‡‡”‡’‘”–‡† Š‹Ž†Š‘‘†ƒ„—•‡ƒ†–Š‡•‡‘—– ‘‡˜ƒ”‹ƒ„Ž‡•Ǥ Methods Participants and procedure.

‹‡–›‘—–’ƒ–‹‡–•™‹–Š‘Ǧƒˆˆ‡ –‹˜‡’•› Š‘–‹ †‹•‘”†‡” ™‡”‡”‡ ”—‹–‡†ˆ”‘ ‘—‹–›–”‡ƒ–‡––‡ƒ•ƒ–”‡‰‹‘ƒŽ‡–ƒŽŠ‡ƒŽ–Š ƒ”‡‹•–‹–—–‡•‹–Š‡ ‡–Š‡”Žƒ†•ȋ–Š‡‹˜‹‡”†—‹‡ •–‹–—–‡ˆ‘”‡–ƒŽ ‡ƒŽ–Šƒ”‡Ž‘ ƒ–‡†‹‡‹†‡ǡ‘‘”Š‘—–ǡƒ† ‘‡–‡”‡‡”ǡƒ†–Š‡Ž–”‡ Š– •–‹–—–‡ˆ‘”‡–ƒŽ ‡ƒŽ–Šƒ”‡‹‡‹•–ȌǤŠ‡‹–‡”˜‡–‹‘–‡ƒ• ™‡”‡ƒ•‡†–‘”‡ˆ‡”ƒ›’ƒ–‹‡–•‡Ž‹‰‹„Ž‡ˆ‘”–Š‡•–—†›ǤŠ‘•‡”‡ˆ‡””‡†–‘–Š‡•–—†›™‡”‡ ‘–ƒ –‡†–‘ƒ••‡••–Š‡‹”‹–‡”‡•–‹’ƒ”–‹ ‹’ƒ–‹‰ƒ†™‡”‡• ”‡‡‡†”‡‰ƒ”†‹‰‹Ǧƒ†‡š Ž—•‹‘ ”‹–‡”‹ƒǤƒ–‹‡–•Šƒ†–‘„‡ƒ–Ž‡ƒ•–ͳͺ›‡ƒ”•‘Ž†ǡŠƒ˜‡ƒ‘Ǧƒˆˆ‡ –‹˜‡’•› Š‘–‹ †‹•‘”†‡” †‹ƒ‰‘•‹•ˆ”‘ƒ’•› Š‹ƒ–”‹•–ǡƒ†„‡‹–”‡ƒ–‡–ˆ‘”ƒ’‡”‹‘†„‡–™‡‡͸‘–Š•ƒ†ͳͲ›‡ƒ”• –‘„‡‡Ž‹‰‹„Ž‡ˆ‘”‹ Ž—•‹‘ǤŠ‡†‹ƒ‰‘•‹•‘ˆ‘Ǧƒˆˆ‡ –‹˜‡’•› Š‘–‹ †‹•‘”†‡”™ƒ•ƒŽ•‘ ‘ˆ‹”‡†„›”‡•‡ƒ” Š‡”•—•‹‰–Š‡‘’”‡Š‡•‹˜‡••‡••‡–‘ˆ ‹•–‘”›ƒ†›’–‘• ‹–‡”˜‹‡™ȋ†”‡ƒ•‡ǡ Žƒ—Ƭ”†–ǡͳͻͻʹȌǤƒ”–‹ ‹’ƒ–•™‹–Š‹–‡ŽŽ‡ –—ƒŽ†‹•ƒ„‹Ž‹–‹‡•ǡ ‹ŽŽ‹–‡”ƒ ›ǡ‘”Žƒ ‘ˆƒ•–‡”›‘ˆ–Š‡—– ŠŽƒ‰—ƒ‰‡™‡”‡‡š Ž—†‡†ˆ”‘’ƒ”–‹ ‹’ƒ–‹‘ǤŽŽ ’ƒ”–‹ ‹’ƒ–•’”‘˜‹†‡†™”‹––‡‹ˆ‘”‡† ‘•‡–ƒˆ–‡”–Š‡’”‘ ‡†—”‡•Šƒ†„‡‡ˆ—ŽŽ›‡š’Žƒ‹‡† ƒ†„‡ˆ‘”‡–‡•–‹‰ǤŠ‡–‡•–•™‡”‡ƒ†‹‹•–‡”‡†„›–”ƒ‹‡†”‡•‡ƒ” Š‡”•™‹–Šƒ–Ž‡ƒ•–ƒ„ƒ Š‡Ž‘” †‡‰”‡‡‹ȋƒ’’Ž‹‡†Ȍ’•› Š‘Ž‘‰›ǤŠ‡ —””‡–•–—†›‹•’ƒ”–‘ˆƒŽƒ”‰‡””‡•‡ƒ” Š’”‘Œ‡ –ˆ‘”™Š‹ Š

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‡–Š‹ ƒŽƒ’’”‘˜ƒŽ™ƒ•‰‹˜‡„›–Š‡‡†‹ ƒŽ‡•‡ƒ” Š–Š‹ •‘‹––‡‡‘ˆ–Š‡‹˜‡”•‹–› ‘•’‹–ƒŽ ƒƒ•–”‹ Š–Measuresƒ†ƒƒ•–”‹ Š–. The Childhood‹˜‡”•‹–› Experienceȋͳ͵Ǧ͵ǦͲ͸͸ǤͷȀƒ„ of Care andȌǤ Abuse ȋǢ‹ˆ—Ž ‘ǡ”‘™ǡƬ ƒ””‹•ǡ ͳͻͻͶȌǡƒ•‡‹Ǧ•–”— –—”‡†‹–‡”˜‹‡™ǡ™ƒ•—•‡†–‘ƒ••‡•• Š‹Ž†Š‘‘†ƒ„—•‡ȋƒ–ƒ‰‡Ͳ–ͳ͸›‡ƒ”•ȌǤ Š‹Ž†Š‘‘†ƒ„—•‡ ‘’”‹•‡†ˆ‘—”–›’‡•‘ˆƒŽ–”‡ƒ–‡–ǣ’•› Š‘Ž‘‰‹ ƒŽƒ„—•‡ǡ’Š›•‹ ƒŽƒ„—•‡ǡ •‡š—ƒŽƒ„—•‡ǡƒ†’ƒ”‡–ƒŽ ‘ˆŽ‹ –Ǥƒ•‡†‘–Š‡‘”›ǡ–Š‡Ž‹™‹–Š‹’ƒ‹”‡†‡–ƒŽ‹œ‹‰‹•Ž‹‡Ž› –‘„‡•–”‘‰‡•–ˆ‘”’ƒ”‡–ƒŽƒ„—•‡ȋŠ‹‡•ƒƬ ‘ƒ‰›ǡʹͲͳͶǢ‹ǡʹͲͳͷȌǤŠ‡”‡ˆ‘”‡ǡ‘Ž›ƒ„—•‡ ’‡”’‡–”ƒ–‡†„› ƒ”‡‰‹˜‡”•™ƒ•–ƒ‡‹–‘ƒ ‘—–Ǥ•› Š‘Ž‘‰‹ ƒŽƒ„—•‡ ‘’”‹•‡†‡š–”‡‡ ”‹–‹ ‹•ǡ”‡Œ‡ –‹‘ǡŠ—‹Ž‹ƒ–‹‘ǡ‘”–‡””‘”‹œ‹‰„›ƒ ƒ”‡‰‹˜‡”ǤŠ›•‹ ƒŽƒ„—•‡™ƒ•†‡ˆ‹‡†ƒ• „‘†‹Ž›Šƒ”‹ˆŽ‹ –‡†„›ƒ ƒ”‡‰‹˜‡”–Šƒ–”‡•—Ž–‡†‹ƒ–Ž‡ƒ•–„”—‹•‹‰Ǥ‡š—ƒŽƒ„—•‡™ƒ•†‡ˆ‹‡† ƒ•–Š‡participant’s”‡’‘”–‘ˆƒ›—™ƒ–‡†•‡š—ƒŽ‹ ‹†‡–’‡”’‡–”ƒ–‡†„›ƒ ƒ”‡‰‹˜‡”Ǥƒ”‡–ƒŽ ‘ˆŽ‹ –™ƒ•†‡ˆ‹‡†ƒ•–Š‡ƒ‘—–‘ˆˆ‹‰Š–‹‰„‡–™‡‡–Š‡ ƒ”‡‰‹˜‡”•ƒ†Ȁ‘”™‹–Š–Š‡ Š‹Ž†Ǥ ƒ Š–›’‡‘ˆƒ„—•‡™ƒ•• ‘”‡†ˆ‘”„‘–Šˆ”‡“—‡ ›ƒ†‹–‡•‹–›Ǥ –‡•‹–›‘ˆƒ„—•‡™ƒ•”ƒ–‡†‘ ƒˆ‘—”Ǧ’‘‹–‹‡”–• ƒŽ‡ǣͲȋ‘‡Ȍǡͳȋ•‘‡Ȍǡʹȋ‘†‡”ƒ–‡Ȍǡ͵ȋƒ”‡†Ȍǡ™‹–Š–Š‡‡š ‡’–‹‘‘ˆ ’ƒ”‡–ƒŽ ‘ˆŽ‹ –ǡ™Š‹ Š™ƒ•• ‘”‡†‘ƒˆ‹˜‡Ǧ’‘‹–• ƒŽ‡–Šƒ–ƒŽ•‘‹ Ž—†‡†Ͷȋ˜‹‘Ž‡ ‡ȌǤ ”‡“—‡ ›‘ˆƒ„—•‡™ƒ•”ƒ–‡†‘ƒˆ‹˜‡Ǧ’‘‹–‹‡”–Ǧ• ƒŽ‡ǣͲȋ‡˜‡”Ȍǡͳȋ”ƒ”‡Ž›ǣ‘ ‡‘”–™‹ ‡Ȍǡʹ 5 ȋ‹ ‹†‡–ƒŽŽ›ǣ‘”‡–Šƒ–™‘–‹‡•ǡ„—–‘–‘–ŠŽ›Ȍǡ͵ȋ”‡‰—Žƒ”Ž›ǣ‘–ŠŽ›‘”‘”‡‘ˆ–‡ȌǡͶ ȋ‘ˆ–‡ǣ™‡‡Ž›‘”‘”‡‘ˆ–‡ȌǤŠ‡•‡˜‡”‹–›• ‘”‡ˆ‘”‡ƒ Š–›’‡‘ˆƒ„—•‡™ƒ•–Š‡’”‘†— –‘ˆ ‹–‡•‹–›ƒ†ˆ”‡“—‡ ›ǤŠ‡–‘–ƒŽ”‡’‘”–‡† Š‹Ž†Š‘‘†ƒ„—•‡• ‘”‡ǡ”ƒ‰‹‰ˆ”‘Ͳ–‘ͷʹǡ™ƒ•–Š‡ •—‘ˆ–Š‡The•‡˜‡”‹–› ability to• ‘”‡• mentalizeˆ‘”‡ƒ Š•—„–›’‡‘ˆƒ„—•‡Ǥ ™ƒ•‘’‡”ƒ–‹‘ƒŽ‹œ‡†ƒ•–Š‡ ƒ’ƒ ‹–›–‘ƒ––”‹„—–‡‹–‡–‹‘•–‘ ‘–Š‡”•ǤŠ‹•™ƒ•‡ƒ•—”‡†—•‹‰–Š‡ ‹–‹‰ƒ•ȋ Ǣ‘” ‘”ƒǡ‡” ‡”ǡƬ ”‹–ŠǡͳͻͻͷȌǡ‹ ™Š‹ Š’ƒ”–‹ ‹’ƒ–•”‡ƒ†‡š–”ƒ –•–Šƒ–†‡• ”‹„‡ƒ‹–‡”ƒ –‹‘„‡–™‡‡–™‘ Šƒ”ƒ –‡”•Ǥ ‡ƒ Š ƒ•‡ǡ‘‡‘ˆ–Š‡ Šƒ”ƒ –‡”••ƒ›••‘‡–Š‹‰™‹–Šƒ‹’Ž‹ ‹–‡••ƒ‰‡Ǥ‘‹ˆ‡”–Š‡‹’Ž‹ ‹– ‡••ƒ‰‡ˆ”‘–Š‡Ž‹–‡”ƒŽ‘‡ǡƒ—†‡”•–ƒ†‹‰‘ˆ–Š‡character’s„‡Ž‹‡ˆ•‘”ˆ‡‡Ž‹‰•‹•‡‡†‡†Ǥ ˆ –Š‡’ƒ”–‹ ‹’ƒ–‹ˆ‡”•–Š‡‡••ƒ‰‡ ‘””‡ –Ž›ǡʹ’‘‹–•ƒ”‡• ‘”‡†Ǥ ˆƒŠ‹–‹•‡‡†‡†‹‘”†‡”–‘ ‹ˆ‡”–Š‡‡••ƒ‰‡ ‘””‡ –Ž›ǡƒ• ‘”‡‘ˆͳ‹•‰‹˜‡Ǥ ˆ–Š‡ƒ•™‡”‹•‹ ‘””‡ –‘”–Š‡’ƒ”–‹ ‹’ƒ– †‘‡•‘–‘™ǡͲ’‘‹–•ƒ”‡• ‘”‡†ǤŠ‡”‡ƒ”‡ͳͲ’ƒ••ƒ‰‡•ǡ•‘’ƒ”–‹ ‹’ƒ–• ƒ• ‘”‡—’–‘ʹͲ ’‘‹–•Ǥ ‘”‡ƒ•‡‘ˆ‹–‡”’”‡–ƒ–‹‘–Š‡ ™ƒ•”‡˜‡”•‡ ‘†‡†ǡ•‘–Šƒ–Š‹‰Š‡”• ‘”‡•”‡ˆŽ‡ –‡† ‰”‡ƒ–‡”The‡–ƒŽ‹œ‹‰ Positive and‹’ƒ‹”‡–Ǥ Negative Syndrome Scale ȋǢƒ›ǡ ‹•œ„‡‹ǡƬ’ˆ‡”ǡͳͻͺ͹Ȍǡƒ ‘„•‡”˜‡”Ǧ”ƒ–‡†‹•–”—‡–ǡ™ƒ•—•‡†–‘ƒ••‡••–Š‡•‡˜‡”‹–›‘ˆ’‘•‹–‹˜‡ƒ†‡‰ƒ–‹˜‡•›’–‘• †—”‹‰–Š‡ʹ™‡‡•’”‡ ‡†‹‰‡ƒ•—”‡‡–ǤŠ‡’‘•‹–‹˜‡•›†”‘‡• ƒŽ‡ ‘’”‹•‡•†‡Ž—•‹‘•ǡ ‘ ‡’–—ƒŽ†‹•‘”‰ƒ‹œƒ–‹‘ǡŠƒŽŽ— ‹ƒ–‹‘•ǡ‡š ‹–‡‡–ǡ‰”ƒ†‹‘•‹–›ǡ•—•’‹ ‹‘—•‡••ǡƒ† Š‘•–‹Ž‹–›ǡ”ƒ–‡†‘ƒ•‡˜‡Ǧ’‘‹–‹‡”–• ƒŽ‡ǤŠ‡‡‰ƒ–‹˜‡•›’–‘•ƒ”‡”‡’”‡•‡–‡†„› ˆŽƒ––‡‡†ƒˆˆ‡ –ǡ‡‘–‹‘ƒŽ™‹–Š†”ƒ™ƒŽǡ’‘‘””ƒ’’‘”–ǡ’ƒ••‹˜‡•‘ ‹ƒŽ™‹–Š†”ƒ™ƒŽǡ†‹ˆˆ‹ —Ž–›‹

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ƒ„•–”ƒ ––Š‹‹‰ǡŽƒ ‘ˆ•’‘–ƒ‡‹–›ǡƒ†•–‡”‡‘–›’‡†–Š‹‹‰Ǥ‘–Š• ƒŽ‡•Šƒ˜‡ƒ”ƒ‰‡‘ˆ͹–‘ ͶͻǤ –‡””ƒ–‡””‡Ž‹ƒ„‹Ž‹–›™ƒ•ƒ••‡••‡†„›‡ƒ•‘ˆƒ˜‹†‡‘–ƒ’‡†‹–‡”˜‹‡™ǡ”ƒ–‡†‹†‡’‡†‡–Ž› „›ƒŽŽ”ƒ–‡”•ǤSocial –‡” dysfunctionǦ”ƒ–‡””‡Ž‹ƒ„‹Ž‹–›™ƒ•Š‹‰Šˆ‘”–Š‡ƒ˜‡”ƒ‰‡‘ˆ‹–‡•ȋ αǤͻͳȌǤ ™ƒ•‡ƒ•—”‡†—•‹‰–Š‡‘ ‹ƒŽ — –‹‘‹‰ ƒŽ‡ȋ Ȍǡƒ•‡ŽˆǦ”‡’‘”– “—‡•–‹‘ƒ‹”‡ȋ‹” Š™‘‘†ǡ‹–Šǡ‘ Š”ƒ‡ǡ‡––‘ǡƬ‘’‡•–ƒ‡ǡͳͻͻͲȌǤŠ‡  ‘–ƒ‹• •‡˜‡†‹‡•‹‘•ȋ•‘ ‹ƒŽ™‹–Š†”ƒ™ƒŽǡ‹–‡”’‡”•‘ƒŽ ‘—‹ ƒ–‹‘ǡ‹†‡’‡†‡ ‡ ȋ ‘’‡–‡ ‡Ȍǡ‹†‡’‡†‡ ‡ȋ’‡”ˆ‘”ƒ ‡Ȍǡ”‡ ”‡ƒ–‹‘ƒŽƒ –‹˜‹–‹‡•ǡ•‘ ‹ƒŽƒ –‹˜‹–‹‡•ǡƒ† ‡’Ž‘›‡–Ȍƒ†Šƒ•„‡‡ˆ‘—†–‘„‡”‡Ž‹ƒ„Ž‡ǡ˜ƒŽ‹†ǡ•‡•‹–‹˜‡ǡƒ†”‡•’‘•‹˜‡–‘ Šƒ‰‡ ȋ‹” Š™‘‘†‡–ƒŽǤǡͳͻͻͲȌǤŠ‡‘˜‡”ƒŽŽ•‘ ‹ƒŽˆ— –‹‘‹‰• ‘”‡‹•†‡–‡”‹‡†„›ƒ˜‡”ƒ‰‹‰ƒŽŽ •—„†‘ƒ‹•ǡ”‡•—Ž–‹‰‹ƒ’‘–‡–‹ƒŽ”ƒ‰‡ˆ”‘ͷͻǤ͹–‘ͳ͵ͶǤͻǤ‰ƒ‹ǡˆ‘”‡ƒ•‡‘ˆ‹–‡”’”‡–ƒ–‹‘ –Š‡• ƒŽ‡Statistical™ƒ•”‡˜‡”•‡ analyses ‘†‡†ǡ. •‘–Šƒ–Š‹‰Š‡”ƒ• ‘”‡‘–Š‡ ‹†‹ ƒ–‡†‰”‡ƒ–‡”†›•ˆ— –‹‘Ǥ Š”‡‡‡†‹ƒ–‘”‘†‡Ž•™‡”‡–‡•–‡†ǡ‘‡ˆ‘”‡ƒ Š‘—– ‘‡˜ƒ”‹ƒ„Ž‡ ȋ’‘•‹–‹˜‡•›’–‘•ǡ‡‰ƒ–‹˜‡•›’–‘•ǡƒ†•‘ ‹ƒŽ†›•ˆ— –‹‘Ȍǡ™‹–Š”‡’‘”–‡† Š‹Ž†Š‘‘† ƒ„—•‡ƒ•–Š‡‹†‡’‡†‡–˜ƒ”‹ƒ„Ž‡ƒ†‡–ƒŽ‹œ‹‰‹’ƒ‹”‡–ƒ•–Š‡‡†‹ƒ–‘”‹‡ƒ Š‘†‡ŽǤ ˜‡”•‹‘n 22 combined with Hayes’s PROCESS macro ȋ ƒ›‡•Ƭ”‡ƒ Š‡”ǡʹͲͳ͵Ȍ™ƒ•—•‡†ˆ‘” –Š‡‡†‹ƒ–‹‘ƒƒŽ›•‡•ǤŠ‡’”‘ ‡••ƒ ”‘—•‡•‘Ǧ’ƒ”ƒ‡–”‹ „‘‘–•–”ƒ’’‹‰ǡ™Š‹ Š‹˜‘Ž˜‡• ”ƒ†‘”‡•ƒ’Ž‹‰‘ˆ‘„•‡”˜ƒ–‹‘•™‹–Š”‡’Žƒ ‡‡––‘‘„–ƒ‹ ‘ˆ‹†‡ ‡‹–‡”˜ƒŽ•ˆ‘”–Š‡ ‹†‹”‡ –‡ˆˆ‡ –ȋƒ†ˆ— –‹‘•–Š‡”‡‘ˆȌǤŠ‡„‘‘–•–”ƒ’ ‘ˆ‹†‡ ‡‹–‡”˜ƒŽ•™‡”‡„ƒ•‡†‘ͳͲͲͲͲ ”‡•ƒ’Ž‡•Ǥˆˆ‡ –•ƒ”‡ ‘•‹†‡”‡†•‹‰‹ˆ‹ ƒ–‹ˆ–Š‡ ‘ˆ‹†‡ ‡‹–‡”˜ƒŽ†‘‡•‘– ‘–ƒ‹ͲǤa b ‡†‹ƒ–‹‘‹•’”‡•‡–‹ˆ–Š‡‹†‹”‡ –‡ˆˆ‡ –ȋ ƒ† Ȍ‘ˆ–Š‡‹†‡’‡†‡–˜ƒ”‹ƒ„Ž‡ȋ”‡’‘”–‡† Š‹Ž†Š‘‘†ƒ„—•‡Ȍ–Š”‘—‰Š–Š‡‡†‹ƒ–‘”ȋ‡–ƒŽ‹œ‹‰‹’ƒ‹”‡–Ȍ‘–Š‡‘—– ‘‡˜ƒ”‹ƒ„Ž‡• ȋ’‘•‹–‹˜‡•›’–‘•ǡ‡‰ƒ–‹˜‡•›’–‘•ǡƒ†•‘ ‹ƒŽ†›•ˆ— –‹‘Ȍ‹••‹‰‹ˆ‹ ƒ–ȋ‹Ǥ‡Ǥǡ–Š‡ ‘ˆ‹†‡ ‡‹–‡”˜ƒŽ†‘‡•‘– ‘–ƒ‹ͲȌƒ†–Š‡†‹”‡ –‡ˆˆ‡ –‘ˆc’ –Š‡†‡’‡†‡–˜ƒ”‹ƒ„Ž‡‘–Š‡c ‘—– ‘‡˜ƒ”‹ƒ„Ž‡™Š‹Ž‡ƒ ‘—–‹‰ˆ‘”–Š‡‡†‹ƒ–‘”ȋ Ȍ‹••ƒŽŽ‡”–Šƒ–Š‡–‘–ƒŽ‡ˆˆ‡ –ȋ Ȍ ȋˆ‹‰—”‡ͳȌǤ 















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1) Positive symptoms RCA  c 2) Negative symptoms

ȋ Ȍ 3) Social dysfunction



 Mentalizing impairment



a b 

 ȋ Ȍȋ Ȍ 1) Positive symptoms

 2) Negative symptoms RCA  c’ 3) Social dysfunction

ȋ Ȍ

Figure 1: 

‡†‹ƒ–‹‘ƒŽ‘†‡Ž™‹–Š”‡’‘”–‡† Š‹Ž†Š‘‘†ƒ„—•‡ȋȌƒ•‹†‡’‡†‡–˜ƒ”‹ƒ„Ž‡ǡ‡–ƒŽ‹œ‹‰ ‹’ƒ‹”‡–ƒ•‡†‹ƒ–‘”ǡƒ†’‘•‹–‹˜‡•›’–‘•ǡ‡‰ƒ–‹˜‡•›’–‘•ǡƒ†•‘ ‹ƒŽ†›•ˆ— –‹‘ƒ•

5 †‡’‡†‡–˜ƒ”‹ƒ„Ž‡•Ǥ Results Sample characteristics.

™‘’ƒ”–‹ ‹’ƒ–•†”‘’’‡†‘—–‘ˆ–Š‡•–—†›„‡ˆ‘”‡ ‘’Ž‡–‹‰ ƒŽŽ“—‡•–‹‘ƒ‹”‡•ǡƒ†ƒ‘–Š‡”’ƒ”–‹ ‹’ƒ–”‡ˆ—•‡†–‘ƒ•™‡”“—‡•–‹‘•”‡‰ƒ”†‹‰ Š‹Ž†Š‘‘† ‡š’‡”‹‡ ‡•ǤŠ‡›™‡”‡‡š Ž—†‡†ˆ”‘ƒƒŽ›•‹•ǤŠ‡ˆ‘ŽŽ‘™‹‰”‡•—Ž–•™‡”‡‘„–ƒ‹‡†ˆ”‘n ƒƒŽ›•‡•™‹–Š–Š‡”‡ƒ‹‹‰ͺ͹’ƒ–‹‡–•Ǥˆ–Š‡•‡’ƒ”–‹ ‹’ƒ–•ǡ͵͸ǤͺΨȋn α͵ʹȌ”‡’‘”–‡†‘ ƒ„—•‡ǡ͸͵ǤʹΨȋn αͷͷȌ”‡’‘”–‡†ƒ–Ž‡ƒ•–‹Ž†ˆ‘”•‘ˆƒ„—•‡‹‘‡‘”‘”‡ ƒ–‡‰‘”‹‡•ǡƒ†͵͹Ǥͻ Ψȋ α͵͵Ȍ”‡’‘”–‡†ƒ–Ž‡ƒ•–ƒ”‡†ˆ‘”•‘ˆƒ„—•‡‹‘‡‘”‘”‡ ƒ–‡‰‘”‹‡•Ǥ–Š‡”†‡• ”‹’–‹˜‡ •–ƒ–‹•–‹ •ƒ”‡’”‡•‡–‡†‹ƒ„Ž‡ͳǤ 

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Table 1.

‘ ‹‘†‡‘‰”ƒ’Š‹  Šƒ”ƒ –‡”‹•–‹ •‘ˆ•ƒ’Ž‡ȋαͺ͹ȌǤ Mean SD

ƒ”‹ƒ„Ž‡ ά  ƒ‰‡ ‰‡ȋ›Ȍ ͵ͳǤ͹άͺǤʹ ͳͻ–ͷ͹ ‡ƒ”••‹ ‡‘•‡–ˆ‹”•–’•› Š‘•‹• ͷǤ͹άͶǤͲ ͳ–ʹʹ  ‡’‘”–‡†Š‹Ž†Š‘‘†„—•‡ ͺǤ͹άͳͲǤ͵ Ͳ–Ͷ͵  ‘—•‡Š‘Ž††‹• ‘”† ͷǤͷάͷǤͺ Ͳ–ͳ͸ Š›•‹ ƒŽƒ„—•‡ ͳǤʹάʹǤ͹ Ͳ–ͳʹ ‘–‹‘ƒŽƒ„—•‡ ͳǤͺά͵Ǥͻ Ͳ–ͳʹ ‡š—ƒŽƒ„—•‡ n ͲǤͳάͲǤ͹ Ͳ–͸  ƒ”‹ƒ„Ž‡ ‡” ‡–ƒ‰‡ ‡š   ƒŽ‡ ͷ͸ ͸ͶǤͶ Ǧ †‹ƒ‰‘•‹•    Š‹œ‘’Š”‡‹ƒ ͷͷ ͸͵Ǥʹ •› Š‘–‹ †‹•‘”†‡” ͳͶ ͳ͸Ǥͳ  Š‹œ‘ƒˆˆ‡ –‹˜‡†‹•‘”†‡” ͳʹ ͳ͵Ǥͺ ”‹‡ˆ’•› Š‘–‹ †‹•‘”†‡” Ͷ ͶǤ͸ ‡Ž—•‹‘ƒŽ†‹•‘”†‡” ʹ ʹǤ͵ Main effects.

b‡’‘”–‡† Š‹Ž†Š‘‘†ƒ„—•‡™ƒ••‹‰‹ˆ‹ ƒ–Ž›”‡Žƒ–‡†–‘–Š‡•‡˜‡”‹–›‘ˆp ’‘•‹–‹˜‡•›’–‘•ȋb αͲǤͳͳǡͻͷΨ ‘ˆ‹†‡ ‡‹–‡”˜ƒŽȏͲǤͲʹǡͲǤʹͲȐǡp αͲǤͲͳͶȌƒ†‡‰ƒ–‹˜‡ •›’–‘•ȋ bαͲǤͳ͹ǡͻͷΨ ‘ˆ‹†‡ ‡‹–‡”˜ƒŽȏͲǤͲ͸ǡͲǤʹͺȐǡ αͲǤͲͲͶȌǡ„—–‘––‘•‘ ‹ƒŽp †›•ˆ— –‹‘ȋ αͲǤͲͷǡͻͷΨ ‘ˆ‹†‡ ‡‹–‡”˜ƒŽȏǦͲǤͳͲǡͲǤʹͲȐǡb αͲǤͷͳ͹ȌǤ —”–Š‡”‘”‡ǡ”‡’‘”–‡† Š‹Ž†Š‘‘†ƒ„—•‡p ™ƒ•”‡Žƒ–‡†–‘‡–ƒŽ‹œ‹‰‹’ƒ‹”‡–ȋ αͲǤͲ͸ǡͻͷΨ ‘ˆ‹†‡ ‡‹–‡”˜ƒŽ ȏͲǤͲͳǡͲǤͳͳȐǡb αͲǤͲʹ͹ȌǤ‡–ƒŽ‹œ‹‰‹’ƒ‹”‡–™ƒ•‘–ƒ••‘ ‹ƒ–‡†™‹–Š–Š‡•‡˜‡”‹–›‘ˆ’‘•‹–‹˜‡p •›’–‘•ȋ αͲǤͳͷǡͻͷΨ ‘ˆ‹†‡ ‡‹–‡”˜ƒŽȏb ǦͲǤʹͲǡͲǤͷͲȐǡ αͲǤ͵ͻͷȌǡ„—–‹–™ƒ•ƒ••‘ ‹ƒ–‡†™‹–Šp •‡˜‡”‹–›‘ˆ‡‰ƒ–‹˜‡•›’–‘•ȋ αͳǤʹͲǡͻͷΨ ‘ˆ‹†‡ ‡‹–‡”˜ƒŽȏͲǤͺʹǡͳǤͷͺȐǡ δͲǤͲͲͳȌǡƒ† –Š‡”‡™ƒ•ƒ’‘•‹–‹˜‡ǡ„—–‘–ƒ•‹‰‹ˆ‹ ƒ–ƒ••‘ ‹ƒ–‹‘„‡–™‡‡‡–ƒŽ‹œ‹‰‹’ƒ‹”‡–ƒ†b p •‘ ‹ƒŽ†›•ˆ— –‹‘ȋ αͲǤͷͷǡͻͷΨ ‘ˆ‹†‡ ‡‹–‡”˜ƒŽȏǦͲǤͲͷǡͳǤͳͶȐǡ αͲǤͲ͹͵ȌǤ –‡”’”‡–ƒ–‹‘‘ˆ –Š‡•‡”‡•—Ž–•†‹†‘– Šƒ‰‡™Š‡™‡ƒ††‡†–Š‡‘–Š‡”‘—– ‘‡˜ƒ”‹ƒ„Ž‡•ƒ• ‘˜ƒ”‹ƒ–‡•–‘‡ƒ Š •‡’ƒ”ƒ–‡ƒƒŽ›•‹•ǤMediation. –Š‡ ƒ•‡‘ˆ‡‰ƒ–‹˜‡•›’–‘•‘Ž›ǡ–Š‡’”‡”‡“—‹•‹–‡•‘ˆ‡†‹ƒ–‹‘–ƒ •‹‰‹ˆ‹ ƒ–ƒ••‘ ‹ƒ–‹‘„‡–™‡‡‹†‡’‡†‡–˜ƒ”‹ƒ„Ž‡ǡ†‡’‡†‡–˜ƒ”‹ƒ„Ž‡ǡƒ†‡†‹ƒ–‘”–™‡”‡ ‡–ǤŠ‡”‡™ƒ•ƒ•‹‰‹ˆ‹ ƒ–‹†‹”‡ –‡ˆˆ‡ –‘ˆ”‡’‘”–‡† Š‹Ž†Š‘‘†ƒ„—•‡b ‘‡‰ƒ–‹˜‡•›’–‘• –Š”‘—‰Š‡–ƒŽ‹œ‹‰‹’ƒ‹”‡–ǡ’ƒ–Šƒ–Š”‘—‰Š„‹ˆ‹p ‰—”‡ͳȋ αͲǤͲ͹ǡͻͷΨ ‘ˆ‹†‡ ‡‹–‡”˜ƒŽ ȏͲǤͲͲʹǡͲǤͳ͹Ȑǡ αͲǤͲ͵ͻȌǡ‹†‹ ƒ–‹˜‡‘ˆƒ‡†‹ƒ–‹‘‡ˆˆ‡ –ǤŠ‡–‘–ƒŽ‡ˆˆ‡ –‘ˆ Š‹Ž†Š‘‘†ƒ„—•‡‘b p ‡‰ƒ–‹˜‡•›’–‘•’ƒ–Š ‹ˆ‹‰—”‡ͳȋ αͲǤͳ͹ǡͻͷΨ ‘ˆ‹†‡ ‡‹–‡”˜ƒŽȏͲǤͲ͸ǡͲǤʹͺȐǡ αͲǤͲͲͶȌ

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146807_JonasWeijers_BNW_def.indd 94 28-10-2020 15:08 Mentalizing impairment as a mediator between childhood abuse and outcome

™ƒ•”‡†— ‡†„›ƒ„b out 40% when mentalizing impairmentp was accounted for, path c’ in figure 1 ȋ αͲǤͳͲǡͻͷΨ ‘ˆ‹†‡ ‡‹–‡”˜ƒŽȏͲǤͲͲ͵ǡͲǤʹͲȐǡSensitivity analysis. αͲǤͲͶ͵Ȍǡ‹†‹ ƒ–‹‰’ƒ”–‹ƒŽ‡†‹ƒ–‹‘Ǥ Š‡ƒ„‘˜‡ƒƒŽ›•‹•ƒ••—‡•–Šƒ–ƒŽŽ˜ƒ”‹ƒ„Ž‡•ƒ”‡”‡Žƒ–‡†‹ƒ Ž‹‡ƒ”ˆƒ•Š‹‘ǡŠ‘™‡˜‡” —”˜‡‡•–‹ƒ–‹‘•”‡˜‡ƒŽ‡†–Šƒ–ƒ“—ƒ†”ƒ–‹ –‡”ƒ›„‡ƒ„‡––‡”ˆ‹–ˆ‘”R p ʹ –Š‡”‡Žƒ–‹‘„‡–™‡‡”‡’‘”–‡† Š‹Ž†Š‘‘†ƒ„—•‡ƒ†‡‰ƒ–‹˜‡•›’–‘•‡˜‡”‹–›ȋR p αͲǤͳͺͲǡ δ ʹ ǤͲͲͳȌǡ–ŠƒƒŽ‹‡ƒ”‘‡ȋ αͲǤͲͻͷǡ αǤͲͲͶȌǤ“—ƒ†”ƒ–‹ –‡”ƒŽ•‘„‡–R –‡”ˆ‹––‡†–Š‡”‡Žƒ–‹‘p ʹ „‡–™‡‡”‡’‘”–‡† Š‹Ž†Š‘‘†ƒ„—•‡ƒ†‹’ƒ‹”‡†‡–ƒŽ‹œ‹‰ȋR p αͲǤͲͺʹǡ αͲǤͲʹ͹Ȍǡ‹•–‡ƒ†‘ˆƒ ʹ Ž‹‡ƒ”‘‡ȋ αͲǤͲͷ͸ǡ αǤͲʹ͹ȌǤ‘–Š‡‰ƒ–‹˜‡•›’–‘•ƒ†‡–ƒŽ‹œ‹‰‹’ƒ‹”‡–‹ ”‡ƒ•‡ ‡š’‘‡–‹ƒŽŽ›ƒ•”‡’‘”–‡† Š‹Ž†Š‘‘†ƒ„—•‡‹ ”‡ƒ•‡•Ǥ Š‡—•‡‘ˆƒ–”ƒ†‹–‹‘ƒŽ‡†‹ƒ–‹‘ƒƒŽ›•‹•‹–Š‹• ƒ•‡ƒ›„‡’”‘„Ž‡ƒ–‹ ǡ„‡ ƒ—•‡‹– ƒŽ —Žƒ–‡•–Š‡•‹‰‹ˆ‹ ƒ ‡‘ˆ‘‡•‹‰Ž‡‹†‹”‡ –‡ˆˆ‡ –ǡƒ••—‹‰–Šƒ––Š‡”‡Žƒ–‹‘•Š‹’„‡–™‡‡ –Š‡‹†‡’‡†‡–˜ƒ”‹ƒ„Ž‡ǡ‡†‹ƒ–‘”ƒ††‡’‡†‡–˜ƒ”‹ƒ„Ž‡‹•Ž‹‡ƒ”Ǥ ‘™‡˜‡”ǡ‹–Š‡ —””‡– ƒ•‡–Š‡‹†‹”‡ –‡ˆˆ‡ –‹•—Ž‹‡Ž›–‘„‡‹†‡–‹ ƒŽˆ‘”‡ƒ ŠŽ‡˜‡Ž‘ˆ”‡’‘”–‡† Š‹Ž†Š‘‘†ƒ„—•‡Ǥ‡ –Š‡”‡ˆ‘”‡ƒŽ•‘ ƒŽ —Žƒ–‡†–Š‡‹†‹”‡ –‡ˆˆ‡ –—•‹‰ƒ‡†‹ƒ–‹‘ƒƒŽ›•‹•–Šƒ–ƒ ‘—–•ˆ‘” “—ƒ†”ƒ–‹ ”‡Žƒ–‹‘•Š‹’•ǡ—•‹‰–Š‡ƒ ”‘ȋ ƒ›‡•ƬPreacher, 2010). “Instantaneous indirect effects” were generated at different levels of reported childhood abuse (one standard 5 †‡˜‹ƒ–‹‘ƒ„‘˜‡ƒ†„‡Ž‘™–Š‡•ƒ’Ž‡‡ƒȌƒ••—‰‰‡•–‡†„› ƒ›‡•Ƭ”‡ƒ Š‡”ȋʹͲͳͲȌǤ‡•—Ž–• •Š‘™‡†ǡ–Šƒ–‘Ž›‹the subgroup reporting relatively high childhood abuse (CECA ≥ 19), there ™ƒ•ƒ•‹‰‹ˆ‹ ƒ–‹†‹”‡ –‡ˆˆ‡ –‘ˆ Š‹Ž†Š‘‘†ƒ„—•‡ȋR pθαͲǤͲͻǡͻͷΨ ‘ˆ‹†‡ ‡‹–‡”˜ƒŽȏͲǤͲͳǡ ʹ ͲǤʹʹȐȌǤŠ‹•‘†‡Ž’”‡†‹ –‡†ƒ„‘—–ͶͲΨȋ αͲǤ͵ͻͶǡ δǤͲͲͳȌ‘ˆ–Š‡˜ƒ”‹ƒ ‡‹‡‰ƒ–‹˜‡ •›’–‘•‡˜‡”‹–›Ǥ  Discussion Discussion of the results.

Š‹••–—†›–‡•–‡†–Š‡Š›’‘–Š‡•‹•–Šƒ–‡–ƒŽ‹œ‹‰ ‹’ƒ‹”‡– ‘•–‹–—–‡•ƒ’ƒ–Š™ƒ›–Š”‘—‰Š™Š‹ Š’ƒ”‡–ƒŽƒ„—•‡ƒˆˆ‡ –• Ž‹‹ ƒŽƒ†ˆ— –‹‘ƒŽ ‘—– ‘‡•‹‘Ǧƒˆˆ‡ –‹˜‡’•› Š‘–‹ †‹•‘”†‡”ǤŠ‡ƒŒ‘”‹–›‘ˆ‘Ǧƒˆˆ‡ –‹˜‡’•› Š‘–‹ †‹•‘”†‡” ’ƒ–‹‡–•‹‘—”•ƒ’Ž‡”‡’‘”–‡†‡š’‡”‹‡ ‹‰’ƒ”‡–ƒŽƒ„—•‡†—”‹‰–Š‡‹” Š‹Ž†Š‘‘†ǤŠ‡ •‡˜‡”‹–›‘ˆ–Š‹•ƒ„—•‡™ƒ•ƒ••‘ ‹ƒ–‡†™‹–Š–Š‡Ž‡˜‡Ž•‘ˆ’‘•‹–‹˜‡ƒ†‡‰ƒ–‹˜‡•›’–‘•ƒ† ™‹–Š‡–ƒŽ‹œ‹‰‹’ƒ‹”‡–ǡ„—–‘–™‹–Š•‘ ‹ƒŽ†›•ˆ— –‹‘Ǥ‡–ƒŽ‹œ‹‰‹’ƒ‹”‡–ǡ‹–—”ǡ •Š‘™‡†ƒ•‹‰‹ˆ‹ ƒ–”‡Žƒ–‹‘•Š‹’–‘–Š‡•‡˜‡”‹–›‘ˆ‡‰ƒ–‹˜‡•›’–‘•ǡ„—–‘•— Š”‡Žƒ–‹‘•Š‹’ –‘’‘•‹–‹˜‡•›’–‘•‘”•‘ ‹ƒŽ†›•ˆ— –‹‘Ǥƒ•–Ž›ǡ–Š‡”‡Žƒ–‹‘•Š‹’„‡–™‡‡”‡’‘”–‡† Š‹Ž†Š‘‘† ƒ„—•‡ƒ†‡‰ƒ–‹˜‡•›’–‘•™ƒ•’ƒ”–Ž›‡†‹ƒ–‡†„›‡–ƒŽ‹œ‹‰‹’ƒ‹”‡–ǡƒ ‘—–‹‰ˆ‘” ƒ’’”‘š‹ƒ–‡Ž›ͶͲΨ‘ˆ–Š‡‡ˆˆ‡ –Ǥ•‡•‹–‹˜‹–›ƒƒŽ›•‹•ǡ™Š‹ Š–”‡ƒ–‡†–Š‡”‡Žƒ–‹‘•„‡–™‡‡ ”‡’‘”–‡† Š‹Ž†Š‘‘†ƒ„—•‡ǡ‡‰ƒ–‹˜‡•›’–‘•ƒ†‡–ƒŽ‹œ‹‰‹’ƒ‹”‡–ƒ•“—ƒ†”ƒ–‹ ǡ ”‡˜‡ƒŽ‡†–Šƒ––Š‡‡†‹ƒ–‹‰”‘Ž‡‘ˆ‡–ƒŽ‹œ‹‰‹’ƒ‹”‡–™ƒ•‘Ž›•‹‰‹ˆ‹ ƒ–‹–Š‡ ƒ•‡‘ˆ ˆƒ‹”Ž›•‡˜‡”‡ƒ„—•‡Ǥ

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146807_JonasWeijers_BNW_def.indd 95 28-10-2020 15:08 Chapter Five

Comparison to previous findings.

Š‡ —””‡–”‡•—Ž–•”‡’Ž‹ ƒ–‡’”‡˜‹‘—•ˆ‹†‹‰• ”‡‰ƒ”†‹‰–Š‡”‡Žƒ–‹‘•Š‹’‘ˆ”‡’‘”–‡† Š‹Ž†Š‘‘†ƒ„—•‡–‘ Ž‹‹ ƒŽ‘—– ‘‡ȋ Š‡‡Žǡ’ƒ—Ž†‹‰ǡ ‹‹ŽŽ‘ǡƬ‹Ž˜‡”•–‡‹ǡʹͲͲͷǢ’ƒ—™‡ǡ”ƒ„„‡†ƒǡ‹‡„ǡ‹–– Š‡Ƭƒ•ǡʹͲͲ͸Ǣ‘‰†‡ǡ ƒ’•‘ǡƬ‡ƒ†ǡʹͲͳͷǢƒƒ‡–ƒŽǤǡʹͲͳͷȌƒ†•—’’‘”––Š‡–Š‡‘”›–Šƒ–’ƒ”‡–ƒŽƒ„—•‡‹• ”‡Žƒ–‡†–‘‡–ƒŽ‹œ‹‰‹’ƒ‹”‡–ȋŠ‹‡•ƒƬ ‘ƒ‰›ǡʹͲͳͶǢ‹ǡʹͲͳͷȌǤŠ‹Ž‡–Š‡ˆ‹†‹‰•†‘ ‘–•—’’‘”––Š‡‹†‡ƒ–Šƒ–‹’ƒ‹”‡†‡–ƒŽ‹œ‹‰‹•”‡Žƒ–‡†–‘’‘•‹–‹˜‡•›’–‘•ǡ–Š‡›†‘’”‘˜‹†‡ ‡˜‹†‡ ‡‘ˆ•— Šƒ”‡Žƒ–‹‘•Š‹’–‘‡‰ƒ–‹˜‡•›’–‘•ǡ‹Ž‹‡™‹–Šƒ›’”‡˜‹‘—••–—†‹‡• ȋ ƒ”‡–›Ƭ ”‡‡ƒǡͳͻͻͻǢ‘‘†›‡–ƒŽǤǡͳͻͻͺǢ‹– ŠŽ‡›‡–ƒŽǤǡͳͻͻͺǢ ”‡‹‰‡–ƒŽǤǡʹͲͲͶǢ‡”‰‹‡–ƒŽǤǡ ʹͲͲ͹ȌǤ‘•‹–‹˜‡•›’–‘•ƒ›‘–”‡ˆŽ‡ –ƒ‘˜‡”ƒŽŽ‹’ƒ‹”‡†ƒ„‹Ž‹–›–‘”‡’”‡•‡–‡–ƒŽ•–ƒ–‡•ǡ „—–rather a tendency to excessively do so, or to ‘hypermentalize’ȋ„—Ǧ‡ŽƬƒ‹Ž‡›ǡʹͲͲͲǢ Ž‡‡•‡‡–ƒŽǤǡʹͲͳ͸ȌǤ— Šƒ–‡†‡ ›Šƒ•ƒŽ•‘„‡‡•—‰‰‡•–‡†–‘„‡•–ƒ–‡ǦŽ‹‡‹ƒ–—”‡ǡ ‘ —””‹‰‘Ž›‹•’‡ ‹ˆ‹  ‹” —•–ƒ ‡•ȋƒŽ•–‘‡–ƒŽǤǡʹͲͲͲǢŠƒ”Ž–‘ǡʹͲͲ͵Ȍǡ™Š‹ Š™‘—Ž† ‡š’Žƒ‹–Š‡‘”ƒŽ‡–ƒŽ‹œ‹‰’‡”ˆ‘”ƒ ‡•‘ˆ’ƒ–‹‡–•™‹–Š’”‡†‘‹ƒ–Ž›’‘•‹–‹˜‡ •›’–‘•‹‘•–•–—†‹‡•ȋ ƒ”‡–›Ƭ ”‡‡ƒǡͳͻͻͻȌǤ –‡”‡•–‹‰Ž›ǡ–Š‡ —””‡–”‡•—Ž–•ƒŽ•‘ •‡‡–‘‡ Š‘”‡ ‡–‘„•‡”˜ƒ–‹‘•–Šƒ–Ž‘‡Ž‹‡••‡†‹ƒ–‡•–Š‡”‡Žƒ–‹‘„‡–™‡‡•‘ ‹ƒŽƒ†˜‡”•‹–› ƒ†‡‰ƒ–‹˜‡ǡ„—–‘–’‘•‹–‹˜‡•›’–‘•ȋ ƒ›ƒǡ• ‘‡ǡƬ‹ ‘ŽǡʹͲͳ͸ȌǤŠ‹•ƒ›‘– ‘‡ƒ•ƒ •—”’”‹•‡ƒ•Ž‘‡Ž‹‡••Šƒ•„‡‡”‡Žƒ–‡†–‘ƒ––ƒ Š‡–Ǧ”‡Žƒ–‡†•–”‡••ȋ‡Ǥ‰Ǥ‡‹‡–ƒŽǤǡʹͲͲͷȌǡ™Š‹ Š ‹–—”Šƒ•„‡‡Ž‹‡†–‘‹’ƒ‹”‡†‡–ƒŽ‹œ‹‰ȋ‘Ž–‡‡–ƒŽǤǡʹͲͳ͵ȌǤŠƒ–‡˜‡”–Š‡ ƒ•‡ƒ›„‡ǡ –Š‡ —””‡–”‡•—Ž–••—’’‘”––Š‡‘–‹‘–Šƒ–ƒ†˜‡”•‹–›ƒ›„‡”‡Žƒ–‡†–‘‡‰ƒ–‹˜‡ƒ†’‘•‹–‹˜‡ •›’–‘•–Š”‘—‰Š†‹ˆˆ‡”‡–’ƒ–Š™ƒ›•ǡƒ•‡–ƒŽŽƒ† ‘ŽŽ‡ƒ‰—‡•Šƒ˜‡”‡ ‡–Ž›•—‰‰‡•–‡† ȋʹͲͳͶȌǤ ‡š’‡ –‡†Ž›ǡ™‡†‹†‘–”‡’Ž‹ ƒ–‡–Š‡’”‡˜‹‘—•Ž›‡•–ƒ„Ž‹•Š‡†”‡Žƒ–‹‘•Š‹’„‡–™‡‡ ”‡’‘”–‡† Š‹Ž†Š‘‘†ƒ„—•‡ƒ†•‘ ‹ƒŽˆ— –‹‘‹‰ȋ›•ƒ‡”‡–ƒŽǤǡʹͲͲͶǢ–ƒ‹‡–ƒŽǤǡʹͲͳ͵Ǣ Žƒ‡†ƒ‡–ƒŽǤǡʹͲͳͷȌǤ’‘••‹„Ž‡‡š’Žƒƒ–‹‘ˆ‘”–Š‹•†‹• ”‡’ƒ ›ƒ›„‡–Š‡ƒ‘—–‘ˆ–‹‡ •‹ ‡‘•‡–‘ˆ’•› Š‘•‹•Ǥ”‡˜‹‘—••–—†‹‡•‘„•‡”˜‡†•— Šƒ••‘ ‹ƒ–‹‘•‡‹–Š‡”„‡ˆ‘”‡ȋ’ƒ—™‡‡– ƒŽǤǡʹͲͲ͸Ǣ‹ƒ‡–ƒŽǤǡʹͲͳ͵Ȍǡ‘”•Š‘”–Ž›ƒˆ–‡”ȋ–ƒ‹‡–ƒŽǤǡʹͲͳ͵ǢŽƒ‡†ƒ‡–ƒŽǤǡʹͲͳͷȌ‘•‡–‘ˆ ’•› Š‘•‹•ǤŠ‡ —””‡–•ƒ’Ž‡ ‘•‹•–‡†‘ˆ’ƒ–‹‡–•™Š‘ǡ‘ƒ˜‡”ƒ‰‡ǡ‡š’‡”‹‡ ‡†–Š‡‹”ˆ‹”•– ’•› Š‘–‹ ‡’‹•‘†‡‘”‡–Šƒͷ›‡ƒ”•ƒ‰‘Ǥ‘ ‹ƒŽˆ— –‹‘‹‰†‡–‡”‹‘”ƒ–‡•‘•–‹–Š‡ˆ‹”•–ͷ ›‡ƒ”•ƒˆ–‡”‘•‡–‘ˆ’•› Š‘•‹•Ǣ–Š‡”ƒ–‡‘ˆ–Š‹•†‡–‡”‹‘”ƒ–‹‘‹•‹ˆŽ—‡ ‡†„›ˆƒ –‘”••— Šƒ•†”—‰ ƒ„—•‡ǡŽƒ ‘ˆ•‘ ‹ƒŽ•—’’‘”–ǡƒ†•›’–‘†‹•–”‡••ȋ‹” Š™‘‘†ǡ‘††ǡƬ ƒ •‘ǡͳͻͻͺȌǤ ‘••‹„Ž›ǡ•‘ ‹ƒŽˆ— –‹‘‹‰‹•ƒˆˆ‡ –‡†„›ƒŠ‹•–‘”›‘ˆ Š‹Ž†Š‘‘†ƒ„—•‡—’–‘ƒ†ƒ”‘—†–Š‡ ‘•‡–‘ˆ’•› Š‘•‹•ǡ„—––Šƒ–‘–Š‡”ˆƒ –‘”•ƒ ‘—–ˆ‘”‹–•†‡ Ž‹‡ƒˆ–‡”™ƒ”†•ǤŽ–‡”ƒ–‹˜‡Ž›ǡ–Š‡ ‡ˆˆ‡ –‘ˆ Š‹Ž†Š‘‘†ƒ„—•‡‘•‘ ‹ƒŽˆ— –‹‘‹‰ƒ›‘ —”‘Ž›‹ ‡”–ƒ‹•—„‰”‘—’•Ǥ ‘” ‡šƒ’Ž‡ǡ‘›‡––‡‡–ƒŽǤȋʹͲͳͶȌˆ‘—†–Šƒ––Š‡‹’ƒ –‘ˆ”‡’‘”–‡† Š‹Ž†Š‘‘†ƒ„—•‡‘•‘ ‹ƒŽ †›•ˆ— –‹‘’ƒ”–Ž›†‡’‡†•‘–Š‡’‡”•‘ƒŽ‹–›‘ˆ–Š‡’ƒ–‹‡–ǡ™Š‡”‡ƒ•›•ƒ‡”‡–ƒŽǤȋʹͲͲͶȌ ˆ‘—†–Šƒ–•—”˜‹˜‘”•‘ˆ•‡š—ƒŽƒ„—•‡•’‡ ‹ˆ‹ ƒŽŽ›•Š‘™‡†’‘‘”‡”˜‘ ƒ–‹‘ƒŽ‘—– ‘‡Ǥ

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146807_JonasWeijers_BNW_def.indd 96 28-10-2020 15:08 Mentalizing impairment as a mediator between childhood abuse and outcome

—”–Š‡”‘”‡ǡ–Š‡’‘•‹–‹˜‡”‡Žƒ–‹‘•Š‹’„‡–™‡‡‡–ƒŽ‹œ‹‰‹’ƒ‹”‡–ƒ†•‘ ‹ƒŽ †›•ˆ— –‹‘ǡƒŽ–Š‘—‰Š‹–Š‡‡š’‡ –‡††‹”‡ –‹‘ǡ™ƒ•‘–•‹‰‹ˆ‹ ƒ–ǤŠ‡”‡Žƒ–‹‘„‡–™‡‡ ‡–ƒŽ‹œ‹‰ƒ†ˆ— –‹‘ƒŽ‘—– ‘‡Ž‹‡Ž›†‡’‡†•‘–Š‡•’‡ ‹ˆ‹ •—„†‘ƒ‹•‡šƒ‹‡†ǡƒ• ‘—–—”‡ǡ‡ƒ†‘„‡”–•ȋʹͲͲ͸ȌŠƒ˜‡•—‰‰‡•–‡†ǤClinical implications.  Š‹••–—†›’”‘˜‹†‡•‹‹–‹ƒŽ•—’’‘”–ˆ‘”–Š‡–Š‡‘”›–Šƒ–‹’ƒ‹”‡† ‡–ƒŽ‹œ‹‰ƒ„‹Ž‹–›‹•ƒ’‘–‡–‹ƒŽ’ƒ–Š™ƒ›–Š”‘—‰Š™Š‹ Š’ƒ”‡–ƒŽƒ„—•‡ƒˆˆ‡ –•–Š‡•‡˜‡”‹–›‘ˆ ‡‰ƒ–‹˜‡•›’–‘•‹‘Ǧƒˆˆ‡ –‹˜‡’•› Š‘–‹ †‹•‘”†‡”ǤŽ–Š‘—‰Š‘”‡”‡•‡ƒ” Š‹•‡‡†‡†–‘ ‘‡–‘ ƒ—•ƒŽ ‘ Ž—•‹‘•ƒ„‘—––Š‡’‘–‡–‹ƒŽŽ›’ƒ–Š‘‰‡‹ ”‘Ž‡‘ˆ‹’ƒ‹”‡†‡–ƒŽ‹œ‹‰ǡ‹–ƒ› „‡ˆ”—‹–ˆ—Ž–‘‡šƒ‹‡–Š‡—•‡ˆ—Ž‡••‘ˆ–ƒ”‰‡–‹‰‡–ƒŽ‹œ‹‰ƒ„‹Ž‹–›ƒ•ƒ–”‡ƒ–‡–•–”ƒ–‡‰›ˆ‘” ‘Ǧƒˆˆ‡ –‹˜‡’•› Š‘–‹ †‹•‘”†‡”Ǥ ‘”‡šƒ’Ž‡ǡ‡–ƒŽ‹œƒ–‹‘„ƒ•‡†–”‡ƒ–‡–ȋ”‡–ǡ ‘Ž–Ƭ ‡•Šƒ˜ƒǡʹͲͳͶǢ‡‹Œ‡”•‡–ƒŽǤǡʹͲͳ͸Ȍƒ†‡–ƒ ‘‰‹–‹˜‡–Š‡”ƒ’›ȋ˜ƒ‘‡”•‰‘‡†‡–ƒŽǤǡʹͲͳͶȌ „‘–Š–ƒ”‰‡–‡–ƒŽ‹œ‹‰„›Š‡Ž’‹‰–Š‡’ƒ–‹‡––‘„‡ ‘‡ƒ™ƒ”‡ƒ†‡Žƒ„‘”ƒ–‡‘–Š‡‹”‘™ ƒˆˆ‡ –‹˜‡•–ƒ–‡•ƒ•™‡ŽŽƒ•–Š‘•‡‘ˆ‘–Š‡”•ǤŽ–‡”ƒ–‹˜‡Ž›ǡ‡–ƒŽ‹œƒ–‹‘„ƒ•‡†–”‡ƒ–‡– ‘—Ž† ’‘–‡–‹ƒŽŽ›„‡‹’Ž‡‡–‡†ƒ•ƒ’”‡˜‡–‹˜‡–Š‡”ƒ’›ˆ‘ —•‹‰‘–Š‘•‡ƒ–”‹•ˆ‘”’•› Š‘•‹• ȋ‡„„ƒ±‡–ƒŽǤǡʹͲͳ͸ȌǤ —”–Š‡”‘”‡ǡ–Š‡”‡•—Ž–•—†‡”• ‘”‡–Š‡‹’‘”–ƒ ‡‘ˆ–ƒ‹‰‹–‘ ƒ ‘—––Š‡’‘••‹„‹Ž‹–›‘ˆ’ƒ–‹‡–•Šƒ˜‹‰‡š’‡”‹‡ ‡†ƒ„—•‡‹ Š‹Ž†Š‘‘†ƒ†–Š‡‹”Ž‡˜‡Ž‘ˆ 5 ‡–ƒŽ‹œ‹‰‹’ƒ‹”‡–ǡƒ•–Š‡•‡ˆƒ –‘”•‡‰ƒ–‹˜‡Ž› ‘–”‹„—–‡–‘‘—– ‘‡‹†‹ˆˆ‡”‡–™ƒ›• ȋ‡Ž–‡ƬLimitationsCantor‐Graae, and 2014) conclusionsǤ . ƒ–—”ƒŽŽ›ǡ•‘‡Ž‹‹–ƒ–‹‘•ƒ’’Ž›Ǥ ‹”•–ǡ Š‹Ž†Š‘‘†ƒ„—•‡ • ‘”‡•™‡”‡„ƒ•‡†‘’ƒ–‹‡–ƒ ‘—–•Ǥ‘‡ƒ›ƒ”‰—‡–Š‹•–‘„‡’”‘„Ž‡ƒ–‹ •‹ ‡–Š‡˜ƒŽ‹†‹–› ‘ˆ”‡–”‘•’‡ –‹˜‡”‡’‘”–•ǡ‡•’‡ ‹ƒŽŽ›„›’•› Š‹ƒ–”‹ ’ƒ–‹‡–•Šƒ•„‡‡“—‡•–‹‘‡†ȋ—••‡”Ƭ ‹†‘ǡʹͲͳ͵ȌǤ ‘™‡˜‡”ǡ”‡’‘”–•‘ˆƒ„—•‡„›’•› Š‹ƒ–”‹ ’ƒ–‹‡–•ǡ‹ Ž—†‹‰–Š‘•‡™‹–Š ’•› Š‘•‹•ǡŠƒ˜‡‰‡‡”ƒŽŽ›„‡‡ˆ‘—†–‘„‡”‡Ž‹ƒ„Ž‡ȋ•‡‡‡ƒ†ǡǡ˜ƒ•ǡǡ‘””‹•‘ǡƬ‘••ǡʹͲͲͷ ˆ‘”ƒ‘˜‡”˜‹‡™ȌǤ —”–Š‡”ǡƒ’”‘•’‡ –‹˜‡•–—†›‘ˆ›‘—‰’‡‘’Ž‡˜‡”›Ž‹‡Ž›–‘Šƒ˜‡„‡‡‡š’‘•‡† –‘•‡š—ƒŽƒ„—•‡ Ž‡ƒ”Ž›•Š‘™‡†ƒ‹ ”‡ƒ•‡†”‹•‘ˆ• Š‹œ‘’Š”‡‹ƒȋ—–ƒŒƒ”‡–ƒŽǤǡʹͲͳͲȌǤ ‡ ‘†ǡ†‹ˆˆ‡”‡–ˆ‘”•‘ˆ Š‹Ž†Š‘‘†ƒ„—•‡™‡”‡’‘‘Ž‡†‹–‘ƒ•‹‰Ž‡•‡˜‡”‹–›• ‘”‡ǡ „‡ ƒ—•‡–Š‡”‡Žƒ–‹˜‡Ž›•ƒŽŽ•ƒ’Ž‡•‹œ‡’”‡ Ž—†‡†•—ˆˆ‹ ‹‡–Ž›’‘™‡”‡†•—„Ǧ‰”‘—’ƒƒŽ›•‡•Ǥ —–—”‡•–—†‹‡•ǡ‹˜‘Ž˜‹‰Žƒ”‰‡”•ƒ’Ž‡•‹œ‡•ǡ•Š‘—Ž† ‘•‹†‡”–Š‡‡ˆˆ‡ –•‘ˆ‡ƒ Š•—„–›’‡‘ˆ ƒ„—•‡•‡’ƒ”ƒ–‡Ž›ǡƒ•†‹ˆˆ‡”‡––›’‡•‘ˆƒ„—•‡ƒ› ‘–”‹„—–‡–‘†‹ˆˆ‡”‡–†‹‡•‹‘•‘ˆ •›’–‘ƒ–‘Ž‘‰›ȋ‡–ƒŽŽ‡–ƒŽǤǡʹͲͳͶȌǤ Š‹”†ǡ‹–‹•‹’‘”–ƒ––‘•–”‡••–Šƒ–‡˜‹†‡ ‡‘ˆ‡†‹ƒ–‹‘†‘‡•‘–‡•–ƒ„Ž‹•Š ƒ—•ƒŽ‹–› ȋƒš™‡ŽŽǡ‘Ž‡Ƭ‹– Š‡ŽŽǡʹͲͳͳȌǤ’”‘•’‡ –‹˜‡•–—†›™‘—Ž†–Š‡”‡ˆ‘”‡„‡’”‡ˆ‡”ƒ„Ž‡‹‘”†‡”–‘ ƒ‡‘”‡”‘„—•– Žƒ‹• ‘ ‡”‹‰ ƒ—•ƒŽ‹–›Ǥ ‘—”–Šǡ‘Ž›‘‡–›’‡‘ˆ‡–ƒŽ‹œ‹‰†‡ˆ‹ ‹–™ƒ•ƒ ‘—–‡†ˆ‘”‹–Š‹••–—†›ǤŠ‡ƒ„‹Ž‹–› –‘‹ˆ‡”‡–ƒŽ•–ƒ–‡•‘ˆ‘–Š‡”•ǡƒ•‡ƒ•—”‡†„›–Š‡Š‹–‹‰–ƒ•ǡ‹•ƒ ‘‰‹–‹˜‡ǡ‘–Š‡”Ǧ‘”‹‡–‡† ˆ‘”‘ˆ‡–ƒŽ‹œ‹‰ƒ†‹•‘Ž›ƒ’ƒ”–‹ƒŽ‹†‹ ƒ–‘”‘ˆ–Š‡–‘–ƒŽ ‘•–”— –‘ˆ‡–ƒŽ‹œ‹‰Ǥ

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—„‡”‘ˆ†‹‡•‹‘ƒŽƒš‡•Šƒ˜‡„‡‡’”‘’‘•‡†–‘—†‡”Ž‹‡‡–ƒŽ‹œ‹‰ǡ‹ Ž—†‹‰ ‘‰‹–‹˜‡– ƒˆˆ‡ –‹˜‡ǡ‹’Ž‹ ‹––‡š’Ž‹ ‹–ǡƒ†•‡Žˆ–‘–Š‡”‘”‹‡–‡†ƒš‡•ȋ ‘ƒ‰›Ƭ—›–‡ǡʹͲͳʹȌǤ’‡ ‹ˆ‹  ‡–ƒŽ‹œ‹‰†‡ˆ‹ ‹–•ƒ›ƒˆˆ‡ –•’‡ ‹ˆ‹  Ž‹‹ ƒŽ•›’–‘•†‹ˆˆ‡”‡–Ž›ǡƒ•Šƒ•”‡ ‡–Ž›„‡‡ ƒ”‰—‡†ȋ‡„„ƒ±‡–ƒŽǤǡʹͲͳ͸ȌǤ †‡‡†ǡ–Š‡•‡˜‡”‹–›‘ˆ’‘•‹–‹˜‡•›’–‘••‡‡•‡•’‡ ‹ƒŽŽ› •—• ‡’–‹„Ž‡–‘†‡ˆ‹ ‹–•‹•‡ŽˆǦ‘”‹‡–‡†‡–ƒŽ‹œ‹‰ȋ‹Ǥ‡Ǥ–Š‡ƒ„‹Ž‹–›–‘„‡ƒ™ƒ”‡‘ˆƒ†‹†‡–‹ˆ› •‡ŽˆǦ‰‡‡”ƒ–‡†‡–ƒŽ‡˜‡–•Ǣ‡Ǥ‰Ǥ”—‡Ž‹‡–ƒŽǤǡʹͲͲ͹ȌǤ —–—”‡•–—†‹‡••Š‘—Ž†–ƒ‡†‹ˆˆ‡”‡– ˆ‘”•‘ˆ‡–ƒŽ‹œ‹‰‹–‘ƒ ‘—–Ǥ Š‹••–—†›‹–‡‰”ƒ–‡†–™‘Ž‹‡•‘ˆ”‡•‡ƒ” Šǣ‘‡–Šƒ–Š‹‰ŠŽ‹‰Š–•–Š‡”‘Ž‡‘ˆ‹’ƒ‹”‡† ‡–ƒŽ‹œ‹‰”‡‰ƒ”†‹‰ Ž‹‹ ƒŽƒ†ˆ— –‹‘ƒŽ‘—– ‘‡‹‘Ǧƒˆˆ‡ –‹˜‡’•› Š‘–‹ †‹•‘”†‡”ȋ ”‹–Šǡ ʹͲͳͶȌƒ†ƒ‘–Š‡”–Šƒ–—†‡”• ‘”‡•–Š‡†‡˜‡Ž‘’‡–ƒŽƒ–—”‡‘ˆ‡–ƒŽ‹œ‹‰ƒ„‹Ž‹–›ȋ ‘ƒ‰›‡– ƒŽǤǡʹͲͲͶȌǤŽ–Š‘—‰Š”‡ ‡–”‡•‡ƒ” ŠŠƒ•‹ ”‡ƒ•‹‰Ž›ˆ‘ —•‡†‘–Š‡”‘Ž‡‘ˆ‡–ƒŽ‹œ‹‰‹‘Ǧ ƒˆˆ‡ –‹˜‡’•› Š‘–‹ †‹•‘”†‡”ǡ•‘ˆƒ”‹–Šƒ•Žƒ”‰‡Ž›‹‰‘”‡†–Š‡†‡˜‡Ž‘’‡–ƒŽ‘”‹‰‹•‘ˆ ‡–ƒŽ‹œ‹‰ƒ„‹Ž‹–›ǤŠ‡ —””‡–ˆ‹†‹‰•‘ˆˆ‡”‹‹–‹ƒŽ‡˜‹†‡ ‡–Šƒ–‹’ƒ‹”‡†‡–ƒŽ‹œ‹‰ƒ› ‘•–‹–—–‡ƒ’ƒ–Š™ƒ›™Š‡”‡„› Š‹Ž†Š‘‘†ƒ„—•‡ƒˆˆ‡ –•ƒ†—Ž–‡‰ƒ–‹˜‡•›’–‘•ǡƒŽ–Š‘—‰Š•— Š ƒ‡ˆˆ‡ –‹•‘Ž›Ž‹‡Ž›–‘„‡‘„•‡”˜‡†™Š‡ Š‹Ž†Š‘‘†ƒ„—•‡‹•ˆƒ‹”Ž›•‡˜‡”‡Ǥƒ•‡†‘–Š‡•‡ ˆ‹†‹‰•ǡ™‡„‡Ž‹‡˜‡–Šƒ–ƒ—†‡”•–ƒ†‹‰‘ˆ–Š‡‘”‹‰‹•‘ˆ‹’ƒ‹”‡†‡–ƒŽ‹œ‹‰ƒ›‘ˆˆ‡” ‘”‡‹•‹‰Š–‹–‘–Š‡’ƒ–Š‘‰‡‡•‹•‘ˆ‘Ǧƒˆˆ‡ –‹˜‡’•› Š‘–‹ †‹•‘”†‡”Ǥ Funding

Š‹•”‡•‡ƒ” Š†‹†‘–”‡ ‡‹˜‡ƒ›•’‡ ‹ˆ‹ ‰”ƒ–ˆ”‘ˆ—†‹‰ƒ‰‡ ‹‡•‹–Š‡’—„Ž‹ ǡ ‘‡” ‹ƒŽǡ ‘”‘–Ǧˆ‘”Ǧ’”‘ˆ‹–•‡ –‘”•Ǥ‡–‡” ‘ƒ‰›™ƒ•‹’ƒ”–•—’’‘”–‡†„›–Š‡ƒ–‹‘ƒŽ •–‹–—–‡ˆ‘” ‡ƒŽ–Š ‡•‡ƒ” Šȋ Ȍ‘ŽŽƒ„‘”ƒ–‹‘ˆ‘”‡ƒ†‡”•Š‹’‹’’Ž‹‡† ‡ƒŽ–Š‡•‡ƒ” Šƒ†ƒ”‡ȋ Ȍ ‘”–ŠŠƒ‡•ƒ–ƒ”–• ‡ƒŽ–Š ”—•–ƒ†‹•‹”‡ ‡‹’–‘ˆ ‡‹‘” ˜‡•–‹‰ƒ–‘”™ƒ”† ȋ”‡ˆǤ Ǧ ǦͲͷͳͶǦͳͲͳͷ͹ȌǤŠ‡˜‹‡™•‡š’”‡••‡†ƒ”‡–Š‘•‡‘ˆ–Š‡ƒ—–Š‘”ȋ•Ȍ ƒ†‘–‡ ‡••ƒ”‹Ž› –Š‘•‡‘ˆ–Š‡ ǡ–Š‡ ‘”–Š‡‡’ƒ”–‡–‘ˆ ‡ƒŽ–ŠǤ

Contributors

—–Š‘” †‡•‹‰‡†–Š‡•–—†›ƒ†™”‘–‡–Š‡ˆ‹”•–†”ƒˆ–Ǥ ‡†‹–‡†–Š‡ƒ—• ”‹’–ǤŽŽƒ—–Š‘”• ”‡˜‹‡™‡†ǡ ‘‡–‡†‘ƒ†Šƒ˜‡ƒ’’”‘˜‡†–Š‡ˆ‹ƒŽ ƒ—• ”‹’–Ǥ Abbreviations.

ǣŠ‹Ž†Š‘‘†š’‡”‹‡ ‡‘ˆƒ”‡ƒ†„—•‡Ǣ ǣ ‹–‹‰ƒ•Ǣ ǣ‘ ‹ƒŽ — –‹‘‹‰ ƒŽ‡Ǣǣ‘•‹–‹˜‡ƒ†‡‰ƒ–‹˜‡›†”‘‡ ƒŽ‡ 

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Disclosure of interest

Š‡ƒ—–Š‘”•†‡ Žƒ”‡–Šƒ––Š‡›Šƒ˜‡‘ ‘’‡–‹‰‹–‡”‡•–Ǥ Acknowledgements

‘‡  References  Psychological medicine, 30

„—Ǧ‡ŽǡǤǡƬƒ‹Ž‡›ǡǤǤȋʹͲͲͲȌǤ‡––‡”Ǥ ȋ͵Ȍǡ͹͵ͷǦ͹͵ͺǤ  ††‹‰–‘ǡ Ǥǡƒ‡‡†‹ǡ ǤǡƬ††‹‰–‘ǡǤȋʹͲͲ͸ȌǤ ƒ ‹ƒŽƒˆˆ‡ –”‡ ‘‰‹–‹‘ǣƒ‡†‹ƒ–‘”„‡–™‡‡Schizophrenia research, 85 ‘‰‹–‹˜‡ƒ†•‘ ‹ƒŽˆ— –‹‘‹‰‹’•› Š‘•‹•ǫ ȋͳȌǡͳͶʹǦͳͷͲǤ Žƒ‡†ƒǡǤǡ ‡””ƒ”‹ǡǤǡƒ—ƒǡǤǡ Š‘ŽƒǦ‡œƒ‡‡ǡǤǡ‘ǡǤǡƬ‘—•ǡǤȋʹͲͳͷȌǤŠ‹Ž†Š‘‘† •‡š—ƒŽƒ†’Š›•‹ ƒŽƒ„—•‡. Psychologicalǣƒ‰‡ƒ–‡š’‘•—”‡‘†—Žƒ–‡•‹’ƒ –‘ˆ— –‹‘ƒŽ‘—– ‘‡‹ medicine, 45 ‡ƒ”Ž›’•› Š‘•‹•’ƒ–‹‡–• ȋͳ͵Ȍǡʹ͹ʹ͹Ǧʹ͹͵͸Ǥ †”‡ƒ•‡ǡǤǤǡ Žƒ—ǡǤǡƬ”†–ǡǤȋͳͻͻʹȌǤŠ‡‘’”‡Š‡•‹˜‡••‡••‡–‘ˆ›’–‘• Archivesƒ† ‹•–‘”›ȋ Ȍǣƒ‹•–”—‡–ˆ‘” of general psychiatry, 49 ƒ••‡••‹‰†‹ƒ‰‘•‹•ƒ†’•› Š‘’ƒ–Š‘Ž‘‰›Ǥ HandbookȋͺȌǡ͸ͳͷ ofǦ mentalizing͸ʹ͵Ǥ in mental health practice. 5 ƒ–‡ƒǡǤǤǡƬ ‘ƒ‰›ǡǤȋʹͲͳʹȌǤ  ”Ž‹‰–‘ǡǣ‡”‹ ƒ•› Š‹ƒ–”‹ —„Ž‹•Š‹‰ǡ  Ǥ ‡–ƒŽŽǡǤǤǡ†‡‘—•ƒǡǤǡƒ”‡•‡ǡ Ǥǡ‹ ŠƒǡǤǡ‹–‘ǡǤǡ ƒƒ”ƒ•ǡǤǡƬ‡ƒ†ǡ ǤȋʹͲͳͶȌǤ ”‘ ƒ†˜‡”•‹–›–‘’•› Š‘•‹•ǣƒ–Š™ƒ›•ƒ†‡ Šƒ‹••ˆ”‘•’‡ ‹ˆ‹ ƒ†˜‡”•‹–‹‡•–‘•’‡ ‹ˆ‹ Social Psychiatry and Psychiatric Epidemiology, 49 •›’–‘•Ǥ ȋ͹ȌǡͳͲͳͳ–ͳͲʹʹǤ ‹ˆ—Ž ‘ǡǤǡ”‘™ǡ ǤǤǡƬ ƒ””‹•ǡǤǤȋͳͻͻͶ. JournalȌǤŠ‹Ž†Š‘‘†š’‡”‹‡ ‡‘ˆƒ”‡ƒ†„—•‡ȋȌǣ of Child Psychology and Psychiatry, 35 ƒ”‡–”‘•’‡ –‹˜‡‹–‡”˜‹‡™‡ƒ•—”‡ ȋͺȌǡ ͳͶͳͻǦͳͶ͵ͷǤ ‹” Š™‘‘†ǡǤǡ‹–Šǡ Ǥǡ‘ Š”ƒ‡ǡǤǡ‡––‘ǡǤǡƬ‘’‡•–ƒ‡ǡǤȋͳͻͻͲȌǤŠ‡‘ ‹ƒŽ — –‹‘‹‰  ƒŽ‡ǤŠ‡†‡˜‡Ž‘’‡–ƒ†˜ƒŽ‹†ƒ–‹‘‘ˆƒ‡™• ƒŽ‡‘ˆ•‘ ‹ƒŽƒ†Œ—•–‡–ˆ‘”—•‡‹The British Journal of ˆƒ‹Ž›‹–‡”˜‡–‹‘’”‘‰”ƒ‡•™‹–Š• Š‹œ‘’Š”‡‹ ’ƒ–‹‡–•ǤPsychiatry, 157 ȋ͸Ȍǡͺͷ͵ǦͺͷͻǤ ‹” Š™‘‘†ǡǤǡ‘††ǡǤǡInternationalƬ ƒ •‘ǡǤȋ Clinicalͳͻͻͺ PsychopharmacologyȌǤƒ”Ž›‹–‡”˜‡–‹‘‹’•› Š‘•‹•ǣ–Š‡ ”‹–‹ ƒŽ, 13 Ǧ’‡”‹‘† Š›’‘–Š‡•‹•Ǥ ǡ͵ͳǦͶͲǤ ‘›‡––‡ǡǤǦǤǡ˜ƒƒǡǤǡ‡‹Œ‡”ǡǤǡ‡Ž–Š‘”•–ǡǤǡƒŠǡǤǡ†‡ ƒƒǡǤǡƒŠǡǤǡ˜ƒ•ǡ Ǥǡ ‹‡”•ƒǡǤǡƬ”—‰‰‡ƒǡǤȋʹͲͳͶȌǤ‡”•‘ƒŽ‹–› ‘’‡•ƒ–‡•ˆ‘”‹’ƒ‹”‡†“—ƒŽ‹–›‘ˆ Ž‹ˆ‡ƒ†•‘ ‹ƒŽˆ— –‹‘‹‰‹’ƒ–‹‡–•™‹–Š’•› Š‘–‹ †‹•‘”†‡”•™Š‘‡Schizophrenia bulletin, 40 š’‡”‹‡ ‡† –”ƒ—ƒ–‹ ‡˜‡–•Ǥ ȋ͸Ȍǡͳ͵ͷ͸Ǧͳ͵͸ͷǤ ”‡–ǡǤǤǡ ‘Ž–ǡǤ Ǥǡ‡•Šƒ˜ƒǡǤǤǡ‡‹†ƒǡǤ ǤǡƬ ‘ƒ‰›ǡǤȋʹͲͳͶȌǤ‡–ƒŽ‹œƒ–‹‘Ǧ„ƒ•‡† –”‡ƒ–‡–ˆ‘”’•› Š‘•‹•ǣŽ‹‹‰ƒƒ––ƒ Š‡–Ǧ„ƒ•‡†‘†‡Ž–‘–Š‡’•› Š‘–Š‡”ƒ’›ˆ‘”

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The Israeli

Journal‹’ƒ‹”‡†‡–ƒŽ•–ƒ–‡—†‡”•–ƒ†‹‰‹’‡‘’Ž‡™‹–Š of Psychiatry and Related Sciences, 51 ’•› Š‘–‹ †‹•‘”†‡”•Ǥ ȋͳȌǡͳ͹ǦʹͶǤ Schizophrenia ”ò‡ǡǤȋbulletinʹͲͲͷ, Ȍ. “Theory of mind” in schizophrenia: a review of the literature. ͵ͳȋͳȌǡʹͳǦͶʹǤ ”—‡Ž‹ǡ Ǥǡ†̵ƒ–‘ǡǤǡ”—ǡǤǡ‡†‹‘—ǡǤǡƒŽŽ‡ŽǡǤǡ‡ǡǤǡ‘—Ž‡–ǡǤǡƬƒ‘—†ǡǤȋʹͲͲ͹ȌǤ ’ƒ‹”‡†˜‡”„ƒŽ•‘—” ‡‘‹–‘”‹‰‹• Š‹œ‘’Š”‡‹ƒǣƒ‹–‡”‡†‹ƒ–‡–”ƒ‹–˜—Ž‡”ƒ„‹Ž‹–›Schizophrenia research, 89 ƒ”‡”ǫ ȋͳȌǡʹͺ͹ǦʹͻʹǤ ƒ”ƒ•ǡǤǤǡƒ Š•ǦŽ–‡”ǡǤǡƬ‹„‘”†›ǡǤǤȋͳͻͻ͸ȌǤ‘–‹‘—†‡”•–ƒ†‹‰‹ƒŽ–”‡ƒ–‡† Š‹Ž†”‡ǣ‡ ‘‰‹–‹‘‘ˆˆƒ ‹ƒŽ‡š’”‡••‹‘•ƒ†‹–‡‰”ƒ–‹‘™‹–Š‘–Š‡”‡‘–‹‘ —‡•ǤEmotional development in atypical children  Ǥ‡™‹•ƬǤǤ—ŽŽ‹˜ƒȋ†•ǤȌǡ ȋ’’ǤʹͲ͵Ǧ ʹʹͷȌǤ ‹ŽŽ•†ƒŽ‡ǡ ǣƒ™”‡ ‡”Ž„ƒ—••‘ ‹ƒ–‡•Ǥ Šƒ”Ž–‘ǡǤ ǤȋʹͲͲ͵ȌǤŠ‡‘”›‘ˆ‹††‡Ž—•‹‘•ƒ†„‹œƒ””‡†‡Ž—•‹‘•‹ƒ‡˜‘Ž—–‹‘ƒ”›The social brain—Evolution and pathology. ’‡”•’‡ –‹˜‡ǣ’•› Š‹ƒ–”›ƒ†–Š‡•‘ ‹ƒŽ„”ƒ‹Ǥ ‡™‘”ǡǣ ‘Š‹Ž‡›Ƭ‘•Ǥ Š‹‡•ƒǡǤǡƬ ‘ƒ‰›ǡǤȋʹͲͳͶȌǤ‡ˆŽ‡ –‹˜‡ˆ— –‹‘ƒ•ƒ‡†‹ƒ–‘”„‡–™‡‡ Š‹Ž†Š‘‘†ƒ†˜‡”•‹–›ǡPersonality and mental health, 8 ’‡”•‘ƒŽ‹–›†‹•‘”†‡”ƒ†•›’–‘†‹•–”‡••Ǥ ȋͳȌǡͷʹǦ͸͸Ǥ ‹ Š‡––‹ǡǤǡ‘‰‘• Šǡ ǤǤǡƒ—‰ŠƒǡǤǡ‘–ŠǡǤǤǡDevelopment and psychopathology,Ƭ”— ‡ǡ ǤȋʹͲͲ͵ 15ȌǤ ƒŽ•‡„‡Ž‹‡ˆ—†‡”•–ƒ†‹‰ ‹ƒŽ–”‡ƒ–‡† Š‹Ž†”‡Ǥ ȋͶȌǡͳͲ͸͹ǦͳͲͻͳǤ Ž‡‡•‡ǡǤǡ˜ƒ•ǡ Ǥǡ”—‡”ǡǤǡ—Š‘ŽǡǤǡ‹˜ƒŽŽǡǤǡ§˜‡”ǡǤǡƒ•ǡǤǤǡƒ”–‡Ž•Ǧ ‡Ž–Š—‹•ǡǤǡ‘˜‰ƒƒ”†ǡǤǡƬ ‡’’‡•‡ǡǤȋʹͲͳ͸ȌǤ•› Š‘–‹ ‡š’‡”‹‡ ‡•ƒ†Š›’‡”Psychological medicine, 46Ǧ –Š‡‘”›Ǧ‘ˆǦ‹†‹’”‡ƒ†‘Ž‡• ‡ ‡–ƒ„‹”–Š ‘Š‘”–•–—†›Ǥ ȋͳȌǡ ͺ͹ǦͳͲͳǤ ‘” ‘”ƒǡǤǡ‡” ‡”ǡ ǤǡƬ ”‹–ŠǡǤǤȋͳͻͻͷȌǤ Š‹œ‘’Š”‡‹ƒǡ•›’–‘ƒ–‘Ž‘‰›ƒ†•‘ ‹ƒŽSchizophrenia inference:research, 17 investigating “theory of mind” in people with schizophrenia. ȋͳȌǡͷǦͳ͵Ǥ ‘—–—”‡ǡǤǤǡ‡ǡǤǤǡƬ‘„‡”–•ǡǤǤSchizophreniaȋʹͲͲ͸Ȍ bulletinǤŠ‡ˆ— –‹‘ƒŽ•‹‰‹ˆ‹ ƒ ‡‘ˆ•‘ ‹ƒŽ ‘‰‹–‹‘‹, 32 • Š‹œ‘’Š”‡‹ƒǣƒ”‡˜‹‡™Ǥ ȋͳȌǡͶͶǦ͸͵Ǥ —–ƒŒƒ”ǡǤǤǡ—ŽŽ‡ǡǤǤǡ‰Ž‘ˆˆǡ ǤǤǡŠ‘ƒ•ǡǤǤǡ‡ŽŽ•ǡǤǤǡƬ’ƒ–ƒ”‘ǡ ǤȋʹͲͳͲȌǤ •› Š‘’ƒ–Š‘Ž‘‰›‹ƒŽƒ”‰‡ ‘Š‘”–‘ˆ•‡š—ƒŽŽ›ƒ„—•‡† Š‹Ž†”‡ˆ‘ŽŽ‘™‡†—’–‘Ͷ͵›‡ƒ”•ǤChild abuse & neglect, 34 ȋͳͳȌǡͺͳ͵ǦͺʹʹǤ ‡„„ƒ±ǡǤǡƒŽƒ‹‹‘•ǡ Ǥǡ—›–‡ǡǤǡƒ†‘—†ǡǤǡ”ƒ†‘ǡǤǡ‘œœ‹ǡǤǤǡ ‘ƒ‰›ǡǤǡƬ”‡–ǡ FrontiersǤǤȋʹͲͳ͸ inȌǤ––ƒ Š‡–ǡ‡—”‘„‹‘Ž‘‰›ǡƒ†‡–ƒŽ‹œ‹‰ƒŽ‘‰–Š‡’•› Š‘•‹• ‘–‹——Ǥ Human Neuroscience, 10 ȋͶͲ͸ȌǡͳǦʹʹǤ ‘‘†›ǡ Ǥǡ ږœǡǤǡ ‘Š•–‘‡ǡǤǡ ”‹–ŠǡǤǡPsychological medicine, 28 Ƭ™‡•ǡǤǤȋͳͻͻͺȌǤŠ‡‘”›‘ˆ‹†ƒ†’•› Š‘•‡•Ǥ ȋʹȌǡ͵ͻ͹ǦͶͲͷǤ

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†™ƒ”†•ǡǤǡŠ‹’ƒǡǤǡƬ”‘™ǡǤȋʹͲͲͷȌǤŠ‡•‘ ‹ƒŽ‹œƒ–‹‘‘ˆ‡‘–‹‘ƒŽ—†‡”•–ƒ†‹‰ǣChild maltreatment, ‘’ƒ”‹•‘‘ˆ‡‰Ž‡ –ˆ—Žƒ†‘‡‰Ž‡ –ˆ—Ž‘–Š‡”•ƒ†–Š‡‹” Š‹Ž†”‡Ǥ 10 ȋ͵Ȍǡʹͻ͵Ǧ͵ͲͶǤ •‹ǡǤǡ‘”ƒ†‹ǡǤǡƒ”‰‡–ǡǤǡ ‘ƒ‰›ǡǤǡƒ„‘—”‹ǡǤǡƬ‡”–Š‡Ž‘–ǡǤȋʹͲͳͷȌǤ ‡–ƒŽ‹œƒ–‹‘‹ Š‹Ž†”‡ƒ†‘–Š‡”•‹–Š‡ ‘–‡š–‘ˆ–”ƒ—ƒǣƒ‹‹–‹ƒŽ•–—†›‘ˆ–Š‡British Journal of Developmental ˜ƒŽ‹†‹–›‘ˆ–Š‡Š‹Ž†‡ˆŽ‡ –‹˜‡ — –‹‘‹‰ ƒŽ‡ǤPsychology, 33 ȋʹȌǡʹͲ͵Ǧʹͳ͹Ǥ ‡––ǡǤǦǤ Ǥǡƒƒ–ǡǤǡƬ ”‘—’ ˜‡•–‹‰ƒ–‘”•ǤȋʹͲͳͳȌǤ‘ ‹ƒŽ ‘Schizophrenia‰‹–‹˜‡‹’ƒ‹”‡–•ƒ†’•› Š‘–‹  bulletin, 35 •›’–‘•ǣ™Šƒ–‹•–Š‡ƒ–—”‡‘ˆ–Š‡‹”ƒ••‘ ‹ƒ–‹‘ǫ ǡͷ͹͵ǦͷͺͺǤ ‘ƒ‰›ǡǤǡ ‡”‰‡Ž›ǡ ǤǡƬ —”‹•–ǡǤǤȋʹͲͲͶȌǤˆˆ‡ –”‡‰—Žƒ–‹‘ǡ‡–ƒŽ‹œƒ–‹‘ƒ†–Š‡ †‡˜‡Ž‘’‡–‘ˆ–Š‡•‡ŽˆǤ‘†‘ǡǣƒ”ƒ „‘‘• ‘ƒ‰›ǡǤǡƬ—›–‡ǡǤȋʹͲͳʹȌǤŠ‡—Ž–‹†‹‡•‹‘ƒŽ ‘•–”— –‘ˆ‡–ƒŽ‹œƒ–‹‘ƒ†‹–•From the Couch to the ”‡Ž‡˜ƒ ‡–‘—†‡”•–ƒ†‹‰„‘”†‡”Ž‹‡’‡”•‘ƒŽ‹–›†‹•‘”†‡”Ǥ ǣLab: Trends in Psychodynamic Neuroscience The cognitive neuropsychology ofǤ schizophrenia.šˆ‘”†ǡǣšˆ‘”†‹˜‡”•‹–›”‡••Ǥ ”‹–ŠǡǤǤȋʹͲͳͶȌǤ  ‘˜‡ǡǣ•› Š‘Ž‘‰›”‡••ǡǤ ”‹–ŠǡǤǤǡPsychologicalƬ‘” ‘”ƒǡǤȋ medicineͳͻͻ͸, 26Ȍ. Exploring ‘theory of mind’‹’‡‘’Ž‡™‹–Š• Š‹œ‘’Š”‡‹ƒǤ 5 ȋ͵ȌǡͷʹͳǦͷ͵ͲǤ ƒ”‡–›ǡǤǤǡƬ ”‡‡ƒǡǤȋͳͻͻͻBritishȌǤ‘‰‹–‹˜‡ƒ’’”‘ƒ Š‡•–‘†‡Ž—•‹‘•ǣƒ ”‹–‹ ƒŽ”‡˜‹‡™‘ˆ journal of clinical psychology, 38 –Š‡‘”‹‡•ƒ†‡˜‹†‡ ‡Ǥ ȋʹȌǡͳͳ͵ǦͳͷͶǤ ”ƒ–ǡǤǤǡƬ‡ ǡǤǤȋʹͲͲͻȌǤ‡ˆ‡ƒ–‹•–„‡Ž‹‡ˆ•ƒ•ƒ‡†‹ƒ–‘”‘ˆ ‘‰‹–‹˜‡‹’ƒ‹”Schizophrenia Bulletin,‡–ǡ 35 ‡‰ƒ–‹˜‡•›’–‘•ǡƒ†ˆ— –‹‘‹‰‹• Š‹œ‘’Š”‡‹ƒǤ ȋͶȌǡ ͹ͻͺ–ͺͲ͸Ǥ ”‡‹‰ǡǤǤǡ”›•‘ǡ Ǥ ǤǡƬ‡ŽŽǡǤǤȋʹͲͲͶȌǤŠ‡‘”›‘ˆ‹†’‡”ˆ‘”ƒ ‡‹• Š‹œ‘’Š”‡‹ƒǣThe Journal of nervous and mental†‹ƒ‰‘•–‹ ǡ•›’–‘ǡƒ†‡—”‘’•› Š‘Ž‘‰‹ ƒŽ ‘””‡Žƒ–‡•Ǥ disease, 192 ȋͳȌǡͳʹǦͳͺǤ ƒ›‡•ǡǤ ǤǡƬ”‡ƒ Š‡”ǡǤ ǤȋʹͲͳͲȌǤ—ƒ–‹ˆ›‹‰ƒ†–‡•–‹‰‹†‹”‡ –‡ˆˆ‡ –•‹•‹’Ž‡‡†‹ƒ–‹‘Multivariate behavioral research, 45‘†‡Ž•™Š‡–Š‡ ‘•–‹–—‡–’ƒ–Š•ƒ”‡‘Ž‹‡ƒ”Ǥ ȋͶȌǡ͸ʹ͹Ǧ͸͸ͲǤ ƒ›‡•ǡǤ ǤǡƬ”‡ƒ Š‡”ǡǤ ǤȋʹͲͳ͵ȌǤ‘†‹–‹‘ƒŽ’”‘ ‡••‘†‡Ž‹‰ǣ•‹‰•–”— –—”ƒŽ‡“—ƒ–‹‘Structural equation modeling: A ‘†‡Ž‹‰–‘‡šƒ‹‡ ‘–‹‰‡– ƒ—•ƒŽ’”‘ ‡••‡•Ǥ ǣsecond course ǡʹͳ͹Ǧʹ͸ͶǤ ƒ›ƒǡǤǤǡ• ‘‡ǡǤǡ‹ ‘ŽǡƬǤǤSchizophreniaȋʹͲͳ͸ȌǤ‘ ‹ƒŽƒ†˜‡”•‹–›ƒ†’•› Š‘•‹•ǣ–Š‡‡†‹ƒ–‹‰”‘Ž‡‘ˆ bulletin, 43 ‘‰‹–‹˜‡˜—Ž‡”ƒ„‹Ž‹–›Ǥ ȋ͵Ȍǡͷͷ͹Ǧͷ͸ͷǤ ƒ›ǡǤǤǡ ‹•œ„‡‹ǡǤǡƬ’ˆ‡”ǡǤǤȋ. Schizophreniaͳͻͺ͹ bulletinȌǤŠ‡’‘•‹–‹˜‡ƒ†‡‰ƒ–‹˜‡•›†”‘‡• ƒŽ‡ȋ, 13 Ȍ ˆ‘”• Š‹œ‘’Š”‡‹ƒ ȋʹȌǡʹ͸ͳǦʹ͹͸Ǥ

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‹ǡǤȋʹͲͳͷȌǤŠ‡‹†‹–Š‡ƒ‹‰ǣ‡˜‡Ž‘’‡–ƒŽƒ†‡—”‘„‹‘Ž‘‰‹ ƒŽ‘”‹‰‹•‘ˆPersonality Disorders: Theory, Research, and Treatment, 6 ‡–ƒŽ‹œ‹‰Ǥ ȋͶȌǡ͵ͷ͸Ǧ͵͸ͷǤ ƒ”†‹‘‹•ǡǤǡƒ–ƒ•–‡”ǡǤǡ‡‰‡Ž‡”•ǡǤǡƒ•ǡ Ǥǡ& Myin‐Germeys,Acta Psychiatrica I. (Scandinavica,ʹͲͳͳȌǤŠ‹Ž†Š‘‘†–”ƒ—ƒ 123 ƒ†‹ ”‡ƒ•‡†•–”‡•••‡•‹–‹˜‹–›‹’•› Š‘•‹•Ǥ ȋͳȌǡʹͺǦ ͵ͷǤ ‹ ‘ŽǡǤǤǡƒ”‹ǡǤǡƬ ƒ›ƒǡǤǤȋʹͲͳ͹ȌǤŠ‹Ž†Š‘‘†–”ƒ—ƒƒ†’•› Š‘–‹ ‡š’‡”‹‡ ‡•‹ƒ ‰‡‡”ƒŽ’‘’—Žƒ–‹‘•ƒ’Ž‡ǣ’”‘•’‡ –‹˜‡•–—†›‘–Š‡‡†‹ƒ–‹‰”‘Ž‡‘ˆ‡‘–‹‘European Psychiatry, 42 ”‡‰—Žƒ–‹‘Ǥ ǡͳͳͳǦͳͳͻǤ ‘‰†‡ǡǤǡƒ’•‘ǡǤǡEpidemiologyƬ‡ƒ†ǡ ǤȋʹͲͳͷ and psychiatricȌǤŠ‹Ž†Š‘‘†ƒ†˜‡”•‹–›ƒ†’•› Š‘•‹•ǣ‰‡‡”ƒŽ‹•‡†‘” sciences, 25 •’‡ ‹ˆ‹ ‡ˆˆ‡ –•ǫ ǡ͵ͶͻǦ͵ͷͻǤ ›•ƒ‡”ǡǤ Ǥǡ‡‡•ǡǤǤǡƒ ƒ•–‡”ǡǤǤǡƬƒ˜‹•ǡǤǤȋʹͲͲͶȌǤ‘ ƒ–‹‘ƒŽˆ— –‹‘ƒ‘‰ ’‡”•‘•™‹–Š• Š‹œ‘’Š”‡‹ƒ™‹–Šƒ†™‹–Š‘—Journal of traumatic stress, 17 –Š‹•–‘”›‘ˆ Š‹Ž†Š‘‘†•‡š—ƒŽ–”ƒ—ƒǤ ȋͷȌǡͶ͵ͷǦͶ͵ͺǤ ƒ ‡–ŠǡǤǡ —Ž‡›ǡǤǡ Š™ƒƒ—‡”ǡǤǡƬ ‹•Š‡”ǡǤȋʹͲͳͳȌǤ––ƒ Š‡–•–ƒ–‡•‘ˆ‹†ǡPsychology and Psychotherapy:mentalization, and Theory, their Research correlates and in Practice, a first‐episode 84 psychosis sample. ȋͳȌǡͶʹǦͷ͹Ǥ ƒš™‡ŽŽǡǤǤǡ‘Ž‡ǡǤǤǡƬ‹– Š‡ŽŽǡǤǤȋʹͲͳͳȌǤ‹ƒ•‹ ”‘••Ǧ•‡ –‹‘ƒŽƒƒŽ›•‡•‘ˆŽ‘‰‹–—†‹ƒŽMultivariate ‡†‹ƒ–‹‘ǣƒ”–‹ƒŽƒ† ‘’Ž‡–‡‡†‹ƒ–‹‘—†‡”ƒƒ—–‘”‡‰”‡••‹˜‡‘†‡ŽǤBehavioral Research, 46 ȋͷȌǡͺͳ͸ǦͺͶͳǤ ‹– ŠŽ‡›ǡǤ Ǥǡƒ”„‡”ǡ Ǥǡ ”ƒ›ǡ ǤǤǡ”‘‘•ǡǤǤǡ. Cognitive NeuropsychiatryƬ‹˜‹‰•–‘ǡǤ, 3 ǤȋͳͻͻͺȌǤ‘’”‡Š‡•‹‘‘ˆ ‹”‘›‹• Š‹œ‘’Š”‡‹ƒ ȋʹȌǡͳʹ͹Ǧͳ͵ͺǤ ‘Ž–‡ǡǤǡ‘ŽŽ‹‰ǡǤǤǡ —†ƒ ǡǤǤǡ ‘ƒ‰›ǡǤǡƒ›‡•ǡǤǡƬ‡Ž’Š”‡›ǡǤǤȋʹͲͳ͵ȌǤ”ƒ‹ ‡ Šƒ‹••—†‡”Ž›‹‰–Š‡‹’ƒ –‘ˆƒ––ƒ Š‡–Frontiers in human neuroscience, 7 Ǧ”‡Žƒ–‡†•–”‡••‘•‘ ‹ƒŽ ‘‰‹–‹‘Ǥ ȋͺͳ͸ȌǡͳǦͳʹǤ ̵”‹• ‘ŽŽǡǤǡƒ‹‰ǡ ǤǡƬƒ•‘ǡǤȋʹͲͳͶȌǤ‘‰‹–‹˜‡‡‘–‹‘”‡‰—Žƒ–‹‘•–”ƒ–‡‰‹‡•ǡƒŽ‡š‹–Š›‹ƒClinical psychology ƒ††‹••‘ ‹ƒ–‹‘‹• Š‹œ‘’Š”‡‹ƒǡƒ”‡˜‹‡™ƒ†‡–ƒreview, 34 ǦƒƒŽ›•‹•Ǥ ȋ͸ȌǡͶͺʹǦͶͻͷǤ ‘ŽŽƒǡǤǤǡ‹ Š‡––‹ǡǤǡ ‘”—‰ǡǤǡƬ‡‡†ǡǤȋʹͲͲͲȌǤ‡ ‘‰‹œ‹‰‡‘–‹‘‹Developmental psychology,ˆƒ ‡•ǣ 36 ‡˜‡Ž‘’‡–ƒŽ‡ˆˆ‡ –•‘ˆ Š‹Ž†ƒ„—•‡ƒ†‡‰Ž‡ –Ǥ ȋͷȌǡ͸͹ͻǤ ‡ƒ”•ǡǤǡƬ ‹•Š‡”ǡǤǤȋʹͲͲͷȌǤ‡˜‡Ž‘’‡–ƒŽǡ ‘‰‹–‹˜‡ǡƒ†‡—”‘’•› Š‘Ž‘‰‹ ƒŽˆ— –‹‘‹‰‹ ’”‡• Š‘‘ŽJournalǦƒ‰‡†ˆ‘•–‡” Š‹Ž†”‡ǣ••‘ ‹ƒ–‹‘•™‹–Š’”‹‘”ƒŽ–” of Developmental & Behavioral Pediatrics, 26 ‡ƒ–‡–ƒ†’Žƒ ‡‡– Š‹•–‘”›Ǥ ȋʹȌǡͳͳʹǦͳʹʹǤ ‡ƒ†ǡ Ǥǡ˜ƒ•ǡ Ǥǡ‘””‹•‘ǡǤǤǡƬ‘••ǡǤǤȋʹͲͲͷȌǤŠ‹Ž†Š‘‘†–”ƒ—ƒǡ’•› Š‘•‹•ƒ†Acta • Š‹œ‘’Š”‡‹ƒǣƒŽ‹–‡”ƒ–—”‡”‡˜‹‡™™‹–Š–Š‡‘”‡–‹ ƒŽƒ† Ž‹‹ ƒŽ‹’Ž‹ ƒ–‹‘•ǤPsychiatrica Scandinavica, 112 ȋͷȌǡ͵͵ͲǦ͵ͷͲǤ

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‡ƒ†ǡ ǤǡƬ —Ž‡›ǡǤȋʹͲͳͲȌǤƒƒ––ƒ Š‡––Š‡‘”›Š‡Ž’‡š’Žƒ‹–Š‡”‡Žƒ–‹‘•Š‹’„‡–™‡‡Telling stories Š‹Ž†Š‘‘†ƒ†˜‡”•‹–›ƒ†’•› Š‘•‹•Ǥ ǡͷͳǦͻͶǤ ‡˜Š‡‹ǡǤǡƬ‡†ƒŽ‹ƒǡǤȋSchizophreniaʹͲͲͶȌǤ‡”„ƒŽ‡‘”›ǡ’”‘„Ž‡ research, 68 Ǧ•‘Ž˜‹‰•‹ŽŽ•ƒ† ‘—‹–›•–ƒ–—• ‹• Š‹œ‘’Š”‡‹ƒǤ ȋʹȌǡͳͶͻǦͳͷͺǤ ‘‰‘• Šǡ ǤǤǡ‹ Š‡––‹ǡǤǡƬ„‡”ǡ ǤǤȋͳͻͻͷȌǤŠ‡”‘Ž‡‘ˆ Š‹Ž†ƒŽ–”‡ƒ–‡–‹‡ƒ”Ž› †‡˜‹ƒ–‹‘•‹ ‘‰‹–‹˜‡ƒ†ƒˆˆ‡ –‹˜‡’”‘ ‡••‹‰ƒ„‹Ž‹–‹‡•ƒ†Žƒ–‡”’‡‡””‡Žƒ–‹‘•Š‹’Development and psychopathology, 7 ’”‘„Ž‡•Ǥ ȋͶȌǡͷͻͳǦ͸ͲͻǤ  Š‡‡ŽǡǤǤǡ’ƒ—Ž†‹‰ǡǤǤǡ‹‹ŽŽ‘ǡǤǡƬ‹Ž˜‡”•–‡‹ǡǤǤȋʹͲͲͷȌǤ ‹•–‘”‹‡•‘ˆ Š‹Ž†Š‘‘† ƒŽ–”‡ƒ–‡–‹• Š‹œ‘’Š”‡‹ƒǣ”‡Žƒ–‹‘•Š‹’•™‹–Š’”‡‘”„‹†ˆ— –‹‘‹‰ǡSchizophrenia research, 76 •›’–‘ƒ–‘Ž‘‰›ǡƒ† ‘‰‹–‹˜‡†‡ˆ‹ ‹–•Ǥ ȋʹȌǡʹ͹͵Ǧʹͺ͸Ǥ ‡Ž–‡ǡ ǤǤǡ˜ƒ†‡”‡ǡǤǡ—––‡ǡǤǤǡSchizophreniaƬƒ–‘”Ǧ ”ƒƒ‡ǡǤȋ bulletin, 39ʹͲͳ͵ȌǤŠ‡•‘ ‹ƒŽ†‡ˆ‡ƒ–Š›’‘–Š‡•‹• ‘ˆ• Š‹œ‘’Š”‡‹ƒǣƒ—’†ƒ–‡Ǥ ȋ͸ȌǡͳͳͺͲǦͳͳͺ͸Ǥ ‡Ž–‡ǡ ǤǤǡ& Cantor‐Graae,Acta Psychiatrica E. (ʹͲͳͶ ScandinavicaȌǤŠ‹Ž†Š‘‘†–”ƒ—ƒƒ†–Š‡–”‡ƒ–‡–ˆ‘”’•› Š‘–‹ , 129 †‹•‘”†‡”Ǥ ȋ͸ȌǡͶ͹ͻǦͶͺͲǤ ‡”‰‹ǡǤ Ǥǡƒ••‘˜•›ǡǤǡ‹†ƒ”ǡǤǡ‡‹•–ǡǤǡ”Šƒ”–ǡǤǡ”ƒˆˆǡǤǤǡƒ”†‡”ǡǤǤǡƬ ”‡‡ǡǤ Ǥ ȋʹͲͲ͹ȌǤ‘ ‹ƒŽ ‘‰‹–‹‘‹• Š‹œ‘’Š”‡‹ƒǣSchizophrenia research,”‡Žƒ–‹‘•Š‹’•™‹–Š‡—”‘ ‘‰‹–‹‘ƒ† 90 5 ‡‰ƒ–‹˜‡•›’–‘•Ǥ ȋͳȌǡ͵ͳ͸Ǧ͵ʹͶǤ Š‹’ƒǡǤǤǡƬ‡ƒǡ ǤȋͳͻͻͻȌǤ‘–‹‘ƒŽ—†‡”•–ƒ†‹‰ǣ ‘’ƒ”‹•‘‘ˆ’Š›•‹ ƒŽŽ›Journal of Clinical Child Psychology, ƒŽ–”‡ƒ–‹‰ƒ†‘ƒŽ–”‡ƒ–‹‰‘–Š‡”28 Ǧ Š‹Ž††›ƒ†•Ǥ ȋ͵ȌǡͶͲ͹ǦͶͳ͹Ǥ ’ƒ—™‡ǡ Ǥǡ”ƒ„„‡†ƒǡǤǡ‹‡„ǡǤǡ‹–– Š‡ǡ ǤǦǤǡƬƒ•ǡ ǤȋʹͲͲ͸ȌǤ ’ƒ –‘ˆ ’•› Š‘Ž‘‰‹ ƒŽ–”ƒ—ƒ‘–Š‡†‡˜‡Ž‘’‡–‘ˆ’•› Š‘–‹ •›’–‘•ǣ”‡Žƒ–‹‘•Š‹’™‹–ŠThe British Journal of Psychiatry, 188 ’•› Š‘•‹•’”‘‡‡••Ǥ ȋ͸Ȍǡͷʹ͹Ǧͷ͵͵Ǥ ’”‘‰ǡǤǡ Š‘–Š‘”•–ǡǤǡ‘•ǡǤǡ ‘šǡ ǤǡThe British JournalƬ ofƒ‰‡Žƒ†ǡ Ǥȋ Psychiatry, 191 ʹͲͲ͹ȌǤŠ‡‘”›‘ˆ‹†‹ • Š‹œ‘’Š”‡‹ƒǤ ȋͳȌǡͷǦͳ͵Ǥ –ƒ‹ǡ Ǥ Ǥǡ”ސ‹ ǡǤǡ ‡‰‡Ž•–ƒ†ǡǤǤǡ ‘ƒǡ Ǥǡ ‘Šƒ‡••‡ǡ ǤǤǡƒ‰‡˜‡Ž†ǡ Ǥǡƒ™ǡǤǡƬ ƒ”•‡ǡǤǤȋʹͲͳ͵ȌǤ ’ƒ –‘ˆ‹–‡”’‡”•‘ƒŽ–”ƒ—ƒ‘–Š‡•‘ ‹ƒŽˆ— –‹‘‹‰‘ˆƒ†—Ž–•Schizophrenia bulletin, 40 ™‹–Šˆ‹”•–Ǧ‡’‹•‘†‡’•› Š‘•‹•Ǥ ǡͳͶͻͳǦͳͶͻͺǤ —••‡”ǡǤǡ‹†‘ǡǤǤSchizophreniaȋʹͲͳʹȌǤ–‹ŽŽ•‡ƒ” Š‹‰ˆ‘”Ž‘•––”—–Š•ƒ„‘—––Š‡„‹––‡”•‘””‘™•‘ˆ bulletin, 38 Š‹Ž†Š‘‘†Ǥ ȋͶȌǡ͸͹ʹǦ͸͹ͷǤ ‹ƒǡǤǡ——–‘‡ǡǤǡ Ž‘‡ǡǤǡ—‘‹‡ǡǤǡ‘–‹¡‹ǡǤǡ ƒƒŽƒǡ ǤǡƬƒŽ‘ƒ‰ƒ•ǡǤǤ ȋʹͲͳ͵ȌǤŠ‹Ž†Š‘‘†–”ƒ—ƒƒ†’”‡‘”„‹†ƒ†Œ—•–Earl‡–ƒ‘‰‹†‹˜‹†—ƒŽ•ƒ– Ž‹‹ ƒŽŠ‹‰Šy intervention in psychiatry, 7 ”‹•ˆ‘”’•› Š‘•‹•ƒ†‘”ƒŽ ‘–”‘Ž•—„Œ‡ –•Ǥ ȋͳȌǡͷͳǦ ͷ͹Ǥ Dialogues in clinical ”±‡ƒ—ǡ Ǥneuroscience,ȋʹͲͲ͸ȌǤ”‡˜‹‡™‘ˆ‡‘–‹‘†‡ˆ‹ ‹–•‹• Š‹œ‘’Š”‡‹ƒǤ 8 ȋͳȌǡͷͻǦ͹ͲǤ

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˜ƒƒǡǤǡ˜ƒ‹‡”‘’ǡǤǡ‹‡ Š–„ƒ—‡”ǡǤǡ‡Ž–Š‘”•–ǡǤǡ˜ƒ‹‡ŽǡǤǡ”—‰‰‡ƒǡǤǡƒŠǡ Ǥǡ‡ ƒƒǡǤǡƒŠǡǤǡƬ‡‹Œ‡”ǡǤȋʹͲͳͷȌǤŠ‹Ž†Š‘‘†ƒ„—•‡ƒ†‡‰Ž‡ –‹”‡Žƒ–‹‘–‘ –Š‡’”‡•‡ ‡ƒ†’‡”•‹•–‡ ‡‘ˆ’•› Š‘–‹ ƒ††‡’”‡••‹˜‡•›’–‘ƒ–‘Ž‘‰›ǤPsychological medicine, 45 ȋ͹Ȍǡͳ͵͸͵Ǧͳ͵͹͹Ǥ ƒ‘‡”•‰‘‡†ǡǤ Ǥǡ‡ ‘‰ǡǤǡƒ†‡” ƒƒ‰ǡǤǡŽ‡ƒǡǤǡ›•ƒ‡”ǡǤ Ǥǡ—†‡”‹ǡǤǡƬ ‹Œ‡„‘”‰ǡ Ǥ ǤǤȋʹͲͳͶȌǤƒ—ƒŽǦ„ƒ•‡†‹†‹˜‹†—ƒŽ–Š‡”ƒ’›–‘‹’”‘˜‡‡–ƒ ‘‰‹–‹‘BMC psychiatry, 14 ‹• Š‹œ‘’Š”‡‹ƒǣ’”‘–‘ ‘Ž‘ˆƒ—Ž–‹Ǧ ‡–‡”Ǥ ȋͳȌǡͳͶNatureǦʹ͹Ǥ , ˜ƒ•ǡ Ǥǡ‡‹•ǡ Ǥǡ468 Ƭ—––‡ǡǤǤ ǤȋʹͲͳͲȌǤŠ‡‡˜‹”‘‡–ƒ†• Š‹œ‘’Š”‡‹ƒǤ ȋ͹͵ʹͳȌǡʹͲ͵ǦʹͳʹǤ ƒ”‡•‡ǡ Ǥǡ‡‡–•ǡ Ǥǡ”—‡”ǡǤǡ‹‡˜‡”•‡ǡǤǡƒ–ƒ•–‡”ǡǤǡ‹‡ Š–„ƒ—‡”ǡǤǡ‡ƒ†ǡ Ǥǡ˜ƒ•ǡ ǤǡƬ ‡–ƒŽŽǡǤǤȋʹͲͳʹȌǤŠ‹Ž†Š‘‘†ƒ†˜‡”•‹–‹‡•‹ ”‡ƒ•‡–Š‡”‹•‘ˆ’•› Š‘•‹•ǣƒ‡–ƒǦ SchizophreniaƒƒŽ›•‹•‘ˆ’ƒ–‹‡– bulletinǦ ‘–”‘Žǡ’”‘•’‡ –‹˜‡, 38 Ǧƒ† ”‘••Ǧ•‡ –‹‘ƒŽ ‘Š‘”–•–—†‹‡•Ǥ ȋͶȌǡ͸͸ͳǦ͸͹ͳǤ ƒ—–ŠǡǤǡò• ŠǡǤǡ‹”–œǡǤǡƬ‘””‹‰ƒǡǤǤȋʹͲͲͶȌǤ‘‡••‘ ‹ƒŽ ‘‰‹–‹‘‹ˆŽ—‡ ‡–Š‡ ”‡Žƒ–‹‘„‡–™‡‡‡—”‘ ‘‰‹–‹˜‡†‡ˆ‹ ‹–•ƒ†˜‘ ƒ–‹‘ƒŽˆ— –‹‘‹‰‹• Š‹œ‘’Š”‡‹ƒǫPsychiatry research, 128 ȋʹȌǡͳͷͷǦͳ͸ͷǤ ƒŽ•–‘ǡ ǤǡŽ‡‡”Šƒ••‡––ǡǤǤǡƬŠƒ”Ž–‘ǡǤ ǤȋʹͲͲͲCognitiveȌ. “Theory Neuropsychiatry, of mind”, persecutory 5 †‡Ž—•‹‘•ƒ†–Š‡•‘ƒ–‹ ƒ”‡”‡ Šƒ‹•Ǥ ȋ͵Ȍǡͳ͸ͳǦͳ͹ͶǤ ‡‹ǡǤǡŠƒˆˆ‡”ǡǤǤǡ‘—‰ǡǤǤǡƬƒƒŽ‹ǡǤǤȋʹͲͲͷȌǤ†—Ž–ƒ––ƒ Š‡–ǡ•Šƒ‡ǡ†‡’”‡••‹‘ǡJournal of ƒ†Ž‘‡Ž‹‡••ǣŠ‡‡†‹ƒ–‹‘”‘Ž‡‘ˆ„ƒ•‹ ’•› Š‘Ž‘‰‹ ƒŽ‡‡†••ƒ–‹•ˆƒ –‹‘ǤCounseling Psychology, 52 ȋͶȌǡͷͻͳǤ ‡‹Œ‡”•ǡ Ǥǡ–‡ƒ–‡ǡǤǡ—”‡Ž‹‰•Ǧ‘–‡‘‡ǡǤǡ‹‡ Š–„ƒ—‡”ǡǤǡƒ’ƒƒ”–ǡǤǡƒ–‡ƒǡǤǡƬ ‡Ž–‡ǡ ǤǦǤȋʹͲͳ͸ȌǤ‡–ƒŽ‹œƒ–‹‘BMC Ǧpsychiatry,„ƒ•‡†–”‡ƒ–‡–ˆ‘”’•› Š‘–‹ †‹•‘”†‡”ǣ’”‘–‘ ‘Ž‘ˆƒ 16 ”ƒ†‘‹œ‡† ‘–”‘ŽŽ‡†–”‹ƒŽǤ ȋͳȌǡͳͻͳǤ            

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PART III:

‡–ƒŽ‹œƒ–‹‘„ƒ•‡†–”‡ƒ–‡–ˆ‘”’•› Š‘–‹ †‹•‘”†‡”

MENTALIZATION

BASED TREATMENT

FOR PSYCHOTIC

DISORDER

III Part

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Chapter Six:

‡–ƒŽ‹œƒ–‹‘Ǧ„ƒ•‡†–”‡ƒ–‡–ˆ‘”’•› Š‘–‹ †‹•‘”†‡”ǣ BMC Psychiatry (2016) ’”‘–‘ ‘Ž‘ˆƒ”ƒ†‘‹œ‡† ‘–”‘ŽŽ‡†–”‹ƒŽǤ JonasMENTALIZATION- Weijers1, 2,*, Coriene ten Kate1, Elisabeth Eurelings-Bontekoe3, Wolfgang Viechtbauer2, Rutger Rampaart1, Anthony Bateman4,5 and Jean-Paul Selten1,2 BASED TREATMENT

FOR PSYCHOTIC DISORDER: PROTOCOL OF A RANDOMIZED CONTROLLED TRIAL 6

ͳ ‹˜‹‡”†—‹‡ •–‹–—–‡ˆ‘”‡–ƒŽ ‡ƒŽ–Šƒ”‡ǡ–Š‡‡–Š‡”Žƒ†•Ǥ ʹ J.G. Š‘‘Žˆ‘”‡–ƒŽ ‡ƒŽ–Šƒ†‡—”‘• ‹‡ ‡ Weijers, C. ten Kate, E.H.M. Eurelings-Bontekoe,ǡƒƒ•–”‹ Š–‹˜‡”•‹–›ǡ–Š‡‡–Š‡”Žƒ†•Ǥ  ͵ W.V.‡’ƒ”–‡–‘ˆŽ‹‹ ƒŽ•› Š‘Ž‘‰›ǡ ‡ƒŽ–Šƒ†‡—”‘’•› Š‘Ž‘‰›ǡ‡‹†‡‹˜‡”•‹–›ǡ‡‹†‡ǡ Viechtbauer, L.J.A. Rampaart, –Š‡ ‡–Š‡”Žƒ†•Ǥ ͶA.W. Bateman, J.-P.C.J. Selten ‡ƒǡƒ ”‡—†‡–”‡ǡǤ ͷ •› Š‘ƒƒŽ›•‹•—‹–ǡ‹˜‡”•‹–›‘ŽŽ‡‰‡‘†‘ǡ ȗ‘””‡•’‘†‡ ‡ǣŒǤ™‡‹Œ‡”•̷”‹˜‹‡”†—‹‡ǤŽ BMC Psychiatry (2016) Chapter Chapter 

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Abstract

Background: ƒ›’ƒ–‹‡–•™‹–Šƒ‘Ǧƒˆˆ‡ –‹˜‡’•› Š‘–‹ †‹•‘”†‡”•—ˆˆ‡”ˆ”‘‹’ƒ‹”‡–•‹ •‘ ‹ƒŽˆ— –‹‘‹‰ƒ†•‘ ‹ƒŽ ‘‰‹–‹‘Ǥ‘–ƒ”‰‡––Š‡•‡‹’ƒ‹”‡–•ǡ‡–ƒŽ‹œƒ–‹‘Ǧ„ƒ•‡† –”‡ƒ–‡–ˆ‘”’•› Š‘–‹ †‹•‘”†‡”ǡƒ’•› Š‘†›ƒ‹ –”‡ƒ–‡–”‘‘–‡†‹ƒ––ƒ Š‡––Š‡‘”›ǡŠƒ• „‡‡†‡˜‡Ž‘’‡†Ǥ –‹•‡š’‡ –‡†–‘‹’”‘˜‡•‘ ‹ƒŽ ‘‰‹–‹‘ǡƒ†–Š‡”‡„›–‘‹’”‘˜‡•‘ ‹ƒŽ ˆ— –‹‘‹‰ǤŠ‡–”‡ƒ–‡–‹•ˆ—”–Š‡”‡š’‡ –‡†–‘‹ ”‡ƒ•‡“—ƒŽ‹–›‘ˆŽ‹ˆ‡ƒ†–Š‡ƒ™ƒ”‡‡••‘ˆ Šƒ˜‹‰ƒ‡–ƒŽ†‹•‘”†‡”ǡƒ†–‘”‡†— ‡•—„•–ƒ ‡ƒ„—•‡ǡ•‘ ‹ƒŽ•–”‡••”‡ƒ –‹˜‹–›ǡ’‘•‹–‹˜‡ Methods/design:•›’–‘•ǡ‡‰ƒ–‹˜‡ǡƒš‹‘—•ƒ† †‡’”‡••‹˜‡•›’–‘•Ǥ Š‡•–—†›‹•ƒ”ƒ–‡”Ǧ„Ž‹†‡†”ƒ†‘‹œ‡† ‘–”‘ŽŽ‡†–”‹ƒŽǤƒ–‹‡–•ƒ”‡‘ˆˆ‡”‡† ͳͺ‘–Š•‘ˆ–Š‡”ƒ’›ƒ†ƒ”‡”ƒ†‘Ž›ƒŽŽ‘ ƒ–‡†–‘‡–ƒŽ‹œƒ–‹‘Ǧ„ƒ•‡†–”‡ƒ–‡–ˆ‘” ’•› Š‘–‹ †‹•‘”†‡”•‘”–”‡ƒ–‡–ƒ•—•—ƒŽǤƒ–‹‡–•ƒ”‡”‡ ”—‹–‡†ˆ”‘‘—–’ƒ–‹‡–†‡’ƒ”–‡–• ‘ˆ–Š‡‹˜‹‡”†—‹‡‡–ƒŽŠ‡ƒŽ–Š‹•–‹–—–‡ǡ–Š‡‡–Š‡”Žƒ†•ǡƒ†ƒ”‡ƒ‰‡†ͳͺ–‘ͷͷ›‡ƒ”•ƒ† Šƒ˜‡„‡‡†‹ƒ‰‘•‡†™‹–Šƒ‘Ǧƒˆˆ‡ –‹˜‡’•› Š‘–‹ †‹•‘”†‡”Ǥ‘ ‹ƒŽˆ— –‹‘‹‰ǡ–Š‡’”‹ƒ”› ‘—– ‘‡˜ƒ”‹ƒ„Ž‡ǡ‹•‡ƒ•—”‡†™‹–Š–Š‡•‘ ‹ƒŽˆ— –‹‘‹‰• ƒŽ‡ǤŠ‡ƒ†‹‹•–”ƒ–‹‘‘ˆƒŽŽ–‡•–• ƒ†“—‡•–‹‘ƒ‹”‡•–ƒ‡•ƒ’’”‘š‹ƒ–‡Ž›ʹʹŠ‘—”•Ǥ‡–ƒŽ‹œƒ–‹‘Ǧ„ƒ•‡†–”‡ƒ–‡–ˆ‘”’•› Š‘–‹  †‹•‘”†‡”•ƒ††•ƒ–‘–ƒŽ‘ˆ͸ͲŠ‘—”•‘ˆ‰”‘—’–Š‡”ƒ’›ƒ†ͳͷŠ‘—”•‘ˆ‹†‹˜‹†—ƒŽ–Š‡”ƒ’›–‘ –”‡ƒ–‡–ƒ•—•—ƒŽǤ‘‘™Š‡ƒŽ–Š”‹••ƒ”‡‹˜‘Ž˜‡†‹–Š‡•–—†›ǡ–Š‘—‰Š‹–‹•‘™–Šƒ– Discussion:‰”‘—’†›ƒ‹ • ƒŠƒ˜‡ƒ†˜‡”•‡‡ˆˆ‡ –•‘ƒ’•› Š‹ƒ–”‹ †‹•‘”†‡”Ǥ  ˆ‡–ƒŽ‹œƒ–‹‘Ǧ„ƒ•‡†–”‡ƒ–‡–ˆ‘”’•› Š‘–‹ †‹•‘”†‡”•’”‘˜‡•–‘„‡‡ˆˆ‡ –‹˜‡ǡ‹– ‘—Ž†„‡ƒ—•‡ˆ—ŽTrial registration:ƒ††‹–‹‘–‘–”‡ƒ–‡–Ǥ  Keywords: —– Š”‹ƒŽ‡‰‹•–‡”ǣͶ͹Ͷ͹Ǥ”‹ƒŽ”‡‰‹•–”ƒ–‹‘†ƒ–‡ͲͺǦͳͻǦʹͲͳͶǤ ‡–ƒŽ‹œƒ–‹‘ǡ”‡ƒ–‡–ǡ Š‹œ‘’Š”‡‹ƒǡ•› Š‘•‹•ǡ‘ ‹ƒŽˆ— –‹‘‹‰ǡ‘ ‹ƒŽ ‘‰‹–‹‘ǡ•› Š‘–Š‡”ƒ’› Background and rationale

‘Ǧƒˆˆ‡ –‹˜‡’•› Š‘–‹ †‹•‘”†‡”•ȋȌŽ‹‡• Š‹œ‘’Š”‡‹ƒƒ”‡ƒ ‘—–ƒ„Ž‡ˆ‘”ƒ•—„•–ƒ–‹ƒŽ ’ƒ”–‘ˆ–Š‡–‘–ƒŽ„—”†‡‘ˆ†‹•‡ƒ•‡ǡ ‘•–‹–—–‹‰–Š‡ˆ‹ˆ–Šƒ†•‹š–ŠŽ‡ƒ†‹‰ ƒ—•‡‘ˆ†‹•ƒ„‹Ž‹–›‹ –Š‡™‘”Ž†ǡˆ‘”‡ƒ†™‘‡”‡•’‡ –‹˜‡Ž›ȋƒ–Š‡”•ǡ ƒ–Ƭ‘‡”ƒǡʹͲͲͺȌǤƒŒ‘” ‘–”‹„—–‘” –‘–Š‹•Š‹‰ŠŽ‡˜‡Ž‘ˆ†‹•ƒ„‹Ž‹–›‹•–Š‘—‰Š––‘„‡–Š‡†‡ Ž‹‡‹•‘ ‹ƒŽˆ— –‹‘‹‰ƒ••‘ ‹ƒ–‡†™‹–Š Ǥƒ–‹‡–•™‹–Š‡š’‡”‹‡ ‡†‹ˆˆ‹ —Ž–› ‘—‹ ƒ–‹‰ȋ‡ŽŽƒ ǡ‘””‹••‘ǡ‹š–‡†Ƭ —‡•‡”ǡʹͲͲʹȌǡƒ†–‡†–‘Šƒ˜‡’‘‘”•‘ ‹ƒŽ’”‘„Ž‡Ǧ•‘Ž˜‹‰•‹ŽŽ•ȋ††‹‰–‘ǡƒ‡‡†‹Ƭ ††‹‰–‘ǡʹͲͲ͸ȌǤŠ‡•‡•‘ ‹ƒŽ†‡ˆ‹ ‹–•ƒ”‡’”‡†‹ –‹˜‡‘ˆ’‘‘”˜‘ ƒ–‹‘ƒŽ‘—– ‘‡ȋ‡ŽŽǡ•ƒ‰ǡ ”‡‹‰ǡƬ”›•‘ǡʹͲͲͻȌƒ†’‘‘”“—ƒŽ‹–›‘ˆŽ‹ˆ‡ȋ‡”Ž‹ ǡ–ƒ•–›ǡƒ––‹•Ƭ‡”‡•‹ǡͳͻͻʹȌǤ –‹• •—”’”‹•‹‰ǡ–Š‡”‡ˆ‘”‡ǡ–Šƒ–ˆ‡™–”‡ƒ–‡–•Šƒ˜‡„‡‡†‡˜‡Ž‘’‡†–‘‡ˆˆ‡ –‹˜‡Ž›–ƒ”‰‡––Š‡Ǥ ‘ ‹ƒŽ ‘‰‹–‹‘–†‡ˆ‹ed as “the ability to construct ”‡’”‡•‡–ƒ–‹‘•‘ˆ–Š‡”‡Žƒ–‹‘ „‡–™‡‡‘‡•‡Žˆƒ†‘–Š‡”•ǡƒ†–‘—•‡–Š‘•‡”‡’”‡•‡–ƒ–‹‘•ˆŽ‡š‹„Ž›–‘‰—‹†‡social behavior”

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ȋ†‘Ž’Š•ǡʹͲͲͳȌŠƒ•„‡‡‹†‡–‹ˆ‹‡†ƒ•‘‡‘ˆ–Š‡•–”‘‰‡•–’”‡†‹ –‘”•‘ˆ•‘ ‹ƒŽˆ— –‹‘‹‰‹ ’ƒ–‹‡–•™‹–Šȋ”ò‡ǡʹͲͲͷȌǤšƒ’Ž‡•‘ˆ•‘ ‹ƒŽ ‘‰‹–‹˜‡‹’ƒ‹”‡–•‹‹ Ž—†‡ †‹ˆˆ‹ —Ž–‹‡•”‡ ‘‰‹œ‹‰‡‘–‹‘•ȋ‘ŠŽ‡”ǡƒŽ‡”ǡƒ”–‹ǡ ‡ƒŽ›Ƭ‘„‡”‰ǡʹͲͳͲȌǡ‡’ƒ–Š‹œ‹‰ ȋ‘”ƒƬƒ–‡Ž‹•ǡʹͲͲͻȌǡ–ƒ‹‰ƒother person’s perspective ȋ‘–ƒ‰ǡ ‡‹œǡ—œƬ ƒŽŽ‹ƒ–ǡ ʹͲͲ͹Ȍƒ†—†‡”•–ƒ†‹‰•‘ ‹ƒŽŠ‹–•ȋ‹œ”ƒŠ‹ǡ‘”‘•–‹Žǡ–ƒ”•–‡‹ǡ‹’—”•›Ƭƒ’—”ǡʹͲͲ͹ȌǤ ”‡ ‡–›‡ƒ”•Œ—•–ƒˆ‡™–”‡ƒ–‡–•ǡ‘•–Ž›”‘‘–‡†‹ ‘‰‹–‹˜‡Ȁ„‡Šƒ˜‹‘”ƒŽ–Š‡‘”› ȋ‘”‹–œƬ‘‘†™ƒ”†ǡʹͲͲ͹Ǣ‘„‡”–•Ƭ‡ǡʹͲͲͻǢ‘„•‡–ƒŽǤǡʹͲͲ͹ȌǡŠƒ˜‡„‡‡†‡˜‡Ž‘’‡† –Šƒ––ƒ”‰‡–•‘ ‹ƒŽ ‘‰‹–‹‘Ǥ‡•—Ž–•ǡƒ”‡’”‡Ž‹‹ƒ”›ǡ„—–†‘•—‰‰‡•––Šƒ–‹’ƒ‹”‡†•‘ ‹ƒŽ ‘‰‹–‹˜‡†‡ˆ‹ ‹–•ƒ”‡–ƒ”‰‡–ƒ„Ž‡„›’•› Š‘•‘ ‹ƒŽ‹–‡”˜‡–‹‘•ȋ‘„‡”–•Ƭ‡ǡʹͲͲͻǢ‘„•‡– ƒŽǤǡʹͲͲ͹Ǣ‘ ŠƒƬ—‡‹”וǡʹͲͳ͵ȌǤ ‡–ƒŽ‹œƒ–‹‘Ǧ„ƒ•‡†–”‡ƒ–‡–ˆ‘”’•› Š‘–‹ †‹•‘”†‡”ȋ’Ȍ‹•„ƒ•‡†‘ƒƒ—ƒŽ‹œ‡† ’•› Š‘†›ƒ‹ –”‡ƒ–‡–ˆ‘”‘”†‡”Ž‹‡‡”•‘ƒŽ‹–›‹•‘”†‡”ȋǢƒ–‡ƒƬ ‘ƒ‰›ǡʹͲͲ͸ȌǤ ‡ ‡–’”‘•’‡ –‹˜‡•–—†‹‡••—‰‰‡•––Šƒ–’•› Š‘†›ƒ‹ –Š‡”ƒ’›ƒ›‹’”‘˜‡‰Ž‘„ƒŽ ˆ— –‹‘‹‰‹ȋ‘•‡„ƒ—‡–ƒŽǤǡʹͲͲ͸Ǣ‘•‡„ƒ—‡–ƒŽǤǡʹͲͳʹȌǡƒŽ–Š‘—‰Š”ƒ†‘‹œ‡† ‘–”‘ŽŽ‡†–”‹ƒŽ••Š‘—Ž†„‡ ‘†— –‡†–‘•—„•–ƒ–‹ƒ–‡–Š‹• Žƒ‹ǤŽ•‘ǡ‡–ƒ ‘‰‹–‹˜‡ ’•› Š‘–Š‡”ƒ’›ȋ‘‡”•‰‘‡†‡–ƒŽǤǡʹͲͳͶȌ–™Š‹ Š‹• Ž‘•‡Ž›”‡Žƒ–‡†–‘ȋ”‡–Ƭ ‘ƒ‰›ǡ ʹͲͳͶȌ–Š‘Ž†•’”‘‹•‡ƒ•ƒ–”‡ƒ–‡–ˆ‘”’ƒ–‹‡–•™‹–Š• Š‹œ‘’Š”‡‹ƒȋ›•ƒ‡”ǡ— Ƭ‹‰‡”ǡ ʹͲͲ͸ȌǤǦ™ƒ•†‡˜‡Ž‘’‡†–‘•’‡ ‹ˆ‹ ƒŽŽ›‹’”‘˜‡•‘ ‹ƒŽˆ— –‹‘‹‰„›–ƒ”‰‡–‹‰–Š‡•‘ ‹ƒŽ 6 ‘‰‹–‹˜e process called ‘mentalizing’. ‡”‰‡Ž›ƒ† ‘ŽŽ‡ƒ‰—‡•ȋʹͲͲʹȌ†‡• ”‹„‡‡–ƒŽ‹œ‹‰ƒ• “the process by whi Š™‡‹’Ž‹ ‹–Ž›ƒ†‡š’Ž‹ ‹–Ž›‹–‡”’”‡––Š‡ƒ –‹‘•‘ˆ‘—”•‡Ž˜‡•ƒ†‘–Š‡”• ƒ•‡ƒ‹‰ˆ—Ž‘–Š‡„ƒ•‹•‘ˆintentional mental states”.  ƒ†Š‡”‡•–‘ƒˆ‡™‹’‘”–ƒ–’”‹ ‹’Ž‡•ǣȋ‹ȌŠ‡–Š‡”ƒ’‹•–ˆ‘ —•‡•‘–Š‡ —””‡– ‡–ƒŽ•–ƒ–‡‘ˆ–Š‡’ƒ–‹‡––‘’”ƒ –‹ ‡ƒ‹‰”‡’”‡•‡–ƒ–‹‘•‘ˆ‹–‡”ƒŽ•–ƒ–‡•Ǣȋ‹‹Ȍ–Š‡ –Š‡”ƒ’‹•–ˆ‘ —•‡•‘–Š‡’”‡•‡–ƒ•‘’’‘•‡†–‘–Š‡’ƒ•–Ǣȋ‹‹‹Ȍ–Š‡–Š‡”ƒ’‹•–ƒ˜‘‹†•–ƒŽ‹‰ƒ„‘—– ‡–ƒŽ•–ƒ–‡•–Šƒ–ƒ”‡‘–Ž‹‡†–‘•—„Œ‡ –‹˜‡Ž›ˆ‡Ž–”‡ƒŽ‹–›Ǣȋ‹˜Ȍ–Š‡–Š‡”ƒ’‹•–ƒ˜‘‹†•–ƒŽ‹‰ ƒ„‘—– ‘’Ž‡š‡–ƒŽ•–ƒ–‡•Ǣȋ˜Ȍ–Š‡–Š‡”ƒ’‹•–ˆ‘ —•‡•‘”‡ ‘˜‡”‹‰‡–ƒŽ‹œ‹‰ǡ‘– ”‡ƒ–‹‰ ‹•‹‰Š–ȋƒ–‡ƒƬ ‘ƒ‰›ǡʹͲͲ͸ȌǤ Š‹•ƒ’’”‘ƒ Š™ƒ•ˆ‘—†–‘”‡†— ‡•›’–‘•ƒ†‹–‡”’‡”•‘ƒŽ†‹•–”‡••ǡƒ†‹’”‘˜‡ •‘ ‹ƒŽˆ— –‹‘‹‰‹’ƒ–‹‡–•™‹–Šȋƒ–‡ƒƬ ‘ƒ‰›ǡͳͻͻͻȌǤŽ–Š‘—‰Šƒ† ƒ›•‡‡“—ƒŽ‹–ƒ–‹˜‡Ž›†‹ˆˆ‡”‡–†‹•‘”†‡”•ǡ‡ƒ”Ž›˜‹‡™•ƒ••—‡†„‘”†‡”Ž‹‡’•› Š‘’ƒ–Š‘Ž‘‰› ‘ —’‹‡†ƒƒ”‡ƒ„‡–™‡‡‡—”‘•‹•ƒ†’•› Š‘•‹•ȋ‡Ǥ‰Ǥ‡”„‡”‰ǡͳͻͺ͸Ȍƒ† ‘—Ž†‹˜‘Ž˜‡ –”ƒ•‹‡–’•› Š‘–‹ ‡’‹•‘†‡•Ǥ‹ ‡–Š‡ǡ‡˜‹†‡ ‡Šƒ••—„•–ƒ–‹ƒ–‡†’•› Š‘•‹•’”‘‡‡••‹ Ǥ•› Š‘–‹ •›’–‘•ǡ‹ Ž—†‹‰ŠƒŽŽ— ‹ƒ–‘”›‡š’‡”‹‡ ‡•ƒ††‡Ž—•‹‘•ǡ‘ —””‡‰—Žƒ”Ž›‹ ’ƒ–‹‡–•™‹–Šǡ‘ˆ–‡’‡”•‹•–‘˜‡”–‹‡ǡƒ†ƒ”‡ˆ‘”ƒŽƒ”‰‡’ƒ”–ƒŽ”‡ƒ†›’”‡•‡–‹‡ƒ”Ž› Š‹Ž†Š‘‘†ȋ‡‡ǡ‘”‡ǡ ™‹‰‰ƒǡ‡ƒ”‡•Ƭ–‡˜‡•‘ǡʹͲͲ͸ȌǤ ƒ”‡ ‡–•–—†›–Šƒ–‹ Ž—†‡† ’ƒ–‹‡–•™‹–Š‡‹–Š‡”‘” Š‹œ‘’Š”‡‹ƒǡͳ͹Ψ‘ˆ’ƒ”–‹ ‹’ƒ–•‡––Š‡ ”‹–‡”‹ƒˆ‘”„‘–Š

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†‹•‘”†‡”•ȋ‹‰†‘ǡ•Š ”‘ˆ–ǡŠƒ†ƒ”‹ǡ Ž‡‡•‘ǡƒ”‹‘‘Ƭ›‘•ǡʹͲͳͲȌǤ††‹–‹‘ƒŽŽ›ǡ•‘‡ ƒ†’ƒ–‹‡–••Šƒ”‡ƒ–‡†‡ ›–‘‡š ‡••‹˜‡Ž›ƒ––”‹„—–‡‹ ‘””‡ –‹–‡–‹‘•–‘‘–Š‡”•ǡ or to “hypermentalize”ȋŽ‡‡•‡‡–ƒŽǤǡʹͲͳͶǢŠƒ”’‡–ƒŽǤǡʹͲͳͳǢ„—Ǧ‡ŽƬƒ‹Ž‡›ǡʹͲͲͲȌǤ —”–Š‡”‘”‡ǡ†‹•–—”„ƒ ‡•‹•‡ŽˆǦƒ™ƒ”‡‡••ƒ†•‡ŽˆǦ”‡’”‡•‡–ƒ–‹‘Šƒ˜‡„‡‡•—‰‰‡•–‡†–‘ ’Žƒ›ƒ‹’‘”–ƒ–”‘Ž‡‹„‘–Š†‹•‘”†‡”•ȋ—‡”„ƒ ŠƬŽƒ––ǡͳͻͻ͸ȌǤƒ•–Ž›ǡ Š‹Ž†Š‘‘†–”ƒ—ƒŠƒ• „‡‡‡•–ƒ„Ž‹•Š‡†ƒ•ƒ‹’‘”–ƒ–ˆƒ –‘”‹–Š‡‘”‹‰‹•‘ˆ„‘–Š†‹•‘”†‡”•ȋƒ”‡•‡‡–ƒŽǤʹͲͳʹȌǤ Š—•ǡƒ•Šƒ•„‡‡•—‰‰‡•–‡†‡ƒ”Ž‹‡”ȋ”‡–Ƭ ‘ƒ‰›ǡʹͲͳͶǢ”‡–ǡʹͲͲͻȌǡƒ›„‡ƒ •‹‹Žƒ”Ž›•—‹–ƒ„Ž‡–”‡ƒ–‡–ˆ‘”Ǥ Research aims and hypotheses Primary research aim.

Š‡’”‹ƒ”›ƒ‹‘ˆ–Š‹••–—†›‹•–‘‡•–ƒ„Ž‹•Š™Š‡–Š‡” ‡–ƒŽ‹œƒ–‹‘Ǧ„ƒ•‡†–”‡ƒ–‡–ˆ‘”’•› Š‘–‹ †‹•‘”†‡”ȋ’Ȍ‹’”‘˜‡••‡ŽˆǦ”‡’‘”–‡†•‘ ‹ƒŽ ˆ— –‹‘‹‰‹’ƒ–‹‡–•™‹–ŠǤ‡Š›’‘–Š‡•‹œ‡–Šƒ–’ƒ–‹‡–•™Š‘”‡ ‡‹˜‡’™‹ŽŽ•Š‘™ ‰”‡ƒ–‡”‹’”‘˜‡‡–•‹•‘ ‹ƒŽˆ— –‹‘‹‰ ‘’ƒ”‡†–‘’ƒ–‹‡–•™Š‘Šƒ˜‡Šƒ†–”‡ƒ–‡–ƒ• —•—ƒŽȋȌ‘Ž›Ǥ‡ƒŽ•‘‡š’‡ ––Šƒ–ƒ›†‹ˆˆ‡”‡ ‡‘„•‡”˜‡†™‹ŽŽ•–‹ŽŽ„‡’”‡•‡–ƒ–ƒ͸Ǧ‘–Š ˆ‘ŽŽ‘™Ǧ—’ǤSecondary research aims. –Š‡”‘—– ‘‡‡ƒ•—”‡•™‡”‡ Š‘•‡™‹–Š’”‡˜‹‘—• ”‡•‡ƒ” Š”‡‰ƒ”†‹‰‹‹†Ǥ ‘”†‹‰–‘ ‘ƒ‰›ƒ†ƒ–‡ƒȋʹͲͲ͸Ȍ, MBT’s mechanism ‘ˆchange is improving patients’ mentalizing capacities.‡–Š‡”‡ˆ‘”‡ƒ‹–‘‡•–ƒ„Ž‹•Š™Š‡–Š‡” ’‹†‡‡†‹ ”‡ƒ•‡•‡–ƒŽ‹œ‹‰ ƒ’ƒ ‹–›ǡ‡ƒ•—”‹‰•‡˜‡”ƒŽ†‹‡•‹‘•‘ˆ•‘ ‹ƒŽ ‘‰‹–‹‘ǡ ƒ†™Š‡–Š‡”–Š‹•‹ ”‡ƒ•‡‡†‹ƒ–‡•ƒ’‘–‡–‹ƒŽ–”‡ƒ–‡–‡ˆˆ‡ –Ǥ —”–Š‡”‘”‡ǡ‹‡ƒ”Ž‹‡”•–—†‹‡•ǡ ƒ–‡ƒƒ† ‘ƒ‰›ȋͳͻͻͻȌ”‡’‘”–‡†ƒ”‡†— –‹‘‘ˆƒš‹‘—•ƒ††‡’”‡••‹˜‡•›’–‘•ƒ†‘ˆ •—„•–ƒ ‡ƒ„—•‡Ǥ‡‡š’‡ –•‹‹Žƒ””‡•—Ž–•”‡‰ƒ”†‹‰’ƒ–‹‡–•Ǥ ‹˜‡–Š‡•–”‘‰”‡Žƒ–‹‘ „‡–™‡‡•‘ ‹ƒŽˆ— –‹‘‹‰ƒ†“—ƒŽ‹–›‘ˆŽ‹ˆ‡ǡ™‡ƒ••—‡–Šƒ–’ƒ–‹‡–•”‡ ‡‹˜‹‰’™‹ŽŽ ”‡’‘”–ƒŠ‹‰Š‡”“—ƒŽ‹–›‘ˆŽ‹ˆ‡Ǥ††‹–‹‘ƒŽŽ›ǡ„ƒ•‡†‘’”‡˜‹‘—•”‡•‡ƒ” Šȋ‘•–ƒ–ƒ‘’‘—Ž‘•‡– ƒŽǤǡʹͲͳͶȌǡ™‡’”‡†‹ ––Šƒ–‹’”‘˜‡‡–‘ˆ•‘ ‹ƒŽ ‘‰‹–‹˜‡ ƒ’ƒ ‹–›™‹ŽŽƒŽ•‘Ž‡ƒ†–‘ƒ ‹ ”‡ƒ•‡†ƒ™ƒ”‡‡••‘ˆŠƒ˜‹‰ƒ‡–ƒŽ†‹•‘”†‡”Ǥ —”–Š‡”‘”‡ǡƒ•ƒ–‡ƒƒ† ‘ƒ‰›ȋʹͲͲ͸Ȍ †‡• ”‹„‡–Šƒ–™ƒ•†‡•‹‰‡†–‘‹’”‘˜‡‡‘–‹‘”‡‰—Žƒ–‹‘‹•‹–—ƒ–‹‘•‘ˆƒ––ƒ Š‡– ”‡Žƒ–‡†ǡ‹Ǥ‡Ǥǡ•‘ ‹ƒŽǡ•–”‡••Ǥƒ•‡†‘–Š‹•ǡ™‡ƒ••‡”––Šƒ–’ƒ–‹‡–•™‹ŽŽŠƒ˜‡Ž‡••ƒ˜‡”•‹˜‡‡‘–‹‘ƒŽ ”‡ƒ –‹‘•–‘•‹–—ƒ–‹‘•‘ˆ•‘ ‹ƒŽ•–”‡••ƒ•ƒ”‡•—Ž–‘ˆ’Ǥ ˆ’ ƒ”‡†— ‡patients’ ‡‘–‹‘ƒŽ”‡ƒ –‹˜‹–›–‘•‘ ‹ƒŽ•–”‡••ǡ–Š‡›ƒ›ƒŽ•‘„‡ ‘‡Ž‡••’”‘‡–‘†‡˜‡Ž‘’’‘•‹–‹˜‡ ’•› Š‘–‹ •›’–‘•ǡƒ••‘ ‹ƒŽ•–”‡••”‡ƒ –‹˜‹–›ƒ›„‡ƒƒˆˆ‡ –‹˜‡’ƒ–Š™ƒ›–‘’•› Š‘•‹•ȋ›‹Ǧ ‡”‡›•Ƭ˜ƒ•ǡʹͲͲ͹ȌǤƒ•–Ž›ǡ„‡ ƒ—•‡•‘ ‹ƒŽˆ— –‹‘‹‰ƒ†‡–ƒŽ‹œ‹‰ƒ„‹Ž‹–›Šƒ˜‡„‡‡ ˆ‘—†–‘„‡•–”‘‰Ž›”‡Žƒ–‡†–‘‡‰ƒ–‹˜‡•›’–‘•ǡ™‡™‹ŽŽ‡šƒ‹‡™Š‡–Š‡”’”‡†— ‡• ‡‰ƒ–‹˜‡•›’–‘•ȋ‘” ‘”ƒǡ‡” ‡”Ƭ ”‹–ŠǡͳͻͻͷǢ ”‡‹‰ǡ”›•‘Ƭ‡ŽŽǡʹͲͲͶǢ‡”‰‹‡–ƒŽǤǡ ʹͲͲ͹ȌǤ

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Covariates.

‡”–ƒ‹’‘–‡–‹ƒŽ‡ˆˆ‡ –‘†‹ˆ‹‡”•™‹ŽŽ„‡–ƒ‡‹–‘ƒ ‘—–Ǥ ‹”•–ǡƒ†˜‡”•‡ Š‹Ž†Š‘‘†‡š’‡”‹‡ ‡••— Šƒ•‡‰Ž‡ –‘”’Š›•‹ ƒŽǡ’•› Š‘Ž‘‰‹ ƒŽǡƒ†•‡š—ƒŽƒ„—•‡Šƒ˜‡„‡‡ ƒ••‘ ‹ƒ–‡†™‹–Š•‘ ‹ƒŽ†›•ˆ— –‹‘Žƒ–‡”‹Ž‹ˆ‡ȋ‹Ž˜‡”ƒǡ‡‹Š‡”œƬ ‹ƒ ‘‹ƒǡͳͻͻ͸ȌǤ‡ ‘†ǡ ’‡”•‘ƒŽ‹–›‘”‰ƒ‹œƒ–‹‘ȋȌŠƒ•„‡‡•Š‘™–‘‹’ƒ –’•› Š‘–Š‡”ƒ’›–”‡ƒ–‡–”‡•’‘•‡ ȋ‘‡Ž‡‡–ƒŽǤǡʹͲͳʹȌƒ†–Š‡Ž‡˜‡Ž‘ˆ•‘ ‹ƒŽ ‘‰‹–‹‘ȋ—”‡Ž‹‰•Ǧ‘–‡‘‡ǡ—›–‡ǡƬ‡ŽŽ‡ǡ ʹͲͲͻȌǤ ‹˜‡Ž‡˜‡Ž•‘ˆ’‡”•‘ƒŽ‹–›‘”‰ƒ‹œƒ–‹‘ȋȌƒ”‡‹†‡–‹ˆ‹‡†ǡ‡ƒ Š Šƒ”ƒ –‡”‹œ‡†„› †‹ˆˆ‡”‡–Ž‡˜‡Ž•‘ˆƒš‹‡–›–‘Ž‡”ƒ ‡ƒ††‹ˆˆ‡”‡– ƒ’ƒ ‹–‹‡•ˆ‘”impulse inhibition or ‘control’: ‡—”‘–‹ ȋ‰‘‘†ƒš‹‡–›–‘Ž‡”ƒ ‡ǡ‘˜‡”Ǧ ‘–”‘ŽȌǢ‘”†‡”Ž‹‡ȋ‘†‡”ƒ–‡–‘’‘‘”ƒš‹‡–› –‘Ž‡”ƒ ‡ǡ†‹ˆˆ‡”‹‰Ž‡˜‡Ž•‘ˆ ‘–”‘ŽȌǢƒ” ‹••‹•–‹ ‘”†‡”Ž‹‡ȋ‰‘‘†ƒš‹‡–›–‘Ž‡”ƒ ‡ǡ —†‡” ‘–”‘ŽȌǢƒ–‡–•› Š‘–‹ ȋ‘†‡”ƒ–‡ƒš‹‡–›–‘Ž‡”ƒ ‡ǡ™‡ƒ ‘–”‘ŽȌǢƒ†ƒ‹ˆ‡•– •› Š‘–‹ ȋ’‘‘”ƒš‹‡–›–‘Ž‡”ƒ ‡ǡ™‡ƒ ‘–”‘ŽȌǤŠ‹”†ǡ–Š‡ƒ™ƒ”‡‡••‘ˆ„‘†‹Ž›•‡•ƒ–‹‘• Šƒ•„‡‡”‡‰ƒ”†‡†ƒ•–Š‡ˆ‹”•–Ž‡˜‡Ž‘ˆ‡‘–‹‘ƒŽƒ™ƒ”‡‡••ȋ‡–Œ‡•ǡ‡‹Œ‡”ǡ‡”•–‡‹ǡ”–œ Ƭ‡†‡†‘”’ǡʹͲͳ͵Ȍǡ™Š‹ Š‹•ƒ‡••‡–‹ƒŽ’ƒ”–‘ˆ•‘ ‹ƒŽ ‘‰‹–‹‘ȋ ”‡‡ǡͳͻͻ͸ȌǤ •› Š‘’ƒ–Š‘Ž‘‰›—•—ƒŽŽ›‹•ƒ ‘’ƒ‹‡†„›ȋ˜ƒ‰—‡Ȍ’Š›•‹ ƒŽ ‘’Žƒ‹–•ǡ ƒŽŽ‡†“somatization”. ˆƒ‹Ž—”‡–‘”‡’‘”–’Š›•‹ ƒŽ ‘’Žƒ‹–•™Š‹Ž‡•—ˆˆ‡”‹‰ȋ•‡˜‡”‡Ȍ’•› Š‘’ƒ–Š‘Ž‘‰›ƒ›„‡ ‹†‹ ƒ–‹˜‡‘ˆƒƒ„•‡ ‡‘ˆ„‘†‹Ž›ƒ™ƒ”‡‡••ƒ†–Š‡”‡ˆ‘”‡ƒ‹’ƒ‹”‡†•‘ ‹ƒŽ ‘‰‹–‹˜‡ ƒ’ƒ ‹–›Ǥ ‘—”–Šǡ‡†‹ ƒ–‹‘—•‡ ƒƒˆˆ‡ –•‘ ‹ƒŽˆ— –‹‘‹‰‹’ƒ–‹‡–•™‹–Šǡ–Š‡”‡ˆ‘”‡ –Š‡–›’‡‘ˆ‡†‹ ƒ–‹‘‹•”‡‰‹•–‡”‡†ƒ†ƒ†Š‡”‡ ‡–‘‡†‹ ƒ–‹‘‹•‡ƒ•—”‡†Ǥ ‹ˆ–Šǡ 6 ƒ––‡†ƒ ‡‹•–ƒ‡‹–‘ƒ ‘—–ǡ„‡ ƒ—•‡‹–‹•‡š’‡ –‡†–Šƒ––Š‘•‡™Š‘ƒ––‡†‘”‡•‡••‹‘• ™‹ŽŽ’”‘ˆ‹–‘”‡Ǥ‹š–Šǡ„ƒ•‡Ž‹‡‡ƒ•—”‡‡–•‘ˆ–Š‡‘—– ‘‡˜ƒ”‹ƒ„Ž‡•™‹ŽŽ„‡ƒ ‘—–‡†ˆ‘”Ǥ ‡˜‡–Šǡ–Š‡†—”ƒ–‹‘‘ˆ‹ŽŽ‡••ǡ„‡ ƒ—•‡‘ˆ‹–•‡‰ƒ–‹˜‡‹’ƒ –‘ˆ— –‹‘‹‰Ǣƒ†‡‹‰Š–Šǡ ƒ†Š‡”‡ ‡–‘–Š‡‘†‡Ž„›–Š‡”ƒ’‹•–•ǡ„‡ ƒ—•‡‹–‹•Ž‹‡Ž›–‘‹ˆŽ—‡ ‡–”‡ƒ–‡–‘—– ‘‡Ǥ Methods/design

Trial design/setting . Š‹••–—†›‹•ƒ”ƒ–‡”Ǧ„Ž‹†‡†ǡ”ƒ†‘‹œ‡† ‘–”‘ŽŽ‡†–”‹ƒŽǤ ƒ–‹‡–•”‡ˆ‡””‡†–‘‘—–’ƒ–‹‡–•‹–‡•‘ˆ–Š‡‹˜‹‡”†—‹‡‡–ƒŽŠ‡ƒŽ–Š‹•–‹–—–‡ƒ”‡”ƒ†‘Ž› ƒ••‹‰‡†–‘”‡ƒ–‡–ƒ••—ƒŽȋȌ’Ž—•’‘”‘Ž›ǤŠ‡‹˜‹‡”†—‹‡‡–ƒŽŠ‡ƒŽ–Š ‹•–‹–—–‡’”‘˜‹†‡•‹Ǧƒ†‘—–’ƒ–‹‡––”‡ƒ–‡––‘–Š‘—•ƒ†•‘ˆ’ƒ–‹‡–•™‹–Š’•› Š‹ƒ–”‹  †‹•‘”†‡”•‹–Š‡—– Š’”‘˜‹ ‡‘ˆ‘—–ŠǦ ‘ŽŽƒ†ȋ‡Ǥ‰Ǥǡ‡‹†‡ǡ ‘—†ƒȌǤŠ‡‹˜‡•–‹‰ƒ–‘”ƒ† ’ƒ–‹‡–•ƒ”‡ƒ™ƒ”‡‘ˆ–”‡ƒ–‡–ƒŽŽ‘ ƒ–‹‘ǡ„—–ƒŽŽ‡ƒ•—”‡‡–•ƒ”‡’‡”ˆ‘”‡†„›”‡•‡ƒ” Š‡”• „Ž‹†–‘–”‡ƒ–‡–ƒŽŽ‘ ƒ–‹‘Ǥ‘ ‹ƒŽˆ— –‹‘‹‰ƒ–„ƒ•‡Ž‹‡ȋ–ͲȌƒ†ƒˆ–‡”–”‡ƒ–‡–ȋ–ʹȌ™‹ŽŽ„‡ ‘’ƒ”‡†ˆ‘”„‘–Š–”‡ƒ–‡– ‘†‹–‹‘•ǤŠ‡Participants. ’ƒ–‹‡–•ƒ”‡„Ž‹†–‘–Š‹•’”‹ƒ”›ƒ‹Ǥ ƒ”–‹ ‹’ƒ–•‹–Š‡•–—†›ƒ”‡’ƒ–‹‡–•™‹–ŠȋǦ  ”‹–‡”‹ƒȋǡ ʹͲͲͲȌȌǣ• Š‹œ‘’Š”‡‹ƒǡ• Š‹œ‘’Š”‡‹ˆ‘”ǡ‘”• Š‹œ‘ƒˆˆ‡ –‹˜‡†‹•‘”†‡”ȋʹͻͷǤšȌǡ†‡Ž—•‹‘ƒŽ †‹•‘”†‡”ȋʹͻ͹ǤͳȌǡ„”‹‡ˆ’•› Š‘–‹ †‹•‘”†‡”ȋʹͻͺǤͺȌǡ‘”’•› Š‘–‹ †‹•‘”†‡”‘–‘–Š‡”™‹•‡•’‡ ‹ˆ‹‡† ȋʹͻͺǤͻȌǤ–Ž‡ƒ•–ͺͲ’ƒ”–‹ ‹’ƒ–•™‹ŽŽ„‡‹ Ž—†‡†ˆ”‘–Š‡‹˜‹‡”†—‹‡‡–ƒŽŠ‡ƒŽ–Š‹•–‹–—–‡Ǥ

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  Ž—•‹‘ ”‹–‡”‹ƒƒ”‡ǣ ––Ž‡ƒ•–͸‘–Š•‘ˆ’”‹‘”–”‡ƒ–‡–Ǥ –‘‘”‡–ŠƒͳͲ›‡ƒ”•‘ˆ–”‡ƒ–‡–ˆ‘”Ǥ –‡–™‡‡ͳͺƒ†ͷͷ›‡ƒ”•‘ˆƒ‰‡Ǥ  š Ž—•‹‘ ”‹–‡”‹ƒƒ”‡ǣ – –‡ŽŽ‡ –—ƒŽ†‹•ƒ„‹Ž‹–›ƒ†Ȁ‘”‹ŽŽ‹–‡”ƒ ›Ǥ –Žƒ ‘ˆƒ•–‡”›‘ˆ–Š‡—– ŠŽƒ‰—ƒ‰‡Ǥ –—„•–ƒ ‡ƒ„—•‡–‘•— Šƒ‡š–‡––Šƒ–‹–‡ ‡••‹–ƒ–‡•‹’ƒ–‹‡–†‡–‘š‹ˆ‹ ƒ–‹‘Ǥˆ–‡” •— ‡••ˆ—Ž†‡–‘š‹ˆ‹ ƒ–‹‘–Š‡’ƒ–‹‡–‹••–‹ŽŽ‡Ž‹‰‹„Ž‡ˆ‘”’ƒ”–‹ ‹’ƒ–‹‘‹–Š‡•–—†›Ǥ ƒ–‹‡–• ƒ‘–’ƒ”–‹ ‹’ƒ–‡‹ƒ•‡••‹‘™Š‹Ž‡—†‡”–Š‡‹ˆŽ—‡ ‡‘ˆ†”—‰•Ǥ Sample size calculation.

Š‡‡•–‹ƒ–‡†‡ˆˆ‡ –•‹œ‡‘ˆ–Š‡ —””‡–•–—†›‹•„ƒ•‡† ‘–™‘’”‡˜‹‘—••–—†‹‡•Ǥ•–—†›‡šƒ‹‹‰–Š‡‡ˆˆ‡ –‘ˆ‘ȋƒ–‡ƒƬ ‘ƒ‰›ǡ d ͳͻͻͻȌ•Š‘™‡†‘†‡”ƒ–‡–‘Žƒ”‰‡”‡†— –‹‘•‘ˆ’”‘„Ž‡•”‡Žƒ–‹‰–‘‹–‡”’‡”•‘ƒŽ†‹•–”‡••ȋd α ͲǤͻͷǢͻͷΨǢ ǣͲǤͷͻ–ͳǤ͵ͲȌƒ†•‘ ‹ƒŽˆ— –‹‘‹‰ȋ αͲǤ͹ʹǢͻͷΨ ͲǤ͵͹–ͳǤͲ͸ȌǤ•–—†› ‘ ‡”‹‰‘ ‹ƒŽ‘‰‹–‹‘ƒ† –‡”ƒ –‹‘”ƒ‹‹‰ȋ Ȍ–ƒ–”‡ƒ–‡–ˆ‘”’ƒ–‹‡–•™‹–Š(d • Š‹œ‘’Š”‡‹ƒ–Šƒ–•Šƒ”‡•‡Ž‡‡–•™‹–Šd –•Š‘™‡†Žƒ”‰‡‡ˆˆ‡ –•‘•‘ ‹ƒŽ‡‰ƒ‰‡‡– αͳǤ͹͹Ȍƒ†‹–‡”’‡”•‘ƒŽ ‘—‹ ƒ–‹‘ȋ αͳǤͷ͹Ȍ‘–Š‡‘ ‹ƒŽ — –‹‘‹‰ ƒŽ‡ȋ‘„‡”–•Ƭ ‡ǡʹͲͲͻȌǤƒ•‡†‘–Š‡•‡”‡•—Ž–•ǡd ™‡‡š’‡ ––‘ˆ‹†ƒ‘†‡”ƒ–‡–‘Žƒ”‰‡‡ˆˆ‡ –‘ˆ’‘ •‘ ‹ƒŽcognition (i.e., a Cohen’s ‘ˆƒ–Ž‡ƒ•–ͲǤ͹ȌǤ‘ ƒŽ —Žƒ–‡–Š‡”‡“—‹”‡†•ƒ’Ž‡•‹œ‡ǡ ȗ‘™‡” ȋ ƒ—Žǡ Ǥǡ”†ˆ‡Ž†‡”ǡǤǡ— Š‡”ǡǤǡƬƒ‰ǡǤǡʹͲͲͻȌ™ƒ•—•‡†Ǥ‘‘„–ƒ‹ƒ•‹‰‹ˆ‹ ƒ–†‹ˆˆ‡”‡ ‡ ™‹–Š’‘™‡”‡“—ƒŽ–‘ǤͺͲ™‹–Šƒ‹†‡’‡†‡–•ƒ’Ž‡•–Ǧ–‡•–ȋˆ‘”ƒ–”—‡‡ˆˆ‡ –•‹œ‡‘ˆǤ͹ƒ†ƒŽ’Šƒ αǤͲͷȌǡ͸ͺ’ƒ”–‹ ‹’ƒ–•ƒ”‡‡‡†‡†Ǥ ‘™‡˜‡”ǡ„‡ ƒ—•‡”‡’‡ƒ–‡†‡ƒ•—”‡‡–•ȋ„ƒ•‡Ž‹‡ƒ† ’‘•–Ǧ–”‡ƒ–‡–Ȍ‹ ”‡ƒ•‡–Š‡’‘™‡”–†‡’‡†‹‰‘–Š‡–‡•–Ǧ”‡–‡•–”‡Ž‹ƒ„‹Ž‹–›‘ˆ–Š‡‘—– ‘‡ ‡ƒ•—”‡–ƒ•ƒŽŽ‡”•ƒ’Ž‡•‹œ‡‹•”‡“—‹”‡†Ǥˆ‘”—ŽƒŠƒ•„‡‡†‡˜‹•‡†ȋ‘”‰ƒƬŠƒ•‡ǡ ʹͲͳ͵Ȍ–‘ƒ ‘—–ˆ‘”–Š‡‹ ”‡ƒ•‡†’‘™‡”™Š‡—•‹‰—Ž–‹’Ž‡‡ƒ•—”‡‡–•ǣ”‡’‡ƒ–‡† –Ǧ–‡•– ‡ƒ•—”‡•αȋͳǦρ2)* ; where ρ is the testǦ”‡–‡•–”‡Ž‹ƒ„‹Ž‹–›‘ˆ–Š‡• ƒŽ‡—•‡†Ǥ”‡˜‹‘—• ”‡•‡ƒ” ŠŠƒ••Š‘™–Šƒ––Š‡–‡•–Ǧ”‡–‡•–”‡Ž‹ƒ„‹Ž‹–›‘ˆ–Š‡•‘ ‹ƒŽˆ— –‹‘‹‰• ƒŽ‡ƒˆ–‡”–™‘ƒ†ƒ half years is ρ = .40 ȋ††‹‰–‘Ƭ††‹‰–‘ǡʹͲͲͲȌǤŠ—•™‡‡‡†ǣȋͳǦ0.42)*68 ≈ 58 ’ƒ”–‹ ‹’ƒ–•–‘Šƒ˜‡ͺͲΨ’‘™‡”–‘ˆ‹†ƒ•‹‰‹ˆ‹ ƒ–†‹ˆˆ‡”‡ ‡Ǥ –‹•†‹ˆˆ‹ —Ž––‘’”‡†‹ ––Š‡ ƒ‘—–‘ˆ†”‘’Ǧ‘—–‹–Š‡•–—†›Ǥ ƒ—’—„Ž‹•Š‡†’‹Ž‘–•–—†›ǡ ‘†— –‡†ƒ––Š‡‹˜‹‡”†—‹‡ ‡–ƒŽŠ‡ƒŽ–Š‹•–‹–—–‡ǡ–Š‡†”‘’Ǧ‘—–”ƒ–‡‘ˆ’™‹–Š‹ƒ’‡”‹‘†‘ˆͳ›‡ƒ”™ƒ•ͳͲΨǤ‹ ‡–Š‡ —””‡– ‘„‹‡•–”‡ƒ–‡–ƒ†‡ƒ•—”‡‡–•ǡ™‡‡•–‹ƒ–‡–Šƒ––Š‡†”‘’Ǧ‘—–”ƒ–‡™‹ŽŽ„‡ Š‹‰Š‡”ǤŠ‡”‡ˆ‘”‡ǡ–‘„‡•—”‡ǡ™‡™‹ŽŽ”‡ ”—‹–ƒ–Ž‡ƒ•–ͶͲȋȌΪͶͲȋ’Ž—•’ȌαͺͲ

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146807_JonasWeijers_BNW_def.indd 114 28-10-2020 15:08 Mentalization based treatment for psychotic disorder: a protocol

‹†‹˜‹†—ƒŽ•Ǥ˜‡‹ˆʹͷΨ‘ˆ–Š‘•‡‹‹–‹ƒŽ’ƒ–‹‡–•ȋ‹Ǥ‡ǤǡʹͲȌ†”‘’‘—–ǡ–Š‡”‡™‹ŽŽ„‡͸Ͳ’ƒ–‹‡–•Ž‡ˆ– –‘†‡–‡ –ƒ‡ˆˆ‡ –Ǥ‡ ƒ—•‡’ƒ–‹‡–•‹–Š‡’ ‘†‹–‹‘”‡ ‡‹˜‡–Š‡”ƒ’›‹‰”‘—’•‘ˆ—’–‘ ‡‹‰Š– ’‡”•‘•ǡˆ‹˜‡‰”‘—’•™‹ŽŽ„‡ˆ‘”‡†‹‘”†‡”–‘”‡ ”—‹–ͶͲ’ƒ–‹‡–•‹–Š‡’ ‘†‹–‹‘Ǥ Procedure

•› Š‹ƒ–”‹•–•ǡ’•› Š‘Ž‘‰‹•–•ǡ‘”’•› Š‹ƒ–”‹ —”•‡•™‹ŽŽ Š‡ –Š‡‹” ƒ•‡Ž‘ƒ†ˆ‘”’ƒ–‹‡–•™Š‘ ‡‡––Š‡”‡“—‹”‡‡–•ˆ‘”’ƒ”–‹ ‹’ƒ–‹‘ƒ†ƒ• ‡”–ƒ‹™Š‡–Š‡”–Š‡›ƒ”‡‹–‡”‡•–‡†‹ ’ƒ”–‹ ‹’ƒ–‹‰Ǥ ˆ–Š‹•‹•–Š‡ ƒ•‡ǡ–Š‡”‡•‡ƒ” Š‡”™‹ŽŽ’”‘˜‹†‡ƒ‹ˆ‘”ƒ–‹‘Ž‡––‡”ǤŠ‡’ƒ–‹‡– ™‹ŽŽ„‡‰‹˜‡•‡˜‡†ƒ›•–‘”‡ƒ†–Š‡Ž‡––‡”ƒ†–‘†‡ ‹†‡™Š‡–Š‡”Š‡Ȁ•Š‡™ƒ–•–‘’ƒ”–‹ ‹’ƒ–‡Ǥ– ƒ•‡ ‘†ƒ’’‘‹–‡–ǡ–Š‡”‡•‡ƒ” Š‡”™‹ŽŽ Š‡ ™Š‡–Š‡”–Š‡’ƒ–‹‡–Šƒ•—†‡”•–‘‘†–Š‡ ‹ˆ‘”ƒ–‹‘‹–Š‡Ž‡––‡”Ǥ—„•‡“—‡–Ž›ǡ„‘–Š’ƒ”–‹‡••‹‰ƒ‹ˆ‘”‡† ‘•‡–ˆ‘”‹–™‘ˆ‘Ž†Ǥ ƒ†‘‹œƒ–‹‘‹•’‡”ˆ‘”‡†„›ƒMeasurements and instruments‹†‡’‡†‡–‡š–‡”ƒŽ. ƒ‰‡ ›Ǥ Š‡”‡ƒ”‡ˆ‘—”‘‡–•‘ˆƒ••‡••‡–‘˜‡”–Š‡ ‘—”•‡‘ˆʹ›‡ƒ”•ǤŠ‡„ƒ•‡Ž‹‡ƒ••‡••‡––ƒ‡•’Žƒ ‡„‡ˆ‘”‡’‹••–ƒ”–‡†Ǥ —”–Š‡”‘”‡ǡ –Š‡”‡™‹ŽŽ„‡ƒƒ••‡••‡–ƒˆ–‡”ͻ‘–Š•ȋŠƒŽˆ™ƒ›’Ȍǡƒˆ–‡”ͳͺ‘–Š•ȋ†‹”‡ –Ž›ƒˆ–‡” ’Šƒ•‡†‡†Ȍǡƒ†ƒˆ–‡”ʹͶ‘–Š•ȋ͸‘–Š•ƒˆ–‡”’Šƒ•‡†‡†ȌǤ‡‡ƒ„Ž‡ͳˆ‘”–Š‡ •’‡ ‹ˆ‹ ‹•–”—‡–•–Šƒ–ƒ”‡—•‡†ƒ–Diagnosis. ‡ƒ Šƒ••‡••‡–Ǥ ŽŽ’ƒ–‹‡–•ƒ”‡†‹ƒ‰‘•‡†ƒ ‘”†‹‰–‘Ǧ  ”‹–‡”‹ƒȋǡʹͲͲͲȌ„›ƒ 6 ’•› Š‹ƒ–”‹•–Ǥ”‹‘”–‘’ƒ”–‹ ‹’ƒ–‹‘ǡ–Š‹•†‹ƒ‰‘•‹•™‹ŽŽƒŽ•‘„‡˜‡”‹ˆ‹‡†—•‹‰–Š‡‘’”‡Š‡•‹˜‡ ••‡••‡–‘ˆ›’–‘•ƒ† ‹•–‘”›ȋ ȌǤŠ‡ ‹•ƒ•‡‹•–”— –—”‡†‹–‡”˜‹‡™–Šƒ– †‘ —‡–••‹‰•ǡ•›’–‘•ǡƒ†Š‹•–‘”›‘ˆ’•› Š‘–‹ ǡƒ‹ ƒ††‡’”‡••‹˜‡•›†”‘‡•ƒ•™‡ŽŽ ƒ••—„•–ƒ ‡ƒ„—•‡ǤŠ‡‹•–”—‡–Šƒ•„‡‡‡š–‡•‹˜‡Ž›–‡•–‡† ‘ ‡”‹‰‹–‡””ƒ–‡” ”‡Ž‹ƒ„‹Ž‹–›ǡ–‡•–Social functioningǦ”‡–‡•–”‡Ž‹ƒ„‹Ž‹–›. ƒ†˜ƒŽ‹†‹–›ȋ†”‡ƒ•‡ǡ Žƒ—Ƭ”†–ǡͳͻͻʹȌǤ ‘ ‹ƒŽˆ— –‹‘‹‰‹•‡ƒ•—”‡†—•‹‰–Š‡‘ ‹ƒŽ — –‹‘‹‰ ƒŽ‡ ȋ Ȍǡƒ•‡ŽˆǦ”‡’‘”–“—‡•–‹‘ƒ‹”‡ǤŠ‡ Šƒ•„‡‡ˆ‘—†–‘„‡”‡Ž‹ƒ„Ž‡ǡ˜ƒŽ‹†ǡ•‡•‹–‹˜‡ǡƒ† ”‡•’‘•‹˜‡–‘ Šƒ‰‡ȋ‹” Š™‘‘†ǡ‹–Šǡ‘ Š”ƒ‡ǡ‡––‘Ƭ‘’‡•–ƒ‡ǡͳͻͻͲȌǤŠ‡• ƒŽ‡ ‘–ƒ‹••‡˜‡†‹‡•‹‘•‘ˆ‰Ž‘„ƒŽ•‘ ‹ƒŽˆ— –‹‘‹‰–Šƒ–ƒ”‡‡•’‡ ‹ƒŽŽ›’‡”–‹‡––‘’ƒ–‹‡–• •—ˆˆ‡”‹‰ˆ”‘’•› Š‘–‹ †‹•‘”†‡”•ǤŠ‡†‹‡•‹‘•ƒ”‡ǣ•‘ ‹ƒŽ™‹–Š†”ƒ™ƒŽǡ‹–‡”’‡”•‘ƒŽ ‘—‹ ƒ–‹‘ǡ‹†‡’‡†‡ ‡ȋ ‘’‡–‡ ‡Ȍǡ‹†‡’‡†‡ ‡ȋ’‡”ˆ‘”ƒ ‡Ȍǡ”‡ ”‡ƒ–‹‘ƒŽ ƒ –‹˜‹–‹‡•ǡ•‘ ‹ƒŽƒ –‹˜‹–‹‡•ǡSocial cognitive or ‘mentalizing’ƒ†‡’Ž‘›‡–Ǥ capacity .  –Šƒ•„‡‡’‘‹–‡†‘—––Šƒ––Š‡”‡‹•–‘†ƒ–‡‘ ƒ‰”‡‡‡–‘–Š‡ƒ••‡••‡–‘ˆ•‘ ‹ƒŽ ‘‰‹–‹‘ǡ„—––Š‡”‡‹•ƒ„”‘ƒ† ‘•‡•—•–Šƒ–‹–‹•ƒ —Ž–‹ˆƒ ‡–‡† ‘•–”— –ȋ‘›‡––‡‡–ƒŽǤǡʹͲͳͶȌǤ –Š‡ —””‡–•–—†›ǡ•‘ ‹ƒŽ ‘‰‹–‹‘‹•–Š‡”‡ˆ‘”‡ ƒ••‡••‡†™‹–Š–™‘‹•–”—‡–•–Šƒ–‡ƒ•—”‡†‹ˆˆ‡”‡–ƒ•’‡ –•‘ˆ•‘ ‹ƒŽ ‘‰‹–‹‘ǣ–Š‡Š‡ƒ–‹  ’’‡” ‡’–‹‘‡•–ȋȌƒ†–Š‡Š‹–‹‰–ƒ•ȋ ȌǤŠ‡ȋ—””ƒ›ǡͳͻͶ͵Ȍǡ• ‘”‡†™‹–Š–Š‡ ‘ ‹ƒŽ‘‰‹–‹‘ƒ†„Œ‡ –‡Žƒ–‹‘•›•–‡ȋǢ‡•–‡ǡͳͻͻͳȌǡ‹•—•‡†–‘ƒ••‡••ˆ‘—”

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146807_JonasWeijers_BNW_def.indd 115 28-10-2020 15:08 Chapter Six

†‹‡•‹‘•‘ˆ•‘ ‹ƒŽ ‘‰‹–‹‘ǣ ‘’Ž‡š‹–›‘ˆ”‡’”‡•‡–ƒ–‹‘•‘ˆ’‡‘’Ž‡ƒ†—†‡”•–ƒ†‹‰‘ˆ •‘ ‹ƒŽ ƒ—•ƒŽ‹–›ǡ™Š‹ Š ‘’”‹•‡ ‘‰‹–‹˜‡ƒ•’‡ –•‘ˆ•‘ ‹ƒŽ ‘‰‹–‹‘ǡƒ†–Š‡ƒˆˆ‡ –Ǧ–‘‡‘ˆ ”‡Žƒ–‹‘•Š‹’•ƒ†–Š‡ ƒ’ƒ ‹–›ˆ‘”‡‘–‹‘ƒŽ‹˜‡•–‡–ǡ ‘’”‹•‹‰ƒˆˆ‡ –‹˜‡ƒ•’‡ –•‘ˆ•‘ ‹ƒŽ ‘‰‹–‹‘Ǥƒ Š†‹‡•‹‘‹•• ‘”‡†‘ƒͷǦ’‘‹–• ƒŽ‡ǡ™‹–ŠŠ‹‰Š‡”• ‘”‡•”‡’”‡•‡–‹‰Š‹‰Š‡” •‘ ‹ƒŽ ‘‰‹–‹˜‡ˆ— –‹‘‹‰‹–Šƒ–†‹‡•‹‘Ǥ‹š’‹ –—”‡•‘ˆ–Š‡ƒ”‡—•‡†Ǥ”‡•’‘•‡• ƒ”‡”‡ ‘”†‡†ƒ†–”ƒ• ”‹„‡†˜‡”„ƒ–‹Ǥ”‡•’‘•‡•ǡ™Š‡ƒƒŽ›œ‡†™‹–Š–Š‡ǡŠƒ˜‡ „‡‡ˆ‘—†–‘„‡ƒ˜ƒŽ‹†ƒ†”‡Ž‹ƒ„Ž‡™ƒ›–‘‡ƒ•—”‡•‘ ‹ƒŽ ‘‰‹–‹‘ƒ†‘„Œ‡ –”‡Žƒ–‹‘• ȋ‡›‡”ǡʹͲͲͶǢ ‹„„ƒ”†ǡ‹– Š‡ŽŽƬ‘” ‡”‡ŽŽ‹ǡʹͲͲͳȌǤ ‘”†‹‰–‘—›–‡ƒ† ‘ŽŽ‡ƒ‰—‡• ȋ—›–‡ǡ ‘ƒ‰›ǡ‘™› Ƭ‡”‘–‡ǡʹͲͳʹȌǡ–Š‡‹•‘‡‘ˆ–Š‡ˆ‡™–‡•–•–Šƒ––ƒ‡•ƒŽ‘•–ƒŽŽ ƒ•’‡ –•‘ˆ‡–ƒŽ‹œƒ–‹‘The HT ‹–‘ƒ ‘—–ǡ‹ Ž—†‹‰ƒˆˆ‡ –‹˜‡ƒ† ‘‰‹–‹˜‡ƒ•’‡ –•Ǥ ȋ‘” ‘”ƒǡ‡” ‡”Ƭ ”‹–ŠǡͳͻͻͷȌ‹•—•‡†–‘‡ƒ•—”‡–Š‡ƒ„‹Ž‹–›–‘‹ˆ‡” intentions from others, or ‘Theory of Mind’ (ToM).ƒ–‹‡–•”‡ƒ†‡š–”ƒ –•–Šƒ–†‡• ”‹„‡ƒ ‹–‡”ƒ –‹‘„‡–™‡‡–™‘ Šƒ”ƒ –‡”•‹™Š‹ Š‘‡ Šƒ”ƒ –‡”•ƒ›••‘‡–Š‹‰™‹–Šƒ‹’Ž‹ ‹– ‡••ƒ‰‡Ǥ ˆ–Š‡’ƒ–‹‡–‹ˆ‡”•–Š‡‹’Ž‹ ‹–‡••ƒ‰‡ ‘””‡ –Ž›ǡ–™‘’‘‹–•ƒ”‡• ‘”‡†Ǥ ˆƒŠ‹–‹• ‡‡†‡†ǡƒ• ‘”‡‘ˆͳ‹•‰‹˜‡ǤŠ‡–Š‡ƒ•™‡”‹•‹ ‘””‡ –‘”–Š‡’ƒ”–‹ ‹’ƒ–†‘‡•‘–‘™ǡͲ ’‘‹–•ƒ”‡• ‘”‡†ǤŠ‡–‡•– ‘’”‹•‡•–‡•Š‘”–’ƒ••ƒ‰‡•ǤŠ‡ ‹–‹‰ƒ•Šƒ•˜‡”›”‡ ‡–Ž› „‡‡”‡˜‹‡™‡†ȋ‹Šƒǡ‡ǡ ”‡‡Ƭ ƒ”˜‡›ǡʹͲͳͷȌ”‡‰ƒ”†‹‰–‡•–Ǧ”‡–‡•–”‡Ž‹ƒ„‹Ž‹–›ǡ—–‹Ž‹–› ƒ•ƒ”‡’‡ƒ–‡†‡ƒ•—”‡ǡ”‡Žƒ–‹‘–‘ˆ— –‹‘ƒŽ‘—– ‘‡ǡƒ†‹–‡”ƒŽ ‘•‹•–‡ ›ƒ†™ƒ•‘‡‘ˆ –™‘–‡•–••Š‘™™‹–Š•–”‘‰’•› Š‘‡–”‹ ’”‘’‡”–‹‡•Social stress reactivity. ƒ ”‘••ƒŽŽ‡˜ƒŽ—ƒ–‹‘ ”‹–‡”‹ƒǤ ‘–‹‘ƒŽ”‡ƒ –‹˜‹–›–‘•–”‡••‹•‘ ‹ƒŽ•‹–—ƒ–‹‘•‹•‡ƒ•—”‡† with an electronic diary using the ‘ExperienceSampling Method’ (ESM; MyinǦ ‡”‡›•‡–ƒŽǤǡ ʹͲͲ͸ȌǤ‹•ƒ”‡’‡ƒ–‡†•‡ŽˆǦƒ••‡••‡––‡ Š‹“—‡™‹–Š‰”‡ƒ–‡ ‘Ž‘‰‹ ƒŽ˜ƒŽ‹†‹–›Ǥƒ”–‹ ‹’ƒ–• ƒ””›ƒ”‘—†ƒ†‡˜‹ ‡ǡ™Š‹ Šˆƒ ‹Ž‹–ƒ–‡•–Š‡‘‹–‘”‹‰‘ˆ†ƒ‹Ž›Ž‹ˆ‡‡š’‡”‹‡ ‡•ƒ† „‡Šƒ˜‹‘”Ǥ‡–‹‡•†ƒ‹Ž›‘ˆ‹˜‡ ‘•‡ —–‹˜‡†ƒ›•ǡ‹–‰‡‡”ƒ–‡•ƒƒ—†‹„Ž‡•‹‰ƒŽȋ„‡‡’Ȍƒ– —’”‡†‹ –ƒ„Ž‡‘‡–•‘ˆ–Š‡†ƒ›™Š‹ Š’ƒ”–‹ ‹’ƒ–•ƒ•™‡”„›—•‹‰–Š‡–‘— Š• ”‡‡‘ˆ–Š‡ †‡˜‹ ‡Ǥƒ”–‹ ‹’ƒ–•ƒ”‡ƒ•‡†™Š‡–Š‡”–Š‡›ƒ”‡ƒŽ‘‡‘”‹ ‘’ƒ›‘ˆ‘–Š‡”•ǤŠ‡ǡ„‘–Š–Š‡ Ž‡˜‡Ž‘ˆ•‘ ‹ƒŽ•–”‡••ƒ†‡‰ƒ–‹˜‡Ȁ’‘•‹–‹˜‡ƒˆˆ‡ –ƒ”‡ƒ••‡••‡†Ǥ‘ ‹ƒŽ•–”‡••‹•‡ƒ•—”‡†™‹–Š items such as: “I would rather „‡ƒŽ‘‡” and “I like the present company” (reverse coded). ‡‰ƒ–‹˜‡ƒˆˆ‡ –‹•–Š‡ƒ˜‡”ƒ‰‡†• ‘”‡‘ˆ–Š‡‘‘†items “anxious”, “lonely”, “insecure”, “‹””‹–ƒ–‡†”, “down”, “guilty”, and“gloomy”. Positive affect will „‡‡ƒ•—”‡†™‹–Š–Š‡‹–‡• “happy”, “satisfied”, “cheerful”, “relaxed”, and “enthusiastic”.ŽŽ‹–‡•ƒ”‡• ‘”‡†‘ƒ͹Ǧ’‘‹– ‹‡”– ƒŽ‡ǤQuality of life. •‹‰–Š‡ƒ Š‡•–‡”Š‘”–••‡••‡–‘ˆ“—ƒŽ‹–›‘ˆŽ‹ˆ‡ȋǢ”‹‡„‡ǡ —šŽ‡›ǡ‹‰Š–Ƭ˜ƒ•ǡͳͻͻͻȌǡ Šƒ‰‡•‹‘˜‡”ƒŽŽ“—ƒŽ‹–›‘ˆŽ‹ˆ‡ƒ”‡‡ƒ•—”‡†ǤŠ‡‹•ƒ ͳ͸Ǧ‹–‡ǡ͹Ǧ’‘‹–‹‡”–• ƒŽ‡•‡ŽˆǦ”ƒ–‹‰‹•–”—‡–Ǥ

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Psychotic symptom severity.

 –‡”˜‹‡™‡”•—•‡–Š‡‘•‹–‹˜‡ƒ†‡‰ƒ–‹˜‡›†”‘‡ ƒŽ‡ ȋȌȋƒ›ǡ ‹•œ„‡‹Ƭ’ˆ‡”Ǥͳͻͺ͹Ȍ–‘ƒ••‡••’‘•‹–‹˜‡ȋ•—„• ƒŽ‡Ȍǡ‡‰ƒ–‹˜‡ȋ•—„• ƒŽ‡Ȍǡ ƒš‹‘—•ȋ‹–‡ ʹȌǡƒ††‡’”‡••‹˜‡•›’–‘•ȋ‹–‡ ͶȌǤŠ‡‹•ƒ͵ͲǦ‹–‡ǡ͹Ǧ’‘‹–‹‡”–Ǧ • ƒŽ‡”ƒ–‹‰‹•–”—‡–†‡˜‡Ž‘’‡†ˆ‘”–Š‡ƒ••‡••‡–‘ˆ’Š‡‘‡ƒƒ••‘ ‹ƒ–‡†™‹–Š • Š‹œ‘’Š”‡‹ƒǤ—– Š˜‡”•‹‘‹•—•‡†ȋ‘Ž–Šƒ—•ǡ‹‰‡ƒ•Ƭ Š‡‡ǡʹͲͲͲȌǤ ††‹–‹‘ƒŽŽ›ǡ–Š‡†‹ƒ”›‹•—•‡†–‘‡ƒ•—”‡‘‡–ƒ”›’•› Š‘–‹ ‡š’‡”‹‡ ‡•Ǥ‡˜‡ ‹–‡•ƒ”‡used: ‘I feel suspicious’, ‘I am afraid of losing control’, ‘ ˆ‡‡Žthat others don’t like me’, ‘I feel that others want tohurt me’, ‘My thoughts are influenced by other people’, ‘Iˆ‡‡Ž unreal’, and ‘I hear voices’.™ƒ”‡‡••‘ˆŠƒ˜‹‰ƒ‡–ƒŽ†‹•‘”†‡”ǤŠ‡ȋ‹–‡ ͳʹȌ‹• —•‡†–‘ƒ••‡••ƒ™ƒ”‡‡••‘ˆSubstance abuse. Šƒ˜‹‰ƒ‡–ƒŽ†‹•‘”†‡”Ǥ ƒ–‹‡–•ƒ”‡ƒ•‡†–‘”‡’‘”–•—„•–ƒ ‡—•‡‘–Š‡†‡˜‹ ‡ƒ–‡ƒ Š „‡‡’—•‹‰ ƒ–‡‰‘”‹ ƒŽ“—‡•–‹‘•Ǥƒ–‹‡–•™‹ŽŽ”‡’‘”–™Š‡–Š‡”–Š‡›Šƒ˜‡—•‡†ƒ›•—„•–ƒ ‡ •‹ ‡–Š‡Žƒ•–„‡‡’ǡ‹ Ž—†‹‰ǣȋͳȌ ƒˆˆ‡‹‡ǡȋʹȌ‹ ‘–‹‡ǡȋ͵Ȍ‡†‹ ƒ–‹‘ǡȋͶȌƒŽ ‘Š‘ŽǡȋͷȌ ƒƒ„‹•ǡ ȋ͸Ȍ‘–Š‡”†”—‰•ǡPersonality‘”ȋ organization/somatization͹Ȍ‘‡Ǥ of psychopathology. ••‡••‡–‘ˆ’‡”•‘ƒŽ‹–› ‘”‰ƒ‹œƒ–‹‘ƒ†–Š‡–‡†‡ ›–‘•‘ƒ–‹œ‡•‡˜‡”‡’•› Š‘’ƒ–Š‘Ž‘‰›‹• ‘†— –‡†—•‹‰–Š‡‘”› †”‹˜‡’”‘ˆ‹Ž‡•‘ˆ–Š‡—– Š•Š‘”– ‘”‘ˆ–Š‡ ȋ Ǣ—–‡‹ŒƬ‘ǡͳͻͺͷȌǡƒͺ͵Ǧ‹–‡ •‡ŽˆǦƒ••‡••‡–“—‡•–‹‘ƒ‹”‡ǤŠ‡ ‡ƒ•—”‡•’‡”•‘ƒŽ‹–›–”ƒ‹–•‘ͷ• ƒŽ‡•ǣš–”ƒ˜‡”•‹‘ǡ 6 •› Š‘’ƒ–Š‘Ž‘‰›ǡŠ›‡••ǡ‘ƒ–‹œƒ–‹‘ǡƒ†‡‰ƒ–‹˜‹•Ǥ•‹‰–Š‡–Š‡‘”›†”‹˜‡’”‘ˆ‹Ž‡ ƒ’’”‘ƒ Š–‘–Š‡ ȋ—”‡Ž‹‰•Ǧ‘–‡‘‡Ƭ‘‡Ž‡ǡʹͲͲ͹Ǣ—”‡Ž‹‰•Ǧ‘–‡‘‡ǡ—›–‡ǡ ••‡ƒ‰‰‡”ǡƒ”‡‡•™‹ŒƬ‘‡Ž‡ǡʹͲͳͲǢ—”‡Ž‹‰•Ǧ‘–‡‘‡ǡ—›–‡ǡ‡‹Œ•‡Ƭ‘‡Ž‡ǡ ʹͲͳͲǢ—”‡Ž‹‰•Ǧ‘–‡‘‡ǡ‡‡ǡ‘–‡„‘‘ǡŽ‡ƒƬ‡‡”ǡʹͲͳʹǢ—”‡Ž‹‰•Ǧ‘–‡‘‡ǡ ‘‡Ž‡ǡŠ‹Œ••‡ǡ†‡‹††‡”Ƭ‡”Š‘ˆǡʹͲͳͶȌǡˆ‹˜‡Ž‡˜‡Ž•‘ˆ‡”•‘ƒŽ‹–›”‰ƒ‹œƒ–‹‘ȋȌƒ”‡ †‹•–‹‰—‹•Š‡†ǣ‡—”‘–‹ ǡ‘”†‡”Ž‹‡ǡƒ” ‹••‹•–‹ ‘”†‡”Ž‹‡ǡƒ–‡–•› Š‘–‹ ƒ† ƒ‹ˆ‡•–•› Š‘–‹ Ǥ‘‡ƒ•—”‡„‘†‹Ž›ƒ™ƒ”‡‡••, the DSFM “Somatization” subscale (20 ‹–‡•Ȍ™‹ŽŽ„‡—•‡†ǤŠ‹••—„• ƒŽ‡‡ƒ•—”‡•–Š‡ƒ‘—–ƒ††‡‰”‡‡‘ˆ‡š’‡”‹‡ ‡†„‘†‹Ž› •›’–‘•ǡƒ†Š‡ ‡ǡ–Š‡ƒ„‹Ž‹–›–‘•—„Œ‡ –‹˜‡Ž›”‡’‘”–ǡƒ†„‡ƒ™ƒ”‡‘ˆ„‘†‹Ž›•‡•ƒ–‹‘•Ǥ• †‡• ”‹„‡†ȋ—”‡Ž‹‰•Ǧ‘–‡‘‡‡–ƒŽǤǡʹͲͳͶȌƒˆˆ‡ –”‡‰—Žƒ–‹‘–Š”‘—‰Š•‘ƒ–‹œƒ–‹‘™‹ŽŽ„‡ ‡š’”‡••‡†ƒ•–Š‡”‡Žƒ–‹˜‡’‘•‹–‹‘‘ˆ• ‘”‡•‘–Š‡•—„• ƒŽ‡•‘ƒ–‹œƒ–‹‘–‘–Šƒ–‘–Š‡•‡˜‡”‡ ’•› Š‘’ƒ–Š‘Ž‘‰›•—„• ƒŽ‡ǤChildhood trauma.  Š‡Š‹Ž†Š‘‘†š’‡”‹‡ ‡‘ˆƒ”‡ƒ†„—•‡ȋǢ‹Žˆ—Ž ‘ǡ”‘™ Ƭ ƒ””‹•ǡͳͻͻͶȌ‹•ƒ•‡‹Ǧ•–”— –—”‡†‹–‡”˜‹‡™–Šƒ–ƒ‹•–‘ƒ••‡••†‡–ƒ‹Ž•ƒ†–Š‡–‹‡Ǧ•‡“—‡ ‡ ‘ˆ–”ƒ—ƒ–‹  Š‹Ž†Š‘‘†‡š’‡”‹‡ ‡•Ǥ –ƒ••‡••‡•Žƒ ‘ˆ ƒ”‡ȋ‡‰Ž‡ –ǡƒ–‹’ƒ–Š›Ȍǡ’Š›•‹ ƒŽƒ„—•‡ǡ •‡š—ƒŽƒ„—•‡ǡƒ†’•› Š‘Ž‘‰‹ ƒŽDrug treatment: ƒ„—•‡Ǥ ƒ Špatient’s medical record is consulted to ƒ• ‡”–ƒ‹–Š‡ ’Šƒ”ƒ ‘–Š‡”ƒ’›’”‡• ”‹„‡†ƒ––Ͳǡ–ͳǡ–ʹǡƒ†–͵Ǥ

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Adherence to the prescribed medication

‹•‡ƒ•—”‡†™‹–Š–Š‡‡†‹ ƒ–‹‘†Š‡”‡ ‡ —‡•–‹‘ƒ‹”‡ȋǢ‘”‹•›ǡ ”‡‡ǡ‡˜‹‡Adherence to the MBT-model. Ƭͳͻͺ͸ȌǤ †Š‡”‡ ‡–‘–Š‡‘†‡Ž„›–Š‡”ƒ’‹•–•‹•”ƒ–‡†„›ƒ ‡š’‡”‹‡ ‡†–Š‡”ƒ’‹•–ƒ ‘”†‹‰–‘–Š‡ƒ†Š‡”‡ ‡ƒ† ‘’‡–‡ ‡• ƒŽ‡ȋƒ”–‡”—†ǡ‡– ƒŽǤǡʹͲͳ͵Ȍǡ—•‹‰ˆ‘‘–ƒ‰‡‘ˆ–Š‡”ƒ’›•‡••‹‘•ǤŠ‡”ƒ’‹•–•ƒ”‡Œ—†‰‡†‘ͳ͹‹–‡•–Šƒ– Šƒ”ƒ –‡”‹œ‡ ’”‘’‡”–”‡ƒ–‡–ǤDuration of illness . General demographics••‡••‡†—•‹‰–Š‡.  ǡ”‡ˆ‡”•–‘–Š‡’‡”‹‘†•‹ ‡ˆ‹”•–’•› Š‘•‹•Ǥ Š‡‰‡‡”ƒŽ†‡‘‰”ƒ’Š‹ “—‡•–‹‘ƒ‹”‡ȋ Ȍ‹•ƒ•–ƒ†ƒ”† ‹•–”—‡–—•‡†‹ƒŽŽ•–—†‹‡• ‘†— –‡†ƒ–ƒƒ•–”‹ Š–‹˜‡”•‹–›Ǥ –†‘ —‡–•–”‡ƒ–‡– Š‹•–‘”›ǡ •‘ ‹‘Ǧ‡ ‘‘‹ •–ƒ–—•ǡ‡†— ƒ–‹‘ƒŽŽ‡˜‡Žǡƒ†—”„ƒ‹ ‹–›‘ˆ–Š‡’Žƒ ‡‘ˆ”‡•‹†‡ ‡Ǥ

Treatment. TAU.

ŽŽ’ƒ–‹‡–•‹–Š‡ —””‡–•–—†›”‡ ‡‹˜‡ƒ—Ž–‹ˆƒ ‡–‡†–”‡ƒ–‡–„ƒ•‡†‘–Š‡ ‘FŽ‡š‹„Ž‡••‡”–‹˜‡‘—‹–›”‡ƒ–‡–’ (FACT) model. FACT teams consist ‘ˆ’•› Š‹ƒ–”‹  —”•‡•ǡ™‡Žˆƒ”‡™‘”‡”•ǡ’•› Š‘Ž‘‰‹•–•ǡƒ†ƒ–Ž‡ƒ•–‘‡’•› Š‹ƒ–”‹•–ǤŠ‡‹–‡”˜‡–‹‘ ‘•‹•–• ‘ˆ’Šƒ”ƒ ‘–Š‡”ƒ’›ǡ ƒ•‡Ǧƒƒ‰‡‡–ǡ’•› Š‘‡†— ƒ–‹‘ǡƒ†‹•‘‡ ƒ•‡• ‘‰‹–‹˜‡ „‡Šƒ˜‹‘”ƒŽ–Š‡”ƒ’›ȋȌǤ‹–‡”˜‡–‹‘•ˆ‘”’•› Š‘•‹•—•—ƒŽŽ›–ƒ‡ƒ”‘—†ʹͲ•‡••‹‘•ƒ† ƒ”‡„ƒ•‡†‘–Š‡™‘”‘ˆ˜ƒ†‡” ƒƒ‰ȋ˜ƒ†‡” ƒƒ‰ǡƒŽƒ‰‰‹ƒǡ˜ƒ‡‡”ƬŽ‘‘ˆˆǡʹͲͲͷǢ˜ƒ †‡” ƒƒ‰ǡ‹‡ƒƬ˜ƒ†‡‡”‰ǡʹͲͳ͵ȌǤŠ‡–Š‡”‘”‘–’ƒ–‹‡–•Šƒ˜‡”‡ ‡‹˜‡†ǡƒ†Š‘™ ƒ›•‡••‹‘•ǡ™‹ŽŽ„‡”‡‰‹•–‡”‡†ƒ†–ƒ‡‹–‘ƒ ‘—–Ǥ —”–Š‡”‘”‡ǡƒŽŽ’ƒ–‹‡–•™‹ŽŽ”‡ ‡‹˜‡ •—’’‘”–‹˜‡•–”— –—”‹‰–Š‡”ƒ’›Ǥ‡••‹‘•ˆ‘ —•‘’”‘„Ž‡•’ƒ–‹‡–•ƒ›‡ ‘—–‡”‹–Š‡‹”

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•‘ ‹ƒŽ‡–™‘”ǡ™‘”ǡ†ƒ‹Ž›ƒ –‹˜‹–‹‡•ǡ‘”‡†‹ ƒ–‹‘ƒ†Š‡”‡ ‡Ǥƒ–‹‡–•‡‡–™‹–Šƒ‡–ƒŽ Š‡ƒŽ–Š’”‘ˆ‡••‹‘ƒŽˆ‘”ƒƒ˜‡”ƒ‰‡‘ˆ͵Ͳ‹‡˜‡”›ʹ™‡‡•ǡ™‹–Šƒ‹‹—‘ˆͳ‡‡–‹‰‘ˆ͵Ͳ ‹’‡”‘–Šǡ‘˜‡”ͳͺ‘–Š•ǤŠ‡–‘–ƒŽ—„‡”‘ˆ‹†‹˜‹†—ƒŽ•‡••‹‘•‹•‡•–‹ƒ–‡†–‘„‡ ƒ”‘—†͵ͲȋͳͷŠ‘ˆ‹†‹˜‹†—ƒŽ–Š‡”ƒ’›ȌǤ†Š‡”‡ ‡–‘–”‡ƒ–‡–•‡••‹‘•‹•‘‹–‘”‡†„› registeringMBTp patients’. ’”‡•‡ ‡‹–Š‡•‡••‹‘•Ǥ ƒ–‹‡–•‹–Š‡’Ž—•’ ‘†‹–‹‘”‡ ‡‹˜‡–Š‡•ƒ‡–”‡ƒ–‡–‡–‹‘‡† ƒ„‘˜‡‹ ‘„‹ƒ–‹‘™‹–Š‹†‹˜‹†—ƒŽƒ†‰”‘—’’ǤŠ‡‡›‡Ž‡‡–•‘ˆǡ•Š‘”–Ž› †‡• ”‹„‡†„‡Ž‘™ǡ’”‘˜‹†‡†–Š‡„ƒ•‹•ˆ‘”’ȋƒ–‡ƒƬ ‘ƒ‰›ǡʹͲͲ͸ȌǤŠ‡”ƒ’‡—–‹ •–ƒ ‡ MBT is characterized by the ‘not knowing stance’ ‹™Š‹ Š–Š‡–Š‡”ƒ’‹•–ƒ†‹–•–‘‘–‘™‹‰ ™Šƒ––Š‡’ƒ–‹‡–‡š’‡”‹‡ ‡•Ǥ›ƒ –‹˜‡Ž›ƒ•‹‰“—‡•–‹‘•–Š‡–Š‡”ƒ’‹•– —Ž–‹˜ƒ–‡•ƒƒ––‹–—†‡‘ˆ •‹ ‡”‡‹–‡”‡•–‹–Š‡’ƒ–‹‡–ǤŠ‹•‰‹˜‡•–Š‡’ƒ–‹‡––Š‡‡š’‡”‹‡ ‡‘ˆbeing ‘keptin mind’ by •‘‡‘‡ǡ„—–ƒŽ•‘•–‹—Žƒ–‡•Interventions. —”‹‘•‹–›‹–Š‡’ƒ–‹‡––‘™ƒ”†•Š‹•‘™‡–ƒŽ•–ƒ–‡•Ǥ Š‡ƒ’’Ž›‹‰‹–‡”˜‡–‹‘•ǡ‹–•Š‘—Ž†ƒŽ™ƒ›•„‡‡’–‹‹†–Šƒ– ƒ”‘—•ƒŽ–‡†•–‘†‹‹‹•Š–Š‡ ƒ’ƒ ‹–›–‘‡–ƒŽ‹œ‡Ǥ ‘—”•–ƒ‰‡•‘ˆ‹–‡”˜‡–‹‘ ƒ„‡—•‡†‹ƒ •–‡’Ǧ™‹•‡ƒ‡”ǡ†‡’‡†‹‰‘–Š‡Ž‡˜‡Ž‘ˆƒ”‘—•ƒŽǤ––Š‡ˆ‹”•–Ž‡˜‡Žǡ‹–‡”˜‡–‹‘•ƒ”‡ƒ‹‡† ƒ–†‘™”‡‰—Žƒ–‹‰ƒ”‘—•ƒŽ‹–Š‡’ƒ–‹‡–ǤŠ‡•‡‹ Ž—†‡‡’ƒ–Š‹ ˜ƒŽ‹†ƒ–‹‘of the patient’s ˆ‡‡Ž‹‰•ƒ† ‘’Ž‹‡–‹‰‰‘‘†‡–ƒŽ‹œ‹‰Ǥ––Š‡•‡ ‘†•–ƒ‰‡–Š‡–Š‡”ƒ’‹•–ƒ••ˆ‘” Žƒ”‹ˆ‹ ƒ–‹‘‘ˆƒ•‹–—ƒ–‹‘‘”‡Žƒ„‘”ƒ–‹‘‘the patient’sˆ‡‡Ž‹‰•ƒ†–Š‘—‰Š–•Ǥˆ–‡–Š‡ 6 –Š‡”ƒ’‹•–•–‘’•or rewinds the patient’s narrative to ‹˜‡•–‹‰ƒ–‡ƒƒ•’‡ –‘ˆ–Š‡†‹ƒŽ‘‰—‡ǤŠ‹• •–ƒ‰‡‹•ƒ„‘—–ƒ‹‰‹’Ž‹ ‹–‡–ƒŽ‹œ‹‰‡š’Ž‹ ‹–Ǥˆ–‡†‡–ƒ‹Ž•ƒ”‡‹˜‡•–‹‰ƒ–‡†–Šƒ–•‡‡–‘ ƒˆˆ‡ ––Š‡’ƒ–‹‡–ǡ‘”•Š‘—Ž†ƒˆˆ‡ ––Š‡’ƒ–‹‡–ǡ„—–†‘‘–ǤŠ‹•–Š‡Ž‡ƒ†•–‘–Š‡‡š–•–ƒ‰‡ǡ ƒŽŽ‡† ‘mentalized affectivity’, which is the activity of ”‡ˆŽ‡ –‹‰‘‡‘–‹‘•ǡ™Š‹Ž‡•‹—Ž–ƒ‡‘—•Ž› ‡š’‡”‹‡ ‹‰–Š‡Ǥ –‹• ‘•‹†‡”‡†–‘„‡ƒ ”— ‹ƒŽƒ•’‡ –‘ˆ‡‘–‹‘”‡‰—Žƒ–‹‘ǤŠ‡‡š’Ž‹ ‹– ‡–ƒŽ‹œ‹‰‘ˆƒ’”‹ƒ”›ƒˆˆ‡ –‹˜‡‡š’‡”‹‡ ‡‰‹˜‡•–Š‡’ƒ–‹‡––Š‡‘’’‘”–—‹–›–‘‡š’”‡••ȋ‘” ‹Š‹„‹–Ȍ‡‘–‹‘•‹ƒ‘Ǧƒ—–‘ƒ–‹ ƒ‡”Ǥ––Š‡Žƒ•–•–ƒ‰‡ǡ–Š‡”‡Žƒ–‹‘•Š‹’„‡–™‡‡ –Š‡”ƒ’‹•–ƒ†’ƒ–‹‡–‘”„‡–™‡‡’ƒ–‹‡–•‹•‡–ƒŽ‹œ‡†Ǥ –Š‹••–ƒ‰‡ǡ„‘–Š’ƒ–‹‡–ƒ†–Š‡”ƒ’‹•– ”‡ˆŽ‡ –‘ƒ†•Šƒ”‡–Š‡‹”ƒˆˆ‡ –‹˜‡‡š’‡”‹‡ ‡–‘„‡ ‘‡ƒ™ƒ”‡Š‘™–Š‡‹””‡Žƒ–‹‘•Š‹’‹• ƒˆˆ‡ –‹‰–Š‡Ǥƒ”‡•Š‘—Ž†„‡–ƒ‡ƒ’’Ž›‹‰–Š‹••–ƒ‰‡‘ˆ‹–‡”˜‡–‹‘ǡƒ•‹–”‡“—‹”‡•ƒ”‘„—•– Ž‡˜‡Ž‘ˆ‡–ƒŽ‹œ‹‰ǤDuration and dose. ‘’ƒ”‡†–‘‘”‹‰‹ƒŽǡ–Š‡Ž‡‰–Š‘ˆ’ǡŠƒ•”‡ƒ‹‡† — Šƒ‰‡†ǣͳͺ‘–Š•Ǥ ‘™‡˜‡”ǡ–Š‡ˆ”‡“—‡ ›ƒ†Ž‡‰–Š‘ˆ•‡••‹‘•Šƒ•„‡‡”‡†— ‡†Ǥ ‘—” ‡š’‡”‹‡ ‡ǡ„ƒ•‡†‘ƒ’‹Ž‘–’‹–‡”˜‡–‹‘ǡ‹•ƒ••‘ ‹ƒ–‡†™‹–Š‘”‡•‡˜‡”‡ ‡–ƒŽ‹œ‹‰†‡ˆ‹ ‹–•–Šƒǡƒ•Šƒ•ƒŽ•‘„‡‡•—‰‰‡•–‡†‡Ž•‡™Š‡”‡ȋ‹–‹ƬŠ‹ƒŽƒǡʹͲͲ͵ȌǤ ‹˜‡ǡ–Š‡†ƒ‰‡”‘ˆ‘˜‡”™Š‡Ž‹‰’ƒ–‹‡–•™‹–Š‡–ƒŽ‹œ‹‰‹–‡”˜‡–‹‘•ǡ‰”‘—’ –Š‡”ƒ’›‹•Ž‹‹–‡†–‘™‡‡Ž›ͳǦŠ‘—”•‡••‹‘•ǡ™Š‹Ž‡‹†‹˜‹†—ƒŽ–Š‡”ƒ’›–ƒ‡•’Žƒ ‡‹„‹™‡‡Ž›

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ŠƒŽˆǦŠ‘—”•‡••‹‘•Ǥ‡ˆ‡‡Ž–Š‹•ƒ’’”‘ƒ Š‹•Œ—•–‹ˆ‹‡†„›–Š‡Ž‘™†”‘’Ǧ‘—–”ƒ–‡‘ˆͳͲΨ‹–Š‡’‹Ž‘– ‹–‡”˜‡–‹‘ǤPsycho -education. ’•–ƒ”–•™‹–Š–™‘–‘ˆ‘—”•‡••‹‘•‘ˆ’•› Š‘Ǧ‡†— ƒ–‹‘ǡ‹™Š‹ Š ’ƒ–‹‡–•ƒ”‡–‘Ž†ƒ„‘—––Š‡‡›ƒ•’‡ –•‘ˆǡ‹ Ž—†‹‰–Š‡‡ƒ‹‰‘ˆ‡–ƒŽ‹œ‹‰ƒ†‹–• •‡•‹–‹˜‹–›–‘Individualƒ”‘—•ƒŽǤ therapy . †‹˜‹†—ƒŽ–Š‡”ƒ’›’”‘˜‹†‡•ƒ‘’’‘”–—‹–›ˆ‘”‹–‡•‹˜‡’”ƒ –‹ ‡‹ ‡–ƒŽ‹œ‹‰ǤŠ‡ˆ‘ —•‹•‘‡•–ƒ„Ž‹•Š‹‰ƒ•‡ —”‡”‡Žƒ–‹‘•Š‹’–Šƒ–ƒ –•ƒ•ƒ•ƒˆ‡„ƒ•‡ˆ”‘ ™Š‹ Šˆƒ‹Ž—”‡•‹‡–ƒŽ‹œ‹‰ ƒ„‡‡š’Ž‘”‡†Ǥ”‡ƒ–‡–‰‘ƒŽ•‘–Š‡„ƒ•‹•‘ˆˆ‹˜‡’”‘„Ž‡ ƒ”‡ƒ•ƒ”‡†‡˜‡Ž‘’‡†ƒ†”‘—–‹‡Ž›”‡˜‹‡™‡†™‹–Š–Š‡’ƒ–‹‡–ǡ‹ Ž—†‹‰ǣ ‘‹–‡––‘ –”‡ƒ–‡–ǡ’•› Š‹ƒ–”‹ •›’–‘•ǡ•‘ ‹ƒŽ‹–‡”ƒ –‹‘Ȁ”‡Žƒ–‹‘•Š‹’•ǡ†‡•–”— –‹˜‡„‡Šƒ˜‹‘”ǡƒ† ‘—‹–›Groupˆ— –‹‘‹‰Ǥ therapy.  ‹ ‡’ƒ–‹‡–•™‹–Š–‡†–‘‡š’‡”‹‡ ‡ƒ‰”‡ƒ–†‡ƒŽ‘ˆ•–”‡••‹ •‘ ‹ƒŽ•‹–—ƒ–‹‘•ǡ‰”‘—’–Š‡”ƒ’›’”‘˜‹†‡•ƒ‘’’‘”–—‹–›–‘’”ƒ –‹ ‡‡–ƒŽ‹œ‹‰‹ƒ•–”‡••Ǧ ‡˜‘‹‰•‡––‹‰Ǥ ”‘—’–Š‡”ƒ’› ƒƒŽ•‘‰‡‡”ƒ–‡ƒ•‡•‡‘ˆ„‡Ž‘‰‹‰ƒ†ƒ––ƒ Š‡––Šƒ–Š‡Ž’ ˆ‘•–‡”‡–ƒŽ‹œ‹‰ǤŠ‡‰”‘—’•‹œ‡‹•ƒƒš‹—‘ˆ‡‹‰Š–’ƒ–‹‡–•ƒ†–Š‡”‡™‹ŽŽ„‡‘‡’ –Š‡”ƒ’‹•–ƒ†‘‡Therapists. ‘ Ǧ–Š‡”ƒ’‹•–’”‡•‡–ƒ–‡ƒ Š•‡••‹‘Ǥ ”‘—’–Š‡”ƒ’‹•–•ƒ”‡‡š’‡”‹‡ ‡†ƒ†”‡‰‹•–‡”‡†–Š‡”ƒ’‹•–•Ǥ †‹˜‹†—ƒŽ –Š‡”ƒ’‹•–•ƒ”‡‡–ƒŽŠ‡ƒŽ–Š’”‘ˆ‡••‹‘ƒŽ•ȋ’•› Š‘Ž‘‰‹•–•ǡ’•› Š‹ƒ–”‹ —”•‡•‘”’•› Š‹ƒ–”‹•–•Ȍ ™Š‘”‡ ‡‹˜‡–”ƒ‹‹‰–‘„‡ ‘‡’–Š‡”ƒ’‹•–•Ǥ—’‡”˜‹•‹‘‹•’”‘˜‹†‡†‹™‡‡Ž›•‡••‹‘•‘ˆ —’–‘ͳŠǡ†—”‹‰™Š‹ Š–Š‡”ƒ’‹•–•”‡ˆŽ‡ –‘–Š‡‹”‹–‡”˜‡–‹‘•ƒ†™Š‡–Š‡”–Š‡›ƒ”‡ˆƒ‹–Šˆ—Ž–‘ –Š‡‘†‡ŽǤ  Statistical analysis Main effect.

Š‡ƒ‹’—”’‘•‡‘ˆ–Š‡•–ƒ–‹•–‹ ƒŽƒƒŽ›•‹•‹•–‘ ‘’ƒ”‡–Š‡‘˜‡”ƒŽŽ‡ˆˆ‡ – ‘ˆ–”‡ƒ–‡– ‘†‹–‹‘‘•‘ ‹ƒŽˆ— –‹‘‹‰Ǥ ‘”–Š‹•ǡƒ™‹ŽŽ„‡—•‡†™‹–Š–”‡ƒ–‡– ‘†‹–‹‘ƒ•„‡–™‡‡Ǧ•—„Œ‡ –•˜ƒ”‹ƒ„Ž‡ǡ’‘•––”‡ƒ–‡–•‘ ‹ƒŽˆ— –‹‘‹‰ƒ•†‡’‡†‡–˜ƒ”‹ƒ„Ž‡ǡ ƒ†„ƒ•‡Ž‹‡•‘ ‹ƒŽˆ— –‹‘‹‰ƒ•ƒ ‘˜ƒ”‹ƒ–‡Ǥ–Š‡”’‘–‡–‹ƒŽ ‘˜ƒ”‹ƒ–‡•‹ Ž—†‡ Š‹Ž†Š‘‘† –”ƒ—ƒǡŽ‡˜‡Ž‘ˆǡ•‘ƒ–‹œƒ–‹‘‘ˆ’•› Š‘’ƒ–Š‘Ž‘‰›ǡ‡†‹ ƒ–‹‘—•‡ǡƒ†ƒ––‡†ƒ ‡‘ˆ’ •‡••‹‘•ǡ†—”ƒ–‹‘‘ˆ‹ŽŽ‡••ƒ†ƒ†Š‡”‡ ‡–‘–Š‡Ǧ‘†‡Ž„›–Š‡”ƒ’‹•–•Ǥ‹‹Žƒ”ƒƒŽ›•‡• ™‹ŽŽ„‡ ‘†— –‡†ˆ‘”–Š‡•‡ ‘†ƒ”›‘—– ‘‡‡ƒ•—”‡•ȋ•‘ ‹ƒŽ ‘‰‹–‹‘ǡ“—ƒŽ‹–›‘ˆŽ‹ˆ‡ǡ ƒ™ƒ”‡‡••‘ˆŠƒ˜‹‰ƒ‡–ƒŽ†‹•‘”†‡”ǡƒš‹‘—•ǡ†‡’”‡••‹˜‡ǡ‡‰ƒ–‹˜‡ƒ†’‘•‹–‹˜‡•›’–‘• ƒ†•—„•–ƒ ‡ƒ„—•‡ȌǤ‹ ‡†”‘’Ǧ‘—–™‹ŽŽ—†‘—„–‡†Ž›”‡•—Ž–‹‹••‹‰†ƒ–ƒǡ–Š‡’‘••‹„‹Ž‹–›‘ˆ ƒ––”‹–‹‘Ǧ„‹ƒ•‹•ƒ ƒ—•‡‘ˆ ‘ ‡”ȋ‡‘‡–ƒŽǤǡʹͲͲ͸ȌǤ ‘”‡šƒ’Ž‡ǡ‹–‹• ‘ ‡‹˜ƒ„Ž‡–Šƒ––Š‘•‡ ™Š‘ˆƒ”‡–Š‡™‘”•–‹–Š‡”ƒ’›–‡†–‘†”‘’‘—–ǡ–Š—• ”‡ƒ–‹‰ƒ„‹ƒ•‡†•ƒ’Ž‡Ǥ ‘ŽŽ‘™‹‰–Š‡ ƒ†˜‹ ‡‘ˆŽ–ƒȋʹͲͲͻȌǡ–Š‡ƒƒŽ›•‡•will therefore be conducted on the basis of ‘intention –‘ –”‡ƒ–’ (ITT), meaning that they will include all ’ƒ–‹‡–•™Š‘•‹‰—’ǡ”‡‰ƒ”†Ž‡••‘ˆƒ –—ƒŽ

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’ƒ”–‹ ‹’ƒ–‹‘‹–Š‡‡–‹”‡’”‘‰”ƒǤ‹••‹‰†ƒ–ƒ™‹ŽŽ„‡Šƒ†Ž‡†„›‡ƒ•‘ˆ—Ž–‹’Ž‡ ‹’—–ƒ–‹‘ȋ Ǣ Šƒˆ‡”ǡͳͻͻͻȌǤ –Š‡ —””‡– ƒ•‡‹••‹‰‡••‹•‘•–Ž‹‡Ž›–‘„‡ ƒ—•‡†„› ’ƒ”–‹ ‹’ƒ–•†”‘’’‹‰‘—–‘ˆ–Š‡‹””‡•’‡ –‹˜‡–”‡ƒ–‡–’”‘‰”ƒ•Ǥ‹ ‡ ‡”–ƒ‹˜ƒ”‹ƒ„Ž‡•Šƒ˜‡ „‡‡ˆ‘—†–‘‹ˆŽ—‡ ‡†”‘’Ǧ‘—–”ƒ–‡•‹’ƒ–‹‡–•™‹–Šǡ™‡ ƒ‘–ƒ••—‡–Šƒ––Š‡†ƒ–ƒ ƒ”‡‹••‹‰ƒ–”ƒ†‘Ǥ”‡˜‹‡™ȋ‘•‡ǡƒ”„—‹Ƭƒ•‡ŽŽƒǡʹͲͲ͵Ȍ‹†‡–‹ˆ‹‡†ƒŽƒ ‘ˆ‹•‹‰Š–ǡ ’‘‘”•‘ ‹ƒŽˆ— –‹‘‹‰ǡ’‘•‹–‹˜‡•›’–‘•ǡ›‘—‰ƒ‰‡ǡƒŽ‡‰‡†‡”ǡƒŠ‹•–‘”›‘ˆ†”—‰ƒ„—•‡ǡƒ† —‡’Ž‘›‡–ƒ•‡›’”‡†‹ –‘”•‘ˆ–”‡ƒ–‡–’”‘‰”ƒ†”‘’‘—–ǤŠ—•ǡ‹–Š‡ —””‡–•–—†›ǡ –Š‡•‡˜ƒ”‹ƒ„Ž‡•™‹ŽŽ„‡—•‡†–‘’”‡†‹ –‹••‹‰‡••Ǥ††‹–‹‘ƒŽŽ›ǡ–”‡ƒ–‡– ‘†‹–‹‘™‹ŽŽ„‡ —•‡†ƒ•ƒ’”‡†‹ –‘”ƒ•™‡ŽŽǡ„‡ ƒ—•‡–Š‡–‹‡‹˜‡•–‡–†‹ˆˆ‡”•„‡–™‡‡ ‘†‹–‹‘•Ǥ ‘”‡ƒ Š ƒƒŽ›•‹•ǡƒ–‘–ƒŽ‘ˆͷ‹’—–‡††ƒ–ƒ•‡–•™‹ŽŽ„‡ ”‡ƒ–‡†—•‹‰ƒˆ—ŽŽ› ‘†‹–‹‘ƒŽƒ”‘˜ Šƒ‹ ‘–‡ƒ”Ž‘ȋȌƒ’’”‘ƒ Šǡ™Š‹ Š™‹ŽŽ„‡ ‘„‹‡†—•‹‰•–ƒ†ƒ”†’”‘ ‡†—”‡•ȋ”‡ƒ Š‡”Ƭ ƒ›‡•ǡʹͲͳ͵MediationȌǤ . ‡ƒŽ•‘ƒ‹–‘‡šƒ‹‡™Š‡–Š‡” Šƒ‰‡•‹˜ƒ”‹‘—••‘ ‹ƒŽ ‘‰‹–‹˜‡ †‹‡•‹‘•‡†‹ƒ–‡–Š‡’‘–‡–‹ƒŽ‹ ”‡ƒ•‡‹•‘ ‹ƒŽˆ— –‹‘‹‰Ǥ ‘”†‡”–‘–‡•––Š‹•‡†‹ƒ–‹‘ƒŽ ‘†‡Žǡ™‡™‹ŽŽ ƒ””›‘—–ƒ—Ž–‹Ǧ‡†‹ƒ–‘”ƒƒŽ›•‹•ȋ”‡ƒ Š‡”Ƭ ƒ›‡•ǡʹͲͲͶȌǤŠ‹•ƒŽŽ‘™•ˆ‘”ƒ ’ƒ”ƒŽŽ‡Ž–‡•–‹‰‘ˆ–Š‡‹†‹”‡ –‡ˆˆ‡ –•‘ˆ•‡˜‡”ƒŽ•‘ ‹ƒŽ ‘‰‹–‹˜‡†‹‡•‹‘•ǡƒ‡Ž›ǣ–Š‡‘”›‘ˆ ‹†ǡ ‘’Ž‡š‹–›‘ˆ”‡’”‡•‡–ƒ–‹‘•ǡƒˆˆ‡ –Ǧ–‘‡‘ˆ”‡Žƒ–‹‘•Š‹’•ǡ ƒ’ƒ ‹–›ˆ‘”‡‘–‹‘ƒŽ ‹˜‡•–‡–ƒ†—†‡”•–ƒ†‹‰‘ˆ•‘ ‹ƒŽ ƒ—•ƒŽ‹–›ȋ ‹‰ǤͳȌǤ 6

Multilevel analysis.  ‘ ‹ƒŽ•–”‡••”‡ƒ –‹˜‹–›‹•‡ƒ•—”‡†„›ǤŠ‹•‡–Š‘†‰‡‡”ƒ–‡• †ƒ–ƒ™‹–Šƒ—Ž–‹Ž‡˜‡Ž•–”— –—”‡„‡ ƒ—•‡–Š‡”‡ƒ”‡—Ž–‹’Ž‡‡ƒ•—”‡‡–•’‡”†ƒ›ˆ‘”—’–‘•‹š †ƒ›•ƒ–ƒ–‹‡ˆ‘”‡ƒ Š’ƒ–‹‡–Ǥ‹ ‡‘„•‡”˜ƒ–‹‘•™‹–Š‹’ƒ–‹‡–•–‡†–‘„‡‘”‡•‹‹Žƒ”–Šƒ ‘„•‡”˜ƒ–‹‘•ˆ”‘†‹ˆˆ‡”‡–’ƒ–‹‡–•ǡ–Š‡›ƒ”‡‘–‹†‡’‡†‡–ǤŠ‹•‡ ‡••‹–ƒ–‡•†‹ˆˆ‡”‡–ȋ‹Ǥ‡Ǥǡ —Ž–‹Ž‡˜‡ŽȌƒƒŽ›•‹•–Šƒ–Š‡‘‡—•‡†ˆ‘”–Š‡‘–Š‡”‘—– ‘‡‡ƒ•—”‡•Ǥ‹‹Žƒ”–‘›‹Ǧ ‡”‡›•ƒ† ‘ŽŽ‡ƒ‰—‡•ȋʹͲͲͳȌǡ†‹ˆˆ‡”‡ ‡•‹•‘ ‹ƒŽ•–”‡••”‡ƒ –‹˜‹–›„‡–™‡‡‰”‘—’•™‹ŽŽ„‡ ƒƒŽ›œ‡†—•‹‰‹š‡†Ǧ‡ˆˆ‡ –•”‡‰”‡••‹‘‘†‡Ž•™‹–Š–”‡ƒ–‡– ‘†‹–‹‘ǡ–Š‡ƒ‘—–‘ˆ•–”‡•• †—”‹‰•‘ ‹ƒŽ•‹–—ƒ–‹‘•ǡƒ†–Š‡‹”‹–‡”ƒ –‹‘–‡”ƒ•‹†‡’‡†‡–˜ƒ”‹ƒ„Ž‡•ǡƒ†’‘•‹–‹˜‡ƒ†

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‡‰ƒ–‹˜‡ƒˆˆ‡ –ƒ•†‡’‡†‡–˜ƒ”‹ƒ„Ž‡•ǤŠ‡‘†‡Ž™‹ŽŽ‹ Ž—†‡”ƒ†‘‹–‡” ‡’–•ƒ†”ƒ†‘ •Ž‘’‡•ˆ‘”–Š‡•–”‡••’”‡†‹ –‘”ƒ––Š‡’ƒ–‹‡–Ž‡˜‡Žǡ™Š‹ ŠƒŽŽ‘™•ˆ‘”†‹ˆˆ‡”‡ ‡•‹‘˜‡”ƒŽŽŽ‡˜‡Ž• ‘ˆ’‘•‹–‹˜‡ƒ†‡‰ƒ–‹˜‡ƒˆˆ‡ –ƒ ”‘••’ƒ–‹‡–•ƒ†ˆ‘”†‹ˆˆ‡”‡ ‡•‹–Š‡•–”‡‰–Š‘ˆ–Š‡ ”‡Žƒ–‹‘•Š‹’„‡–™‡‡•–”‡••ƒ†–Š‡•‡‘—– ‘‡•Ǥ Discussion

Š‡”‡‹•‡˜‹†‡ ‡–Šƒ–‹’”‘˜‡•ǡƒ‘‰‘–Š‡”•ǡ•‘ ‹ƒŽˆ— –‹‘‹‰ƒ†‹–‡”’‡”•‘ƒŽ †‹•–”‡••‹’ƒ–‹‡–•™‹–Šȋ‡Ǥ‰Ǥƒ–‡ƒƬ ‘ƒ‰›ǡͳͻͻͻǢƒ–‡ƒƬ ‘ƒ‰›ǡʹͲͲͻȌƒ†–Šƒ– –Š‡•‡‡ˆˆ‡ –•”‡ƒ‹ƒ–ˆ‘ŽŽ‘™Ǧ—’ȋƒ–‡ƒƬ ‘ƒ‰›ǡʹͲͲͳȌǤ ‹˜‡–Š‡•‹‹Žƒ”‹–‹‡•‹„‘–Š ‘”‹‰‹•ƒ†•›’–‘•‘ˆƒ†ǡ‹–Šƒ•’”‡˜‹‘—•Ž›„‡‡•—‰‰‡•–‡†–Šƒ– ‘—Ž†„‡ƒ —•‡ˆ—Ž–”‡ƒ–‡–ˆ‘”ȋ”‡–Ƭ ‘ƒ‰›ǡʹͲͳͶǢ”‡–ǡʹͲͲͻȌǤŠ‹•”ƒ†‘‹œ‡† ‘–”‘ŽŽ‡† –”‹ƒŽǡ™‹ŽŽ„‡–Š‡ˆ‹”•––‘‡šƒ‹‡–Š‡‡ˆˆ‡ –‹˜‡‡••‘ˆƒ•ƒƒ†Œ— ––Š‡”ƒ’›ˆ‘”’ƒ–‹‡–•™‹–Š Ǥ Acknowledgement

‹˜‹‡”†—‹‡ •–‹–—–‡ˆ‘”‡–ƒŽ ‡ƒŽ–Šƒ”‡‹•ˆ—†‹‰–Š‡ ‘•–•ˆ‘”–Š‹•–”‹ƒŽˆ‘”ƒ–Ž‡ƒ•–Ͷ ›‡ƒ”•ǤŠ‡ ‘•–•‹ Ž—†‡’ƒ”–‹ ‹’ƒ–‹‘ˆ‡‡•ˆ‘”—’–‘ͺͲ’ƒ”–‹ ‹’ƒ–•ǡ–”‡ƒ–‡–‰‹˜‡ǡ ‘”‰ƒ‹œƒ–‹‘ƒŽ ‘•–•ƒ†–Š‡•ƒŽƒ”‹‡•‘ˆ’”‹ ‹’ƒŽ‹˜‡•–‹‰ƒ–‘” ‡ƒǦƒ—Ž‡Ž–‡ƒ†Ž‘ ƒŽ ‹˜‡•–‹‰ƒ–‘” ‘ƒ•‡‹Œ‡”•Ǥ Š‹•ˆ—†‹‰•‘—” ‡Šƒ•‘”‘Ž‡‹–Š‡†‡•‹‰‘ˆ–Š‹••–—†›ƒ†™‹ŽŽ‘–Šƒ˜‡ƒ›”‘Ž‡†—”‹‰‹–• ‡š‡ —–‹‘ǡƒƒŽ›•‡•ǡ‹–‡”’”‡–ƒ–‹‘‘ˆ–Š‡†ƒ–ƒǡ‘”†‡ ‹•‹‘–‘•—„‹–”‡•—Ž–•ǤŠ‡’”‘–‘ ‘Ž™ƒ• ‘–’‡‡”Ǧ”‡˜‹‡™‡†„›–Š‹•ˆ—†‹‰„‘†›Ǥ Availability of data and materials

‘ƒ’’Ž‹ ƒ„Ž‡Ǥ  Authors’ contributions

–†”ƒˆ–‡†–Š‡ˆ‹”•–˜‡”•‹‘‘ˆ–Š‡ƒ—• ”‹’–Ǥ  ‘’Ž‡–‡†–Š‡ƒ—• ”‹’–™‹–Šƒ†˜‹ ‡ˆ”‘ –ǡǡǡǡǡƒ† ƒ†‹•–Š‡Ž‡ƒ†ƒ—–Š‘”Ǥ ‹•ƒŽ•‘”‡•’‘•‹„Ž‡ˆ‘”–Š‡ ‘ŽŽ‡ –‹‘‘ˆ †ƒ–ƒǤ ‹•’”‹ ‹’ƒŽ‹˜‡•–‹‰ƒ–‘”ƒ†”‡•’‘•‹„Ž‡ˆ‘”–Š‡ ‘‘”†‹ƒ–‹‘‘ˆ–Š‡•–—†›ǤŽŽƒ—–Š‘”• ’”‘˜‹†‡† ‘‡–•ǡ”‡ƒ†ƒ†ƒ’’”‘˜‡†–Š‡ˆ‹ƒŽƒ—• ”‹’–Ǥ Competing interests

Š‡ƒ— –Š‘”•†‡ Žƒ”‡–Šƒ––Š‡›Šƒ˜‡‘ ‘’‡–‹‰‹–‡”‡•–•Ǥ

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Consent for publication

‘•‡––‘’—„Ž‹•Š”‡•—Ž–•ƒ†•–‘”‡†ƒ–ƒƒ†ƒ–‡”‹ƒŽ•ˆ‘”ƒƒš‹—‘ˆͳͷ›‡ƒ”•™‹ŽŽ„‡ ‘„–ƒ‹‡†ˆ”‘ƒŽŽ’ƒ”–‹ ‹’ƒ–•Ǥ‘•‡––‘•Šƒ”‡”ƒ™†ƒ–ƒ™‹–Š‘—–•‹†‡’ƒ”–‹‡•™‹ŽŽ‘–„‡ ‘„–ƒ‹‡†Ǥ‡’‘”–‹‰‘ˆ†ƒ–ƒ‘ ‡‘„–ƒ‹‡†™‹ŽŽƒ†Š‡”‡–‘–Š‡‰—‹†‡Ž‹‡•ȋ‘Š‡”ǡ  Š—ŽœƬŽ–ƒǡʹͲͲͳȌǤ Ethics approval and consent to participate

Š‡‡†‹ ƒŽ‡•‡ƒ” Šƒ†–Š‹ •‘‹––‡‡ȋȌ‘ˆƒƒ•–”‹ Š–‹˜‡”•‹–›‹Š‡ ‡–Š‡”Žƒ†•Šƒ•ƒ’’”‘˜‡†–Š‹••–—†›ǡ”‡‰‹•–‡”‡†—†‡”Ͷ͹ʹ͵͸Ͳ͸ͺȀͳ͵ǦͲ͵ǦͲ͸͸Ǥ ‘•‡––‘’ƒ”–‹ ‹’ƒ–‡™‹ŽŽ„‡‘„–ƒ‹‡†ˆ”‘ƒŽŽ’ƒ”–‹ ‹’ƒ–•Ǥ ˆ‘ ‘•‡–‹•‰‹˜‡ǡ–Š‡ ’ƒ”–‹ ‹’ƒ–™‹ŽŽ„‡ ‘•‹†‡”‡†ƒ†”‘’Ǧ‘—–Ǥ†‹‹•–”ƒ–‹˜‡‹ˆ‘”ƒ–‹‘”‘–‘ ‘Ž‹†‡–‹ˆ‹‡”ǣ ‡”•‹‘Ͷǡ†ƒ–‡ǣͲʹǦͲ͸ǦʹͲͳ͸’‘•‘”ǣƒƒ•–”‹ Š–‹˜‡”•‹–›ǡ–Š‡‡–Š‡”Žƒ†•Ǥ‘””‡•’‘†‡ ‡ǣ D. Op ‘t‹Œ†‡ǡǤǤ‘š͸ͳ͸ȋ ͳȌǡ͸ʹͲͲƒƒ•–”‹ Š–Ϊ͵ͳͶ͵͵ͺͺ͵ͺ͸ͻǤ —†‡”ǣ ‹˜‹‡”†—‹‡ •–‹–—–‡ˆ‘”‡–ƒŽ ‡ƒŽ–Šƒ”‡ǡ–Š‡‡–Š‡”Žƒ†•ǡƒ†‹ˆ‘”–†”‡‡ˆͳͻǡʹ͵͵͵ ‡‹†‡Ǥ”‹ƒŽ”‡‰‹•–”ƒ–‹‘†ƒ–ƒ„ƒ•‡ǣ—– Š”‹ƒŽ‡‰‹•–‡””‹ƒŽ”‡‰‹•–”ƒ–‹‘ǣ Ͷ͹Ͷ͹‡‰‹•–”ƒ–‹‘†ƒ–‡ǣͲͺ ǦͳͻǦʹͲͳͶ Abbreviations 6 (Z)MLK, Abbreviation for the Dutch term ‘(zeer) moeilijk lerende kinderen’ meaning: children ™‹–Šȋ•‡˜‡”‡ȌŽ‡ƒ”‹‰†‹•ƒ„‹Ž‹–‹‡•Ǣǡ„‘”†‡”Ž‹‡’‡”•‘ƒŽ‹–›†‹•‘”†‡”Ǣ ǡ ‘’”‡Š‡•‹˜‡ ƒ••‡•‡–‘ˆ•›’–‘•ƒ†Š‹•–‘”›Ǣǡ ‘‰‹–‹˜‡„‡Šƒ˜‹‘”ƒŽ–Š‡”ƒ’›Ǣǡ Š‹Ž†Š‘‘† ‡š’‡”‹‡ ‡•‘ˆ ƒ”‡ƒ†ƒ„—•‡Ǣ ǡ—– Š•Š‘”–ˆ‘”‘ˆ–Š‡‹‡•‘–ƒ—Ž–‹’Šƒ•‹  ’‡”•‘ƒŽ‹–›‹˜‡–‘”›Ǣǡ‡š’‡”‹‡ ‡•ƒ’Ž‹‰‡–Š‘†Ǣ ǡ‰‡‡”ƒŽ†‡‘‰”ƒ’Š‹  “—‡•–‹‘ƒ‹”‡Ǣ ǡŠ‹–‹‰–ƒ•Ǣ ǡ –‡–‹‘–‘–”‡ƒ–Ǣǡƒ Š‡•–‡”•Š‘”–ƒ••‡••‡–ˆ “—ƒŽ‹–›‘ˆŽ‹ˆ‡Ǣǡ‡†‹ ƒ–‹‘ƒ†Š‡”‡ ‡“—‡•–‹‘ƒ‹”‡Ǣǡ‡–ƒŽ‹œƒ–‹‘Ǧ„ƒ•‡†–”‡ƒ–‡– ȋˆ‘”„‘”†‡”Ž‹‡’‡”•‘ƒŽ‹–›†‹•‘”†‡”ȌǢ’ǡ‡–ƒŽ‹œƒ–‹‘„ƒ•‡†–”‡ƒ–‡–ˆ‘”’•› Š‘–‹  †‹•‘”†‡”•Ǣǡƒ”‘˜ Šƒ‹‘–‡ ƒ”Ž‘Ǣ ǡ—Ž–‹’Ž‡‹’—–ƒ–‹‘Ǣǡ‹š‡†‘†‡Žˆ‘” ”‡’‡ƒ–‡†‡ƒ•—”‡•ǢȀǡ‡†‹ ƒŽ”‡•‡ƒ” Š‡–Š‹ • ‘‹––‡‡ȋȌǢ‹—– Šǣ ‡†‹• Š‡–Š‹• Š‡–‘‡–•‹‰ ‘‹••‹‡ȋȌǢǡ‘ƒˆˆ‡ –‹˜‡’•› Š‘–‹ †‹•‘”†‡”Ǣǡ ’‘•‹–‹˜‡ƒ†‡‰ƒ–‹˜‡•›†”‘‡• ƒŽ‡Ǣǡ’‡”•‘ƒŽ‹–›‘”‰ƒ‹œƒ–‹‘Ǣǡ•‘ ‹ƒŽ ‘‰‹–‹‘ƒ† ‘„Œ‡ –”‡Žƒ–‹‘••›•–‡Ǣ ǡ•‘ ‹ƒŽˆ— –‹‘‹‰• ƒŽ‡Ǣǡ–Š‡ƒ–‹ ƒ’’‡” ‡’–‹‘–‡•–Ǣǡ –”‡ƒ–‡–ƒ•—•—ƒŽǤ References 

„—Ǧ‡ŽǡǤǡPsychologicalƬƒ‹Ž‡›ǡǤǤȋʹͲͲͲȌǤŠ‡’‘••‹„‹Ž‹–›‘ˆ†‹ˆˆ‡”‡–ˆ‘”•‘ˆ–Š‡‘”›‘ˆ‹†Ǥ Medicine, 30 ǡ͹͵ͷ–͹͵ͺǤ

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††‹‰–‘ǡ ǤǡƬ††‹‰–‘ǡǤȋʹͲͲͲȌǤ‡—”‘ ‘‰‹–‹˜‡ƒ†•‘ ‹ƒŽˆ— –‹‘‹‰‹• Š‹œ‘’Š”‡‹ƒǣƒSchizophrenia research, 44 ʹǤͷ›‡ƒ”ˆ‘ŽŽ‘™Ǧ—’•–—†›Ǥ ȋͳȌǡͶ͹Ǧͷ͸Ǥ ††‹‰–‘ǡ Ǥǡƒ‡‡†‹ǡ ǤǡƬ††‹‰–‘ǡǤȋʹͲͲ͸ȌǤ ˆŽ—‡ ‡‘ˆ•‘ ‹ƒŽ’‡” ‡’–‹‘ƒ†•‘ ‹ƒŽBritish Journal of Psychiatry,189‘™Ž‡†‰‡‘ ‘‰‹–‹˜‡ƒ†•‘ ‹ƒŽˆ— –‹‘‹‰‹‡ƒ”Ž›’•› Š‘•‹•Ǥ ǡ͵͹͵–͵͹ͺǤ Current Opinion in Neurobiology,11 †‘Ž’Š•ǡǤȋʹͲͲͳȌǤŠ‡‡—”‘„‹‘Ž‘‰›‘ˆ•‘ ‹ƒŽ ‘‰‹–‹‘Ǥ ǡ ʹ͵ͳ–ͻǤƒ–‡ƒǡǤǡƬ ‘ƒ‰›ǡǤȋʹͲͲͻȌǤƒ†‘‹œ‡† ‘–”‘ŽŽ‡†–”‹ƒŽ‘ˆ‘—–’ƒ–‹‡–•ǡ ‡–ƒŽ‹œƒ–‹‘„ƒ•‡†–”‡ƒ–‡–˜‡”•—••–”— –—”‡† Ž‹‹ ƒŽƒƒ‰‡‡–ˆ‘”„‘”†‡”Ž‹‡American Journal of Psychiatry, 166 ’‡”•‘ƒŽ‹–›†‹•‘”†‡”Ǥ . Diagnostic and statistical Manualǡͳ͵ͷͷ of M–ͳ͵͸ͶǤental disorders ‡”‹ ƒ•› Š‹ƒ–”‹ ••‘ ‹ƒ–‹‘ ǡȋͶ–Š ‡†ǤȌǤȋʹͲͲͲȌǤƒ•Š‹‰–‘ǡǣ‡”‹ ƒ•› Š‹ƒ–”‹ ••‘ ‹ƒ–‹‘Ǥ †”‡ƒ•‡ǡǤǤǡ Žƒ—ǡǤǡƬ”†–ǡǤȋͳͻͻʹȌǤŠ‡‘’”‡Š‡•‹˜‡••‡••‡–‘ˆ›’–‘•. ƒ† ‹•–‘”›ȋ Ȍǣƒ‹•–”—‡–ˆ‘”ƒ••‡••‹‰†‹ƒ‰‘•‹•ƒ†’•› Š‘’ƒ–Š‘Ž‘‰›Archives of General Psychiatry, 49 ȋͺȌǡ͸ͳͷ–ʹ͵Ǥ Open Ž–ƒǡǤ ǤȋʹͲͲͻȌǤ‹••‹‰‘—– ‘‡•‹”ƒ†‘‹œ‡†–”‹ƒŽ•ǣƒ††”‡••‹‰–Š‡†‹Ž‡ƒǤMedicine, 3 ȋʹȌǡͷͳ–ͷ͵Ǥ —‡”„ƒ Šǡ ǤǤǡƬŽƒ––ǡǤ Ǥȋͳͻͻ͸ȌǤ‡ŽˆPsychoanalyticalǦ”‡’”‡•‡–ƒ–‹‘‹•‡˜‡”‡’•› Š‘’ƒ–Š‘Ž‘‰›ǣŠ‡”‘Ž‡‘ˆ Psychology, 13 ”‡ˆŽ‡š‹˜‡•‡ŽˆǦƒ™ƒ”‡‡••Ǥ ȋ͵Ȍǡʹͻ͹Ǥ ƒ–‡ƒǡǤǡƬ ‘ƒ‰›ǡǤȋͳͻͻͻȌǤˆˆ‡ –‹˜‡‡••‘ˆ’ƒ”–‹ƒŽŠ‘•’‹–ƒŽ‹œƒ–‹‘‹–Š‡–”‡ƒ–‡–‘ˆAmerican Journal of „‘”†‡”Ž‹‡’‡”Psychiatry, 156•‘ƒŽ‹–›†‹•‘”†‡”ǣƒ”ƒ†‘‹œ‡† ‘–”‘ŽŽ‡†–”‹ƒŽǤ ǡͳͷ͸͵–ͳͷ͸ͻǤ ƒ–‡ƒǡǤǡƬ ‘ƒ‰›ǡǤȋʹͲͲͳȌǤ”‡ƒ–‡–‘ˆ„‘”†‡”Ž‹‡’‡”•‘ƒŽ‹–›†‹•‘”†‡”™‹–ŠAmerican ’•› Š‘ƒƒŽ›–‹ ƒŽŽ›‘”‹‡–‡†’ƒ”–‹ƒŽŠ‘•’‹–ƒŽ‹œƒ–‹‘ǣƒͳͺJournal of Psychiatry, 158 Ǧ‘–Šˆ‘ŽŽ‘™Ǧ—’Ǥ ǡʹͶͶMentalisation–ʹͷͳǤ based treatment: a practical guide. ƒ–‡ƒǡǤǡƬ ‘ƒ‰›ǡǤȋʹͲͲ͸ȌǤ šˆ‘”†ǣ šˆ‘”†‹˜‡”•‹–›”‡••Ǥ Handbook of mentalizing in mental health practice. ƒ–‡ƒǡǤǡƬ ‘ƒ‰›ǡǤȋʹͲͳʹȌǤ ƒ•Š‹‰–‘ǣ‡”‹ ƒ•› Š‹ƒ–”‹ —„Ž‹•Š‹‰ǡ  Ǥ ‡ŽŽǡǤǡ•ƒ‰ǡ ǤǤǡ ”‡‹‰ǡǤǤǡƬ”›•‘ǡ Ǥ ǤȋʹͲͲͻȌǤ‡—”‘ ‘‰‹–‹‘ǡ•‘ ‹ƒŽ ‘‰‹–‹‘ǡSchizophrenia ’‡” ‡‹˜‡†•‘ ‹ƒŽ†‹• ‘ˆ‘”–ǡƒ†˜‘ ƒ–‹‘ƒŽ‘—– ‘‡•‹• Š‹œ‘’Š”‡‹ƒǤBulletin, 35 ȋͶȌǡ͹͵ͺ–͹Ͷ͹Ǥ ‡ŽŽƒ ǡǤǤǡ‘””‹••‘ǡǤǡ‹š–‡†ǡ ǤǤǡBritish Journal ofƬ Psychiatry,—‡•‡”ǡǤȋͳͻͻͲȌǤƒƒŽ›•‹•‘ˆ•‘ ‹ƒŽ ‘’‡–‡ ‡‹ 156 • Š‹œ‘’Š”‡‹ƒǤ ǡͺͲͻ–ͺͳͺǤ ‹ˆ—Ž ‘ǡǤǡ”‘™ǡ ǤǤǡƬ ƒ””‹•ǡǤǤȋͳͻͻͶȌǤŠ‹Ž†Š‘‘†š’‡”‹‡ ‡‘ˆƒ”‡ƒ†„—•‡ȋȌǣJournal of Child Psychology and Psychiatry, 35 ”‡–”‘•’‡ –‹˜‡‹–‡”˜‹‡™‡ƒ•—”‡Ǥ ǡͳͶͳͻ– ͳͶ͵ͷǤ

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‹” Š™‘‘†ǡǤǡ‹–Šǡ Ǥǡ‘ Š”ƒ‡ǡǤǡ‡––‘ǡǤǡƬ‘’‡•–ƒ‡ǡǤȋͳͻͻͲȌǤŠ‡‘ ‹ƒŽ — –‹‘‹‰  ƒŽ‡ǤŠ‡‡˜‡Ž‘’‡–ƒ†˜ƒŽ‹†ƒ–‹‘‘ˆƒ‡™• ƒŽ‡‘ˆ•‘ ‹ƒŽƒ†Œ—•–‡–ˆ‘”—•‡‹British Journal of ˆƒ‹Ž›‹–‡”˜‡–‹‘’”‘‰”ƒ‡•™‹–Š• Š‹œ‘’Š”‡‹ ’ƒ–‹‡–•ǤPsychiatry, 157 ȋ͸Ȍǡͺͷ͵–ͺͷͻǤ ‘”ƒǡǤǤǤǡSchizophreniaƬƒ–‡Ž‹•ǡǤȋʹͲͲͻȌǤǡŠ‡‘”›‘ˆ‹†‹’ƒ‹ Researc, 109 ”‡–‹• Š‹œ‘’Š”‡‹ƒǣ‡–ƒǦƒƒŽ›•‹•Ǥ ȋͳȌǡͳ–ͻǤ ‘›‡––‡ǡǤǦǤǡ˜ƒƒǡǤǡ‡‹Œ‡”ǡǤǡ‡Ž–Š‘”•–ǡǤǡƒŠǡǤǡƬ†‡ ƒƒǡǤǡ‡–ƒŽǤȋʹͲͳͶȌǤ ‡”•‘ƒŽ‹–› ‘’‡•ƒ–‡•ˆ‘”‹’ƒ‹”‡†“—ƒŽ‹–›‘ˆŽ‹ˆ‡ƒ†•‘ ‹ƒŽˆ— –‹‘‹‰‹’ƒ–‹‡Schizophrenia Bulletin, –• 40™‹–Š’•› Š‘–‹ †‹•‘”†‡”•™Š‘‡š’‡”‹‡ ‡†–”ƒ—ƒ–‹ ‡˜‡–•Ǥ ȋ͸Ȍǡͳ͵ͷ͸–ͳ͵͸ͷǤ Journal of ”‡–ǡǤȋʹͲͲͻȌǤ‡–ƒŽ‹œƒ–‹‘Clinical Psychology, 65 Ǧƒ•‡†•› Š‘†›ƒ‹ •› Š‘–Š‡”ƒ’›ˆ‘”•› Š‘•‹•Ǥ ȋͺȌǡͺͲ͵–ͺͳͶǤ ”‡–ǡǤǤǡƬ ‘ƒ‰›ǡǤȋʹͲͳͶȌǤ‡–ƒŽ‹œƒ–‹‘Social cognitionǦ„ƒ•‡†ƒ’’”‘ƒ Š–‘†‹•–—”„ƒ ‡•‘ˆ•‘ ‹ƒŽ and metacognition in schizophrenia —†‡”•–ƒ†‹‰‹• Š‹œ‘’Š”‡‹ƒǤ Ǥ ƒŽ–Šƒǣ ƒ†‡‹ ǡ’’ǤʹͶͷ–ʹͷ͹Ǥ Schizophrenia Brüne, M.Bulletin, (2005). 31 “Theory of mind” in schizophrenia: a review of the li–‡”ƒ–—”‡Ǥ ȋͳȌǡʹͳ–ͶʹǤ Ž‡‡•‡ǡǤǡ˜ƒ•ǡ Ǥǡ‘˜‰ƒƒ”†ǡǤǤǡ§˜‡”ǡǤǡŽ‹Œ†Ǧ ‘‘‰‡™›•ǡǤǤǡƒ”–‡Ž•Ǧ‡Ž–Š—‹•ǡPLoS 6 One,ǤǤǡ‡–ƒŽǤ 9 ȋʹͲͳͶȌǤ ›’‡”Ǧ–Š‡‘”›Ǧ‘ˆǦ‹†‹ Š‹Ž†”‡™‹–Š’•› Š‘–‹ ‡š’‡”‹‡ ‡•Ǥ ȋͳͳȌǡ‡ͳͳ͵ͲͺʹǤ ‘„•ǡǤǤǡ†ƒ•ǡǤǤǡ‡ǡǤǤǡ‘„‡”–•ǡǤǡ‹‡‰”‡‡ǡ ǤǡƬ–‡ǡǤȋʹͲͲ͹ȌǤ‘ ‹ƒŽ‘‰‹–‹‘ ƒ† –‡”ƒ –‹‘”ƒ‹‹‰ȋ Ȍˆ‘”‹’ƒ–‹‡–•™‹–Š• Š‹œ‘’Š”‡‹ƒ•’‡ –”—†‹•‘”†‡”•ǣSchizophrenia Research, 91 ’”‡Ž‹‹ƒ”›ˆ‹†‹‰•Ǥ ȋͳȌǡͳͳʹ–ͳͳ͸Ǥ ‘” ‘”ƒǡǤǡ‡” ‡”ǡ ǤǡƬ ”‹–ŠǡǤǤȋͳͻͻͷȌǤ Š‹œ‘’Š”‡‹ƒǡ•›’–‘ƒ–‘Ž‘‰›ƒ†•‘ ‹ƒŽSchizophrenia inference:Research, 17 Investigating “theory of mind” in people with schizophrenia. ǡͷ–ͳ͵Ǥ ‘‡”•‰‘‡†ǡǤ ǤǤǡ‡ ‘‰ǡǤǡ˜ƒ†‡” ”ƒƒ‰ǡǤǡŽ‡ƒǡǤǡ›•ƒ‡”ǡǤ Ǥǡ—†‡”‹ǡǤǡ‡–ƒŽǤ ȋʹͲͳͶȌǤƒ—ƒŽǦ„ƒ•‡†‹†‹˜‹†—ƒŽ–Š‡”ƒ’›–‘‹’”‘˜‡‡–ƒ ‘‰‹–‹‘‹• Š‹œ‘’Š”‡‹ƒǣBMC Psychiatry, 14 ’”‘–‘ ‘Ž‘ˆƒ—Ž–‹Ǧ ‡–‡”Ǥ ǡʹ͹Ǥ —”‡Ž‹‰•Ǧ‘–‡‘‡ǡǤ ǤǤǡƬ‘‡Ž‡ǡ ǤǤȋʹͲͲ͹ȌǤ‡‘ƒ–‹•ƒ–‹‡Ǧ”•–‹‰‡•› Š‘’ƒ–Š‘Ž‘‰‹‡ ‘„‹ƒ–‹‡„‹‡†‡–Š‡‘”‹‡‰‡•–——”†‡’”‘ˆ‹‡Ž‹–‡”’”‡–ƒ–‹‡˜ƒ†‡ǣ‘ƒ–‹•ƒ–‹‡ƒŽ•Tijdschrift Klinische Psychologie. ƒˆˆ‡ –”‡‰—Žƒ–‘”‡ƒƒ–˜‘‘”•‘ ‹ƒŽ‡ȋ‹Ȍ ‘’‡–‡–‹‡Ǥ37 ȋʹȌǡͳͲ͹–ͳʹʹǤ —”‡Ž‹‰•Ǧ‘–‡‘‡ǡǤ ǤǤǡ—›–‡ǡǤǡƬ‡ŽŽ‡ǡǤǤȋʹͲͲͻȌǤƒŽ‹†ƒ–‹‘‘ˆ–Š‡–Š‡‘”›†”‹˜‡ ’”‘ˆ‹Ž‡‹–‡”’”‡–ƒ–‹‘‘ˆ–Š‡—– ŠŠ‘”–ˆ‘”‘ˆ–Š‡ —•‹‰–Š‡‘ ‹ƒŽ

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Journal of Personality Assessment, 91

‘‰‹–‹‘ƒ†„Œ‡ –”‡Žƒ–‹‘• ƒŽ‡ȋȌǤ ǡͳͷͷ– ͸ͷǤ —”‡Ž‹‰•Ǧ‘–‡‘‡ǡǤ ǤǤǡ—›–‡ǡǤǡ ••‡ƒ‰‰‡”ǡǤǡƒ”‡‡•™‹ŒǡǤǡƬ‘‡Ž‡ǡ ǤǤȋʹͲͳͲȌǤ Relationship between personalityPersonality organizationand Individual and Differences, Young’s cognitive 49 model of ’‡”•‘ƒŽ‹–›’ƒ–Š‘Ž‘‰›Ǥ ǡͳͻͺ–ʹͲ͵Ǥ —”‡Ž‹‰•Ǧ‘–‡‘‡ǡǤ ǤǤǡ—›–‡ǡǤǡ‡‹Œ•‡ǡǤǡƬ‘‡Ž‡ǡ ǤǤȋʹͲͳͲȌǤ••‘ ‹ƒ–‹‘„‡–™‡‡ ’‡”•‘ƒŽ‹–›‘”‰ƒ‹œƒ–‹‘ƒ•ƒ••‡••‡†„›–Š‡‘”›†”‹˜‡’”‘ˆ‹Ž‡•‘ˆ—– ŠŠ‘”– ‘”‘ˆ. Journal of Personality  ƒ†•‡ŽˆAssessment, 92Ǧ”‡’‘”–‡†•–”— –—”ƒŽ’‡”•‘ƒŽ‹–›’ƒ–Š‘Ž‘‰› ȋ͸Ȍǡͷͻͻ–͸ͲͻǤ —”‡Ž‹‰•Ǧ‘–‡‘‡ǡǤ ǤǤǡ‡‡ǡ Ǥǡ‘–‡„‘‘ǡǤǡŽ‡ƒǡǤǡƬ‡‡”ǡ ǤȋʹͲͳʹȌǤ‹ˆˆ‡”‡–‹ƒŽ –”‡ƒ–‡–”‡•’‘•‡‘ˆ•—„–›’‡•‘ˆ’ƒ–‹‡–•™‹–Š„‘”†‡”Ž‹‡’‡”•‘ƒŽ‹–›‘”‰ƒ‹œƒ–‹‘ǡƒ• ƒ••‡••‡†™‹–Š–Š‡‘”›. JournalǦ†”‹˜‡’”‘ˆ‹Ž‡•‘ˆ–Š‡—– Š•Š‘”–ˆ‘”‘ˆ–Š‡ of Personality Assessment, 94 ǣƒƒ–—”ƒŽ‹•–‹  ˆ‘ŽŽ‘™Ǧ—’•–—†› ȋͶȌǡ͵ͺͲ–͵ͻʹǤ —”‡Ž‹‰•Ǧ‘–‡‘‡ǡǤǡ‘‡Ž‡ǡ ǤǡŠ‹Œ••‡ǡǤǡ†‡‹††‡”ǡǤǡƬ‡”Š‘ˆǡ ǤȋʹͲͳͶȌǤŠ‡‹’ƒ –‘ˆ Ž‡˜‡Ž‘ˆ’‡”•‘ƒŽ‹–›‘”‰ƒ‹œƒ–‹‘ƒ†•‘ƒ–‹œƒ–‹‘‘’•› Š‘Ž‘‰‹ ƒŽ†‹Journal of Sleep Disorders:•–”‡••ǡ™‘””›‹‰ǡ Treatment andƒ† ‘’‹‰ƒ‘‰’ƒ–‹‡–•™‹–Š•Ž‡‡’†‹•‘”†‡”•Ǥ Care, ͵͵Ǥ ƒ—Žǡ Ǥǡ”†ˆ‡Ž†‡”ǡǤǡ— Š‡”ǡǤǡƬƒ‰ǡǤȋʹͲͲͻȌǤ–ƒ–‹•–‹ ƒŽ’‘™‡”ƒƒŽ›•‡•—•‹‰ ȗ‘™‡”Behavior Research Methods, 41 ͵Ǥͳǣ‡•–•ˆ‘” ‘””‡Žƒ–‹‘ƒ†”‡‰”‡••‹‘ƒƒŽ›•‡•Ǥ ȋͶȌǡ ͳͳͶͻǦͳͳ͸ͲǤ ‘ƒ‰›ǡǤǡƬJournalƒ–‡ƒǡǤȋʹͲͲ͸ȌǤ‡ Šƒ‹••‘ˆ Šƒ‰‡‹‡–ƒŽ‹œƒ–‹‘ of Clinical Psychology, 62 Ǧ„ƒ•‡†–”‡ƒ–‡–‘ˆ Ǥ ǡͶͳͳ–Ͷ͵ͲǤAffect regulation, mentalization, and the ‡”‰‡Ž›ǡ Ǥǡ ‘ƒ‰›ǡǤǡ —”‹•–ǡǤǡdevelopment of the self. Ƭƒ”‰‡–ǡǤȋʹͲͲʹȌǤ ‘†‘ǣƒ”ƒ ‘‘•Ǥ ”‡‡ǡǤ Ǥȋͳͻͻ͸ȌǤŠƒ–ƒ”‡–Š‡ˆ— –‹‘ƒŽ ‘•‡“—‡ ‡•‘ˆ‡—”‘ ‘‰‹–‹˜‡†‡ˆ‹ ‹–•‹American Journal Psychiatry, 153 • Š‹œ‘’Š”‡‹ƒǫ ǡ͵ʹͳ–͵ͲǤ ”‡‹‰ǡǤǤǡ”›•‘ǡ Ǥ ǤǡƬ‡ŽŽǡǤǤȋʹͲͲͶȌǤŠ‡‘”›‘ˆ‹†’‡”ˆ‘”ƒ ‡‹• Š‹œ‘’Š”‡‹ƒǣJournal of Nervous Mental Disease,†‹ƒ‰‘•–‹ ǡ•›’–‘ 192 ǡƒ†‡—”‘’•› Š‘Ž‘‰‹ ƒŽ ‘””‡Žƒ–‡•Ǥ ȋͳȌǡͳʹ–ͳͺǤ Psychosomatics, 36 ƒŽŽǡǤǤȋͳͻͻͷȌǤ Ž‘„ƒŽƒ••‡••‡–‘ˆˆ— –‹‘‹‰ǣƒ‘†‹ˆ‹‡†• ƒŽ‡Ǥ ȋ͵Ȍǡ ʹ͸͹–͹ͷǤ ‹„„ƒ”†ǡǤǡ‹– Š‡ŽŽǡǤǡƬ‘” ‡”‡ŽŽ‹ǡ ǤȋʹͲͲͳȌǤ –‡”ƒŽ ‘•‹•–‡ ›‘ˆ–Š‡‘„Œ‡ –”‡Žƒ–‹‘•ƒ†Journal of Personality •‘ ‹ƒŽ ‘‰‹–‹‘• ƒŽ‡•ˆ‘”–Š‡–Š‡ƒ–‹ ƒ’’‡” ‡’–‹‘–‡•–ǤAssessment, 77 ȋ͵ȌǡͶͲͺ–ͶͳͻǤ

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‡‘ǡǤǤǡƒŽŽ‹ ”‘†–ǡǤ ǤǡŠ—ƒ‰Ǧ–‡‹ǡǤǡ” Š‹„ƒŽ†ǡǤ Ǥǡ” Š‡”ǡ ǤǤǡƬŠƒ”–‹‡”ǡǤ ȋʹͲͲ͸ȌǤ––”‹–‹‘‹”ƒ†‘‹œ‡† ‘–”‘ŽŽ‡† Ž‹‹ ƒŽ–”‹ƒŽ•ǣ‡–Š‘†‘Ž‘‰‹ ƒŽ‹••—‡•‹Biological Psychiatry, 59 ’•› Š‘’Šƒ”ƒ ‘Ž‘‰›Ǥ ǡͳͲͲͳ–ͳͲͲͷǤ ƒ”–‡”—†ǡǤǡ‡†‡”•‡ǡ Ǥǡ‰‡ǡǤǡ ‘Šƒ•‡ǡǤǤǡ ‘Šƒ••‘ǡǤǤǡ ŠŽò–‡”ǡǤǡ‡–ƒŽǤȋʹͲͳ͵ȌǤ Š‡†Š‡”‡ ‡ƒ†‘’‡Psychotherapy Research,–‡ ‡ ƒŽ‡ȋ 23 ǦȌǣ†‡˜‡Ž‘’‡–ǡ•–”— –—”‡ƒ† ”‡Ž‹ƒ„‹Ž‹–›Ǥ ȋ͸Ȍǡ͹Ͳͷ–͹ͳ͹Ǥ ƒ›ǡǤǤǡ ‹•œ„‡‹ǡǤǡƬ’ˆ‡”ǡǤǤȋͳͻͺ͹ȌǤŠ‡’‘•‹–‹˜‡ƒ†‡‰ƒ–‹˜‡•›†”‘‡• ƒŽ‡ȋȌSchizophrenia Bulletin, 13 ˆ‘”• Š‹œ‘’Š”‡‹ƒǤ ȋʹȌǡʹ͸ͳǤ Essential papers on ‡”„‡”‰ǤǤȋͳͻͺ͸ȌǤ‘”†‡”Ž‹‡‡”•‘ƒŽ‹–›”‰ƒ‹œƒ–‹‘Ǥ ǣ–‘‡ Ǥborderline disorders: One hundred years at the border. ‡™‘”ǣ”‡••Ǥ ‹‰†‘ǡǤ Ǥǡ•Š ”‘ˆ–ǡǤǡŠƒ†ƒ”‹ǡǤǡ Ž‡‡•‘ǡǤǡƒ”‹‘‘ǡǤǡƬ›‘•ǡǤǡ‡–ƒŽǤȋʹͲͳͲȌǤ  Š‹œ‘’Š”‡‹ƒƒ†„‘”†‡”Ž‹‡’‡”•‘ƒŽ‹–›†‹•‘”†‡”ǣ•‹‹Žƒ”‹–‹‡•ƒ††‹ˆˆ‡”‡ ‡•‹–Š‡Journal of Nervous‡š’‡”‹‡ ‡‘ˆƒ—†‹–‘”›ŠƒŽŽ— ‹ƒ–‹‘•ǡ’ƒ”ƒ‘‹ƒǡƒ† Š‹Ž†Š‘‘†–”ƒ—ƒǤ and Mental Disease, 198(6 Ȍǡ͵ͻͻ–ͶͲ͵Ǥ ‘‡Ž‡ǡ ǤǤǡ—›–‡ǡǤǡ—”‡Ž‹‰•Ǧ‘–‡‘‡ǡǤ Ǥǡ‹‰—‡”ǡǤǡ‡”‘–‡ǡǤǡ‘™› ǡǤǡ‡–ƒŽǤȋʹͲͳʹȌǤ Š‡‹’ƒ –‘ˆŽ‡˜‡Ž‘ˆ’‡”•‘ƒŽ‹–›‘”‰ƒ‹œƒ–‹‘‘–”‡ƒ–‡–”‡•’‘•‡ǣ•›•–‡ƒ–‹ Psychiatry, 75 ”‡˜‹‡™Ǥ ȋͶȌǡ͵ͷͷ–͹ͶǤ ‘ŠŽ‡”ǡǤ ǤǡƒŽ‡”ǡ ǤǤǡƒ”–‹ǡǤǤǡ ‡ƒŽ›ǡǤǤǡƬ‘„‡”‰ǡǤ ǤȋʹͲͳͲȌǤ ƒ ‹ƒŽ‡‘–‹‘Schizophrenia Bulletin, 36 6 ’‡” ‡’–‹‘‹• Š‹œ‘’Š”‡‹ƒǣƒ‡–ƒǦƒƒŽ›–‹ ”‡˜‹‡™Ǥ ȋͷȌǡͳͲͻ– ͳͳͻǤ ‘•–ƒ–ƒ‘’‘—Ž‘•ǡ ǤǡŽ‘—’‹†‹•ǡǤǡ—Ž‹•ǡǤǡƒ–”‹‡Ž‹•ǡǤǡ‹‹–‘’‘—Ž‘—ǡǤǡƒ’ƒ†‹‹–”‹‘—ǡ ǤǤǡ‡–ƒŽǤȋʹͲͳͶȌǤŠ‡”‡Žƒ–‹‘•Š‹’„‡–™‡‡‹•‹‰Š–ƒ†–Š‡‘”›‘ˆ‹†‹• Š‹œ‘’Š”‡‹ƒǤSchizophrenia Research, 152 NVM, ȋͳȌǡʹͳ͹Nederlandse–ʹʹʹǤ Verkorte MMPI, handleiding, herziene versie —–‡‹Œǡ ǤǡƬ‘ǡǤǤȋͳͻͺͷȌǤ Ǥ ‹••‡ǣ™‡–•Ƭ‡‹–Ž‹‰‡”Ǥ Handbook —›–‡ǡǤǡ ‘ƒ‰›ǡǤǡ‘™› ǡǤǡof mentalizing in mental healthƬ‡”‘–‡ǡǤȋʹͲͳʹȌǤ practice ••‡••‡–‘ˆ‡–ƒŽ‹œƒ–‹‘Ǥ Ǥ’’ǤͶ͵–͸ͷǤ ›•ƒ‡”ǡǤ Ǥǡ— ǡǤǤǡƬ‹‰‡”ǡ ǤȋʹͲͲ͹ȌǤŠ‡”‡ ‘˜‡”›‘ˆ‡–ƒ ‘‰‹–‹˜‡ ƒ’ƒ ‹–›‹ • Š‹œ‘’Š”‡‹ƒƒ ”‘••͵ʹ‘–Š•‘ˆ‹†‹˜‹†—ƒŽ’•› Š‘–Š‡”ƒ’›ǣ ƒ•‡•–—†›ǤPsychotherapy Research, 17 ȋ͸Ȍǡ͹ͳ͵–͹ʹͲǤThe global burden of disease: 2004 update. ƒ–Š‡”•ǡǤǡ ƒ–ǡǤǤǡƬ‘‡”ƒǡ ǤǤȋʹͲͲͺǤȌ ‡‡˜ƒǣ ‘”Ž† ‡ƒŽ–Š”‰ƒ‹œƒ–‹‘Ǥ ‡›‡”ǡ Ǥ ǤȋʹͲͲͶȌǤŠ‡”‡Ž‹ƒ„‹Ž‹–›ƒ†˜ƒŽ‹†‹–›‘ˆ–Š‡‘”• Šƒ Šƒ†Š‡ƒ–‹ ’’‡” ‡’–‹‘‡•– ȋȌ‘’ƒ”‡†–‘‘–Š‡”•› Š‘Ž‘‰‹ ƒŽƒ†‡†‹ ƒŽ’”‘ ‡†—”‡•ǣƒƒŽ›•‹•‘ˆComprehensive handbook of psychological assessment. •›•–‡ƒ–‹ ƒŽŽ›‰ƒ–Š‡”‡†‡˜‹†‡ ‡Ǥ ‘„‘‡ǡ ǣ‹Ž‡›ƒ†‘•ǡ’’Ǥ͵ͳͷ–͵ͶʹǤ

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‹–‹ǡ ǤǡƬŠ‹ƒ‹ƒǡǤȋʹͲͲ͵ȌǤƒ––‡”•‘ˆƒ––ƒ Š‡–ƒ†–Š‡‡–‹‘Ž‘‰›‘ˆ†‹••‘ ‹ƒ–‹˜‡†‹•‘”†‡”•Journal of Trauma Practice, 2 ƒ†„‘”†‡”Ž‹‡’‡”•‘ƒŽ‹–›†‹•‘”†‡”Ǥ ȋʹȌǡͳͻ–͵ͷǤ ‹œ”ƒŠ‹ǡǤǡ‘”‘•–‹ŽǡǤǡ–ƒ”•–‡‹ǡǤǡ‹’—”•›ǡǤǤǡPsychologicalƬƒ’—”ǡǤȋʹͲͲ͹ȌǤŠ‡‡ˆˆ‡ –‘ˆ Medicine, 37 ƒ–‹’•› Š‘–‹ –”‡ƒ–‡–‘–Š‡‘”›‘ˆ‹†Ǥ ǡͷͻͷ–͸ͲͳǤ ‘Š‡”ǡǤǡ Š—ŽœǡǤ ǤǡƬŽ–ƒǡǤ ǤȋʹͲͲͳȌǤŠ‡•–ƒ–‡‡–ǣ”‡˜‹•‡† ”‡ ‘‡†ƒ–‹‘•ˆ‘”‹’”‘˜‹BMC Medical Research and‰–Š‡“—ƒŽ‹–›‘ˆ”‡’‘”–•‘ˆ’ƒ”ƒŽŽ‡Ž‰”‘—’”ƒ†‘‹œ‡† Methodology, 1 –”‹ƒŽ•Ǥ ȋͳȌǡʹǤ ‘–ƒ‰ǡǤǡ ‡‹œǡǤǡ—œǡǤƬ ƒŽŽ‹ƒ–ǡ ǤȋʹͲͲ͹ȌǤǡ‡ŽˆSchizophrenia Research, 92 Ǧ”‡’‘”–‡†‡’ƒ–Š‹ ƒ„‹Ž‹–‹‡•‹ • Š‹œ‘’Š”‡‹ƒǤ ǡͺͷ–ͺͻǤ ‘”‰ƒǡǤǤǡƬƒ•‡ǡǤǤȋʹͲͳ͵ȌǤ‘•‡”˜ƒ–‹˜‡•ƒ’Ž‡•‹œ‡†‡–‡”‹ƒ–‹‘ˆ‘””‡’‡ƒ–‡†Annals of biometrics & biostatistics, 1 ‡ƒ•—”‡•ƒƒŽ›•‹•‘ˆ ‘˜ƒ”‹ƒ ‡Ǥ ȋͳȌǤ ‘”‹–œǡǤǡƬ‘‘†™ƒ”†ǡǤǤȋʹͲͲ͹ȌǤ‡–ƒ ‘‰‹–‹˜‡–”ƒ‹‹‰‹• Š‹œ‘’Š”‡‹ƒǣˆ”‘„ƒ•‹ Current Opinion in Psychiatry, 20 ”‡•‡ƒ” Š–‘‘™Ž‡†‰‡–”ƒ•Žƒ–‹‘ƒ†‹–‡”˜‡–‹‘Ǥ ȋ͸Ȍǡ ͸ͳͻ–͸ʹͷǤ ‘”‹•›ǡǤǤǡ ”‡‡ǡǤǤǡƬ‡˜‹‡ǡǤǤȋͳͻͺ͸ȌǤ‘ —””‡–ƒ†’”‡†‹ –‹˜‡˜ƒŽ‹Medical Care, 24 †‹–›‘ˆƒ‡ŽˆǦ ‡’‘”–‡†‡ƒ•—”‡‘ˆ‡†‹ ƒ–‹‘†Š‡”‡ ‡ǤThematic Apperception Test. ȋͳȌǡ͸͹–͹ͶǤ —””ƒ›ǡ ǤǤȋͳͻͶ͵ȌǤ ƒ„”‹†‰‡ǡǣ ƒ”˜ƒ”†‹˜‡”•‹–›”‡••Ǥ ›‹Ǧ ‡”‡›•ǡ ǤǡƬ˜ƒ•ǡ Ǥǡ Š™ƒ”–œǡ ǤǤǡ–‘‡ǡǤǤǡ‡Ž‡•’ƒ—ŽǡǤǤȋʹͲArchives General Psychiatry,ͲͳȌǤ‘–‹‘ƒŽ 58 ”‡ƒ –‹˜‹–›–‘†ƒ‹Ž›Ž‹ˆ‡•–”‡••‹’•› Š‘•‹•Ǥ ǡͳͳ͵͹–ͳͳͶͶǤ ›‹Ǧ ‡”‡›•ǡ ǤǡƬ˜ƒ•ǡ ǤȋʹͲͲ͹ȌǤ–”‡••Clinical PsychologyǦ”‡ƒ –‹˜‹–›‹’•› Š‘•‹•ǣ˜‹†‡ ‡ˆ‘”ƒƒˆˆ‡ –‹˜‡ Review, 27 ’ƒ–Š™ƒ›–‘’•› Š‘•‹•Ǥ ǡͶͲͻ–ͶʹͶǤ ›‹Ǧ ‡”‡›•ǡ Ǥǡ‘”• Š‘–ǡǤǡ‘ŽŽ‹’ǡǤǡƒ–ƒ•–‡”ǡ Ǥǡ‡Ž‡•’ƒ—ŽǡǤǡƬ˜ƒ•ǡ ǤȋʹͲͲͻȌǤ š’‡”‹‡ ‡•ƒ’Ž‹‰”‡•‡ƒ” Š‹’•› Š‘’ƒ–Š‘Ž‘‰›ǣ‘’‡‹‰–Š‡„Žƒ „‘š‘ˆ†ƒ‹Ž›Ž‹ˆ‡ǤPsychological Medicine, 39 ȋͲͻȌǡͳͷ͵͵–ͳͷͶ͹Ǥ ‡–Œ‡•ǡǤǡ‡‹Œ‡”ǡǤǡ‡”•–‡‹ǡǤǡ”–œǡǤǡƬ‡†‡†‘”’ǡǤȋʹͲͳ͵ȌǤ”‹‡ˆ‘—‹ ƒ–‹‘ǣ ˜‡•–‹‰ƒ–‹‰–Š‡Journal of Personality‡Žƒ–‹‘•Š‹’‡–™‡‡•› Š‘’ƒ–Š›ƒ† –‡”‘ ‡’–‹˜‡™ƒ”‡‡••Ǥ Disorders, 27 ȋͷȌǡ͸ͳ͹–ʹͶǤ ‘•±ǡǤǡƒ”„—‹ǡǤǡƬƒ•‡ŽŽƒǡǤȋʹͲͲ͵ȌǤ ‘™‘ˆ–‡†‘’ƒ–‹‡–•™‹–Š’•› Š‘•‹•ˆƒ‹Ž–‘ƒ†Š‡”‡–‘Psychological Medicine, 33 –”‡ƒ–‡–’”‘‰”ƒ‡•ǫ•›•–‡ƒ–‹ ”‡˜‹‡™Ǥ ȋͲ͹ȌǡͳͳͶͻ– ͳͳ͸ͲǤ ‡”Ž‹ ǡǤǡ–ƒ•–›ǡǤǡƒ––‹•ǡǤǡƬ‡”‡•‹ǡ ǤȋͳͻͻʹȌǤ‘–”‹„—–‹‘‘ˆˆƒ‹Ž›ǡ ‘‰‹–‹˜‡ƒ† Ž‹‹Schizophrenia Research, 6, ƒŽ †‹‡•‹‘•–‘Ž‘‰Ǧ–‡”‘—– ‘‡‹• Š‹œ‘’Š”‡‹ƒǤ ʹͷ͹–͸ͷǤ ‹ŠƒǡǤǤǡ‡ǡǤǤǡ ”‡‡ǡǤ ǤǡƬ ƒ”˜‡›ǡǤǤȋʹͲͳͷȌǤ‘ ‹ƒŽ ‘‰‹–‹‘’•› Š‘‡–”‹ Schizophrenia Bulletin ‡˜ƒŽ—ƒ–‹‘ǣ‡•—Ž–•‘ˆ–Š‡‹‹–‹ƒŽ’•› Š‘‡–”‹ •–—†›Ǥ ǡ†‘‹ǣ ͳͲǤͳͲͻ͵Ȁ• Š„—ŽȀ•„˜Ͳͷ͸Ǥ

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”‡ƒ Š‡”ǡǤ ǤǡƬ ƒ›‡•ǡǤ ǤȋʹͲͲͶȌǤƒ†’”‘ ‡†—”‡•ˆ‘”‡•–‹ƒ–‹‰‹†‹”‡ –‡ˆˆ‡ –•‹Behavior Research Methods, Instruments and Computers, 36 •‹’Ž‡‡†‹ƒ–‹‘‘†‡Ž•Ǥ ȋͶȌǡ ͹ͳ͹–͹͵ͳǤ ”‡ƒ Š‡”ǡǤǡƬ ƒ›‡•ǡǤȋʹͲͳ͵ȌǤ –”‘†— –‹‘–‘‡†‹ƒ–‹‘ǡ‘†‡”ƒ–‹‘ǡƒ† ‘†‹–‹‘ƒŽ’”‘ ‡•• ƒƒŽ›•‹•ǣ”‡‰”‡••‹‘Ǧ„ƒ•‡†ƒ’’”‘ƒ ŠǤ‡™‘”ǣ —‹Žˆ‘”†”‡••Ǣ ”‹‡„‡ǡǤǡ —šŽ‡›ǡǤǡ‹‰Š–ǡǤǡƬ˜ƒ•ǡǤȋͳͻͻͻȌǤ’’Ž‹ ƒ–‹‘ƒ†”‡•—Ž–•‘ˆ–Š‡ƒ Š‡•–‡”). International Journal of Social Psychiatry, Š‘”–••‡••‡–‘ˆ—ƒŽ‹–›45 ‘ˆ‹ˆ‡ȋ ȋͳȌǡ͹–ͳʹǤ ‘„‡”–•ǡǤǤǡƬ‡ǡǤǤȋʹͲͲͻȌǤ‘ ‹ƒŽ ‘‰‹–‹‘ƒ†‹–‡”ƒ –‹‘–”ƒ‹‹‰ȋ Ȍˆ‘”Psychiatry Research, 166 ‘—–’ƒ–‹‡–•™‹–Š• Š‹œ‘’Š”‡‹ƒǣ’”‡Ž‹‹ƒ”›•–—†›Ǥ ǡͳͶͳ–ͳͶ͹Ǥ ‘ ŠƒǡǤǤǡƬ—‡‹”וǡǤȋʹͲͳ͵ȌǤ‡–ƒ ‘‰‹–‹˜‡ƒ†•‘ ‹ƒŽ ‘‰‹–‹‘–”ƒ‹‹‰ȋȌ‹Schizophrenia Research, 150 • Š‹œ‘’Š”‡‹ƒǣƒ’”‡Ž‹‹ƒ”›‡ˆˆ‹ ƒ ›•–—†›Ǥ ȋͳȌǡ͸Ͷ–͸ͺǤ ‘•‡„ƒ—ǡǤǡƒŽ„ƒǡǤǡ ƒ”†‡”ǡǤǡ—†•‡ǡǤǡޕ–‡”ǡǤǡƒŒ‡”ǡǤǡ‡–ƒŽǤȋʹͲͲ͸ȌǤ”‡ƒ–‡– ‘ˆ’ƒ–‹‡–•™‹–Šˆ‹”•–Ǧ‡’‹•‘†‡’•› Š‘•‹•ǣ–™‘World Psychiatry,Ǧ›‡ƒ”‘—– ‘‡†ƒ–ƒˆ”‘–Š‡ƒ‹•Š 5 ƒ–‹‘ƒŽ Š‹œ‘’Š”‡‹ƒ’”‘Œ‡ –Ǥ ȋʹȌǡͳͲͲ–ͳͲ͵Ǥ ‘•‡„ƒ—ǡǤǡ ƒ”†‡”ǡǤǡ—†•‡ǡǤǡޕ–‡”ǡǤǡ‹†Šƒ”†–ǡǤǡƒŒ‡”ǡǤǡ‡–ƒŽǤȋʹͲͳʹȌǤ —’’‘”–‹˜‡’•› Š‘†›ƒ‹ ’•› Š‘–Š‡”ƒ’›˜‡”•—•–”‡ƒ–‡–ƒ•—•—ƒŽˆ‘”ˆ‹”•–Psychiatry, 75 Ǧ‡’‹•‘†‡ ’•› Š‘•‹•ǣ–™‘Ǧ›‡ƒ”‘—– ‘‡Ǥ StatiȋͶȌǡ͵͵ͳstical– ͵ͶͳǤMethods in Medical Research, 8 6  Šƒˆ‡”ǡ ǤǤȋͳͻͻͻȌǤ—Ž–‹’Ž‡‹’—–ƒ–‹‘ǣƒ’”‹‡”Ǥ ȋͳȌǡ ͵–ͳͷǤ ‡”‰‹ǡǤ Ǥǡƒ••‘˜•›ǡǤǡ‹†ƒ”ǡǤǡ‡‹•–ǡǤǡ”Šƒ”–ǡǤǡ”ƒˆˆǡǤǤǡ‡–ƒŽǤȋʹͲͲ͹ȌǤ‘ ‹ƒŽ ‘‰‹–‹‘‹• Š‹œ‘’Š”‡‹ƒǣ”‡Žƒ–‹‘•Š‹’•™‹–Š‡—”‘ ‘‰‹–‹‘ƒ†‡‰ƒ–‹˜‡•›’–‘•ǤSchizophrenia Research, 90 ȋͳȌǡ͵ͳ͸–ʹͶǤ Šƒ”’ǡǤǡƒ‡ǡ Ǥǡ ƒǡǤǡ‡–ƒǡǤǡƒ–‡ŽǡǤǤǡ–—”‡ǡ Ǥǡ‡–ƒŽǤȋʹͲͳͳȌǤŠ‡‘”›‘ˆ‹†ƒ†Journal of the ‡‘–‹‘ǣ”‡‰—Žƒ–‹‘†‹ˆˆ‹ —Ž–‹‡•‹ƒ†‘Ž‡• ‡–•™‹–Š„‘”†‡”Ž‹‡–”ƒ‹–•ǤAmerican Academy of Child and Adolescent Psychiatry, 50 ȋ͸Ȍǡͷ͸͵Gedachten–ͷ͹ͶǤ uitpluizen: ˜ƒ†‡” ƒƒ‰ǡǤǡƒŽƒ‰‰‹ƒVaardigheden oefenboek.ǡǤǤǡ˜ƒ‡‡”ǡǤǤǡ Cognitieve gedragstherapieƬŽ‘‘ˆˆǡǤ ǤȋʹͲͲͷȌǤ bij achterdocht en stemmen.  ‡‰•–‰‡‡•–ǣ–‹ Š–‹‰‘‰‹–‹‡‡•› Š‘•‡Ǥ CBT for Those at Risk of a First Episode ˜ƒ†‡” ƒƒ‰ǡǤǡ‹‡ƒǡǤǡPsychosis: Evidence-basedƬƒ†‡‡”‰ǡǤȋʹͲͳ͵ȌǤ Psychotherapy for People with an ' at Risk Mental State. ‡™ ‘”ǣ‘—–Ž‡†‰‡Ǥ ƒ”‡•‡ǡ Ǥǡ‡‡–•ǡ Ǥǡ”—‡”ǡǤǡ‹‡˜‡”•‡ǡǤǡƒ–ƒ•–‡”ǡǤǡ‹‡ Š–„ƒ—‡”ǡǤǡ‡–ƒŽǤȋʹͲͳʹȌǤ Š‹Ž†Š‘‘†ƒ†˜‡”•‹–‹‡•‹ ”‡ƒ•‡–Š‡”‹•‘ˆ’•› Š‘•‹•ǣƒ‡–ƒSchizophreniaǦƒƒŽ›•‹•‘ˆ’ƒ–‹‡– Bulletin, 38 Ǧ ‘–”‘Žǡ ’”‘•’‡ –‹˜‡Ǧƒ† ”‘••Ǧ•‡ –‹‘ƒŽ ‘Š‘”–•–—†‹‡•Ǥ ǡ͸͸ͳ–͸͹ͳǤ

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Journal of Personality

‡•–‡ǡǤȋͳͻͻͳȌǤŽ‹‹ ƒŽƒ••‡••‡–‘ˆ‘„Œ‡ –”‡Žƒ–‹‘•—•‹‰–Š‡ǤAssessment, 56 ǡͷ͸–͹ͶǤ ‘Ž–Šƒ—•ǡ ǤǤǡ‹‰‡ƒ•ǡǤǤǡƬ Š‡‡ǡǤ ǤȋʹͲͲͲȌǤ‘’‘‡–•–”— –—”‡‘ˆ–Š‡‘•‹–‹˜‡ƒ† ‡‰ƒ–‹˜‡›†”‘‡ ƒŽ‡ȋȌ‹’ƒ–‹‡–•™‹–Š”‡ ‡–‘•‡–• Š‹œ‘’Š”‡‹ƒƒ†Psychopharmacology, 150 •’‡ –”—†‹•‘”†‡”•Ǥ ǡ͵ͻͻ–ͶͲ͵Ǥ ‡‡ǡǤǡ‘”‡”ǡǤ Ǥǡ ™‹‰‰ƒǡǤǡ‡ƒ”‡•ǡǤǤǡComprehensiveƬ–‡˜‡•‘ǡ ǤȋʹͲͲͷȌǤ‡”•‹•–‡–ŠƒŽŽ— ‹‘•‹•‹ Psychiatry, 46 „‘”†‡”Ž‹‡’‡”•‘ƒŽ‹–›†‹•‘”†‡”Ǥ ȋʹȌǡͳͶ͹–ͳͷͶǤ                

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Chapter Seven:

‡–ƒŽ‹œƒ–‹‘„ƒ•‡†–”‡ƒ–‡–ˆ‘”’•› Š‘–‹ †‹•‘”†‡”ǣƒ Psychological Medicine (2020) ”ƒ–‡”Ǧ„Ž‹†‡†ǡ—Ž–‹Ǧ ‡–‡”ǡ”ƒ†‘‹œ‡† ‘–”‘ŽŽ‡†–”‹ƒŽǤ J.MENTALIZATION Weijers 1,2**; C. ten Kate1; W. Viechtbauer2; L.J.A. Rampaart BASED1; E.H.M. Eurelings3*; J.P. Selten1,2

TREATMENT FOR PSYCHOTIC DISORDER: A RATER-BLINDED, MULTI-CENTER, RANDOMIZED CONTROLLED TRIAL 7

ͳ ‹˜‹‡”†—‹‡ •–‹–—–‡ˆ‘”‡–ƒŽ ‡ƒŽ–Šƒ”‡ǡ–Š‡‡–Š‡”Žƒ†• ʹ   Š‘‘Žˆ‘”‡–ƒŽ ‡ƒŽ–Šƒ†‡—”‘• ‹‡ ‡ǡƒƒ•–”‹ Š–‹˜‡”•‹–›ǡ–Š‡‡–Š‡”Žƒ†•Ǥ ͵ J.‡’ƒ”–‡–‘ˆŽ‹‹ ƒŽ•› Š‘Ž‘‰›ǡ ‡ƒŽ–Šǡƒ†‡—” G. Weijers, C. ten Kate, W.V. Viechtbauer,‘’•› Š‘Ž‘‰›ǡ‡‹†‡‹˜‡”•‹–› ǡ–Š‡‡–Š‡”Žƒ†•Ǥ ‘–Š ƒ†  ‘–”‹„—–‡†‡“—ƒŽŽ›–‘–Š‡ƒ—• ”‹’– ȗȗL.J.A. Rampaart, E.H.M. Eurelings-Bontekoe, J.-P. C.J. Selten ‘””‡•’‘†‹‰ƒ—–Š‘”ǣ ‘ƒ•‡‹Œ‡”•Ǥƒ‹Žƒ††”‡••ǣŒǤ™‡‹Œ‡”•̷”‹˜‹‡”†—‹‡ǤŽǤ   Psychological Medicine (2020) Chapter Chapter 

146807_JonasWeijers_BNW_def.indd 133 28-10-2020 15:08 Chapter Seven

Abstract Background.

 ’ƒ‹”‡†‡–ƒŽ‹œ‹‰ƒ„‹Ž‹–›–ƒ‹’ƒ‹”‡†ƒ„‹Ž‹–›–‘—†‡”•–ƒ†‘‡̵•‘™ƒ† ‘–Š‡”’‡‘’Ž‡̵•„‡Šƒ˜‹‘”‹–‡”•‘ˆ‡–ƒŽ•–ƒ–‡•–‹•ƒ••‘ ‹ƒ–‡†™‹–Š•‘ ‹ƒŽ†›•ˆ— –‹‘‹‘Ǧ ƒˆˆ‡ –‹˜‡’•› Š‘–‹ †‹•‘”†‡”ȋȌǤ‡–‡•–‡†™Š‡–Š‡”ƒ††‹‰‡–ƒŽ‹œƒ–‹‘ƒ•‡†”‡ƒ–‡– ˆ‘”•› Š‘–‹ †‹•‘”†‡”ȋ’Ȍ–‘–”‡ƒ–‡–ƒ•—•—ƒŽȋȌ”‡•—Ž–•‹‰”‡ƒ–‡”‹’”‘˜‡‡–‹ •‘ ‹ƒŽˆ— –‹‘‹‰ǤMethods.  —Ž–‹ ‡–‡”ǡ”ƒ–‡”Ǧ„Ž‹†‡†ǡ”ƒ†‘‹œ‡† ‘–”‘ŽŽ‡†–”‹ƒŽǤ‹‰Š–›Ǧˆ‘—”’ƒ–‹‡–•™‹–Š ™‡”‡ƒ••‹‰‡†–‘‘”’’Ž—•Ǥƒ–‹‡–•‹–Š‡’‰”‘—’”‡ ‡‹˜‡†ͳͺ‘–Š• ‘ˆ’ǡ ‘•‹•–‹‰‘ˆ™‡‡Ž›‰”‘—’•‡••‹‘•ƒ†‘‡‹†‹˜‹†—ƒŽ•‡••‹‘’‡”–™‘™‡‡•Ǥ‘ ‹ƒŽ ˆ— –‹‘‹‰™ƒ•‡ƒ•—”‡†—•‹‰–Š‡‘ ‹ƒŽ — –‹‘‹‰ ƒŽ‡Ǥ‡ ‘†— –‡†•–‘ ‡šƒ‹‡–Š‡†‹ˆˆ‡”‡ ‡„‡–™‡‡–”‡ƒ–‡– ‘†‹–‹‘•†‹”‡ –Ž›ƒˆ–‡”–”‡ƒ–‡–ƒ†ƒ–͸Ǧ‘–Š ˆ‘ŽŽ‘™Results.Ǧ—’ƒ†’‡”ˆ‘”‡†‘†‡”ƒ–‹‘ƒ†‡†‹ƒ–‹‘ƒƒŽ›•‡•Ǥ  –‡–‹‘p Ǧ–‘Ǧ–”‡ƒ–ƒƒŽ›•‡••Š‘™‡†‘•‹‰‹ˆ‹ ƒ–†‹ˆˆ‡”‡ ‡•„‡–™‡‡‰”‘—’•’‘•–p Ǧ –”‡ƒ–‡–ȋ αǤ͵ͳȌ„—–”‡˜‡ƒŽ‡†–Š‡’Ǧ‰”‘—’–‘„‡•—’‡”‹‘”–‘ƒ–ˆ‘ŽŽ‘™Ǧ—’ȋ αǤͲ͵ȌǤ ƒ–‹‡–•‹–Š‡’‰”‘—’ƒŽ•‘•‡‡‡†–‘’‡”ˆ‘”„‡––‡”‘‡ƒ•—”‡•‘ˆ‡–ƒŽ‹œ‹‰ƒ„‹Ž‹–›ǡp ƒŽ–Š‘—‰Š‡˜‹†‡ ‡‘ˆƒ‡†‹ƒ–‹‘‡ˆˆ‡ –™ƒ•Ž‹‹–‡†ȋ αǤͲ͸ȌǤƒ•–Ž›ǡ’–”‡ƒ–‡–™ƒ•Ž‡••p ‡ˆˆ‡ –‹˜‡‹ Š”‘‹ ’ƒ–‹‡–•–Šƒ‹”‡ ‡–‘•‡–’ƒ–‹‡–•ȋ αǤͲͶͻȌƒ†‘˜‡”ƒŽŽ•›’–‘•ƒ– „ƒ•‡Ž‹‡™‡”‡‹Ž†ǡ™Š‹ Šƒ›Šƒ˜‡”‡†— ‡†‘˜‡”ƒŽŽ‡ˆˆ‡ –‹˜‡‡••‘ˆ–Š‡‹–‡”˜‡–‹‘ǤConclusion.  Š‡”‡•—Ž–••—‰‰‡•––Šƒ–’’Ž—•ƒ›Ž‡ƒ†–‘‘”‡”‘„—•–‹’”‘˜‡‡–•‹ •‘ ‹ƒŽˆ— –‹‘‹‰ ‘’ƒ”‡†–‘ǡ‡•’‡ ‹ƒŽŽ›ˆ‘”’ƒ–‹‡–•™‹–Šƒ”‡ ‡–‘•‡–‘ˆ’•› Š‘•‹•Ǥ Introduction

‘Ǧƒˆˆ‡ –‹˜‡’•› Š‘–‹ †‹•‘”†‡”ȋȌ‹•‘ˆ–‡ƒ ‘’ƒ‹‡†„›ƒ•‹‰‹ˆ‹ ƒ–”‡†— –‹‘‹ •‘ ‹ƒŽˆ— –‹‘‹‰ǡ–Š‡ ƒ—•‡•‘ˆ™Š‹ Šƒ”‡•–‹ŽŽ’‘‘”Ž›—†‡”•–‘‘†Ǥ ’ƒ‹”‡†‡–ƒŽ‹œ‹‰ǡ †‡ˆ‹‡†ƒ•–Š‡‹ƒ‰‹ƒ–‹˜‡‡–ƒŽƒ –‹˜‹–›–Šƒ–Ž‡–•—•’‡” ‡‹˜‡ƒ†‹–‡”’”‡–Š—ƒ„‡Šƒ˜‹‘”‹ –‡”•‘ˆ‹–‡–‹‘ƒŽ‡–ƒŽ•–ƒ–‡•ȋƒ–‡ƒƬ ‘ƒ‰›ǡʹͲͲͶȌ–‹•ƒ’‘–‡–‹ƒŽ ƒ†‹†ƒ–‡Ǥ‡ˆ‹ ‹–• ‹•‡˜‡”ƒŽ†‹‡•‹‘•‘ˆ‡–ƒŽ‹œ‹‰Šƒ˜‡„‡‡™‹†‡Ž›‘„•‡”˜‡†‹ǡ•— Šƒ•ƒ‹’ƒ‹”‡† ability to infer others’ mental states, i.e. ‘Theory of Mind’ (Sprong et al., 2007; Bechi et al., 2020), ƒ†–‘identify and describe one’s own and others’ emotional states (O’Driscoll, Laing & Mason, ʹͲͳͶǢ”±‡ƒ—ǡʹͲͲ͸Ǣ‘ŠŽ‡”ǡƒŽ‡”ǡƒ”–‹ǡ ‡ƒŽ›ǡ‘„‡”‰ǡʹͲͳͲȌǤ‡š––‘‡–ƒŽ‹œ‹‰ ‹’ƒ‹”‡–•ȋ•‡‡ ‡––‡–ƒŽǤʹͲͳͳˆ‘”ƒ‘˜‡”˜‹‡™Ȍǡ‹’ƒ‹”‡†‡–ƒ ‘‰‹–‹‘ǡƒ ‘•–”— –Žƒ”‰‡Ž› ‘˜‡”Žƒ’’‹‰™‹–Š‡–ƒŽ‹œƒ–‹‘ǡŠƒ•ƒŽ•‘„‡‡‹†‡–‹ˆ‹‡†ƒ•ƒƒŒ‘” ‘–”‹„—–‘”–‘•‘ ‹ƒŽ †›•ˆ— –‹‘ȋ‡Ǥ‰Ǥǡ•‡‡”‘Ǧ‹„‡ˆ‡Ž†ʹͲͳ͹ˆ‘”ƒ‘˜‡”˜‹‡™Ǣ ƒ‰‡‡–ƒŽǤǡʹͲͳͻǢ”Ú ‡”‡–ƒŽǤǡ ʹͲʹͲȌǡ’ƒ”–‹ —Žƒ”Ž›†‡ˆ‹ ‹–•‹•’‡ ‹ˆ‹ •—„Ǧ ‘’‘‡–•‘ˆ‡–ƒǦ ‘‰‹–‹‘•— Šƒ•‡’ƒ–Š‹  ’‡”•’‡ –‹˜‡–ƒ‹‰ƒ†•‡ŽˆǦ”‡ˆŽ‡ –‹˜‹–›ȋ•‡‡”ò‡ǡ›•ƒ‡”ƒ†‹ƒ‰‰‹‘ǡʹͲͳͳˆ‘”ƒ”‡˜‹‡™ȌǤ

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‡–ƒŽ‹œƒ–‹‘ƒ•‡†”‡ƒ–‡–ȋȌ‹•ƒ‡˜‹†‡ ‡Ǧ„ƒ•‡†–”‡ƒ–‡–ˆ‘”‘”†‡”Ž‹‡ ‡”•‘ƒŽ‹–›‹•‘”†‡”ȋƒ–‡ƒƬ ‘ƒ‰›ǡͳͻͻͻȌǡƒ••‘ ‹ƒ–‡†™‹–ŠƒŽ‘‰ǦŽƒ•–‹‰†‡ ”‡ƒ•‡‘ˆ †‡’”‡••‹˜‡•›’–‘•ǡ•—‹ ‹†ƒŽƒ†’ƒ”ƒǦ•—‹ ‹†ƒŽ„‡Šƒ˜‹‘”ǡ—„‡”‘ˆ†ƒ›•Š‘•’‹–ƒŽ‹œ‡†ƒ† ‹’”‘˜‡‡–•‹•‘ ‹ƒŽƒ†‹–‡”’‡”•‘ƒŽˆ— –‹‘‹‰Ǥ –‡”‡•–‹‰Ž›ǡƒ–‡ƒƒ† ‘ƒ‰› ȋʹͲͲͳǢʹͲͲͺȌˆ‘—†–Šƒ––”‡ƒ–‡–‡ˆˆ‡ –•Šƒ†ˆ—”–Š‡”‹ ”‡ƒ•‡†„‘–Šƒ–ͳͺ‘–Š•ƒ†ˆ‹˜‡ ›‡ƒ”•ƒˆ–‡”–”‡ƒ–‡––‡”‹ƒ–‹‘Ǥƒ–‡”•–—†‹‡•ƒŽ•‘”‡˜‡ƒŽ‡†–Šƒ– ƒ‹’”‘˜‡ ‡–ƒŽ‹œ‹‰ȋ‘••‘—™‡–ƒŽǤʹͲͳʹǢ†‡‡—Ž‡‡‡•–‡”‡–ƒŽǤǡʹͲͳͺȌǤŠ‹•Šƒ••’ƒ”‡†‹–‡”‡•–‹ ƒ•ƒ–”‡ƒ–‡–ˆ‘”ȋ”‡–Ƭ ‘ƒ‰›ǡʹͲͳͶǢ‡‹Œ‡”•‡–ƒŽǤǡʹͲͳ͸Ǣ‡‹Œ‡”•‡–ƒŽǤǡʹͲʹͲȌ ƒ†‹–•’”‘†”‘ƒŽ•–ƒ–‡•ȋ‡„„ƒ±‡–ƒŽǤǡʹͲͳ͸ȌǤ Š‡ —””‡–•–—†›‹•ƒ”ƒ†‘‹œ‡†ǡ ‘–”‘ŽŽ‡†–”‹ƒŽ‡šƒ‹‹‰™Š‡–Š‡”’ƒ–‹‡–•™Š‘ ”‡ ‡‹˜‡‡–ƒŽ‹œƒ–‹‘„ƒ•‡†–”‡ƒ–‡–ˆ‘”’•› Š‘–‹ †‹•‘”†‡”ȋ’Ȍ•Š‘™ƒ‰”‡ƒ–‡” ‹’”‘˜‡‡–‹•‘ ‹ƒŽˆ— –‹‘‹‰–Šƒ’ƒ–‹‡–•™Š‘”‡ ‡‹˜‡–”‡ƒ–‡–ƒ•—•—ƒŽȋȌ‘Ž›Ǥ ˆ •‘ǡ™‡Š›’‘–Š‡•‹œ‡†–Šƒ––Š‡‡ˆˆ‡ –‘ˆ’‘•‘ ‹ƒŽˆ— –‹‘‹‰™ƒ•ƒ–Ž‡ƒ•–’ƒ”–‹ƒŽŽ›‡†‹ƒ–‡† „›‡–ƒŽ‹œ‹‰ƒ„‹Ž‹–›Ǥ††‹–‹‘ƒŽŽ›ǡ’ƒ–‹‡–•™Š‘”‡ ‡‹˜‡’™‡”‡‡š’‡ –‡†–‘ˆƒ”‡„‡––‡”‘ –Š‡ˆ‘ŽŽ‘™‹‰‘—– ‘‡•ǣ“—ƒŽ‹–›‘ˆŽ‹ˆ‡Ǣ’‘•‹–‹˜‡ǡ‡‰ƒ–‹˜‡ǡƒš‹‘—•ǡƒ††‡’”‡••‹˜‡•›’–‘•Ǣ ‹•‹‰Š–Ǣ†”—‰—•‡Ǣ’•› Š‘–‹ ‡š’‡”‹‡ ‡•Ǣ‡‰ƒ–‹˜‡ƒ†’‘•‹–‹˜‡ƒˆˆ‡ –Ǣ•‘ ‹ƒŽ•–”‡••Ǣƒ†•‘ ‹ƒŽ •–”‡••”‡ƒ –‹˜‹–›ȋ‹Ǥ‡Ǥǡ–Š‡ƒˆˆ‡ –‹˜‡ƒ†’•› Š‘–‹ ”‡ƒ –‹‘–‘•‘ ‹ƒŽ•–”‡••ȌǤ  Methods

’”‘–‘ ‘Žˆ‘”–Š‹••–—†›™ƒ•”‡‰‹•–‡”‡†’”‹‘”–‘‹’Ž‡‡–ƒ–‹‘‘ˆ–Š‡•–—†›ȋ—– Š”‹ƒŽ ‡‰‹•–‡”ǣ”‹ƒŽͶͷͺͺȌǡƒ’’”‘˜‡†„›–Š‡‡†‹ ƒŽ–Š‹ •‘‹––‡‡‘ˆƒƒ•–”‹ Š–‹˜‡”•‹–› 7 ƒ†’—„Ž‹•Š‡†ǤŠ‡’”‡•‡–’ƒ’‡”’”‘˜‹†‡•‡••‡–‹ƒŽ‹ˆ‘”ƒ–‹‘‘Ž›Ǥ‡‡–Š‡•—’’Ž‡‡–ƒŽet al. ƒ–‡”‹ƒŽƒ†‡‹Œ‡”•Participants and procedure.ȋʹͲͳ͸Ȍˆ‘”‘”‡†‡–ƒ‹Ž•Ǥ  Ž‹‹ ‹ƒ•‘ˆ ‘—‹–›–”‡ƒ–‡––‡ƒ•ƒ––™‘‡–ƒŽ Š‡ƒŽ–Š ƒ”‡ˆƒ ‹Ž‹–‹‡•‹–Š‡‡–Š‡”Žƒ†•ȋ ‹˜‹‡”†—‹‡ƒ†Ž–”‡ Š–Ȍ• ƒ‡†–Š‡‹” ƒ•‡Ž‘ƒ†•ˆ‘”’ƒ–‹‡–•‡Ž‹‰‹„Ž‡–‘’ƒ”–‹ ‹’ƒ–‡Ǥ  Ž—•‹‘ ”‹–‡”‹ƒ™‡”‡ǣƒ–Ž‡ƒ•–͸‘–Š•ǡ„—–‘ ‘”‡–ŠƒͳͲ›‡ƒ”•‘ˆ–”‡ƒ–‡–ˆ‘”Ǣ„‡–™‡‡ͳͺƒ†ͷͷ›‡ƒ”•‘ˆƒ‰‡Ǥš Ž—•‹‘ ”‹–‡”‹ƒ ™‡”‡ǣ‹–‡ŽŽ‡ –—ƒŽ†‹•ƒ„‹Ž‹–›ƒ†Ȁ‘”‹ŽŽ‹–‡”ƒ ›Ǣ‹•—ˆˆ‹ ‹‡–‘™Ž‡†‰‡‘ˆ–Š‡—– ŠŽƒ‰—ƒ‰‡Ǣ ƒ††‹ –‹‘–‘•— Šƒ‡š–‡––Šƒ–‹–‡ ‡••‹–ƒ–‡†‹’ƒ–‹‡–†‡–‘š‹ˆ‹ ƒ–‹‘Ǥn  Ž‹‰‹„Ž‡’ƒ–‹‡–•ȋ αͳ͸ʹȌ”‡ ‡‹˜‡†™”‹––‡‹ˆ‘”ƒ–‹‘ƒ„‘—––Š‡–”‹ƒŽƒ†™‡”‡‰‹˜‡ ƒ–Ž‡ƒ•–•‡˜‡†ƒ›•–‘†‡ ‹†‡™Š‡–Š‡”–‘’ƒ”–‹ ‹’ƒ–‡Ǥˆ–‡”–Š‡„ƒ•‡Ž‹‡‡ƒ•—”‡‡–•ǡƒ ‹†‡’‡†‡–”‡•‡ƒ” Š ‘‘”†‹ƒ–‘””ƒ†‘Ž›ƒ••‹‰‡†–Š‡’ƒ–‹‡–•–‘‡‹–Š‡”–Š‡ ‘†‹–‹‘ ‘”–Š‡’Ž—•’ ‘†‹–‹‘ǤŠ‡ƒ—–Š‘”•ƒ†’ƒ–‹‡–•™‡”‡ƒ™ƒ”‡‘ˆ–”‡ƒ–‡–ƒŽŽ‘ ƒ–‹‘ǡ „—––Š‡”ƒ–‡”•™‡”‡„Ž‹†–‘–Š‹•Ǥ‡ˆ‘”‡‡ƒ Š‡ƒ•—”‡‡–ǡ’ƒ–‹‡–•™‡”‡‹•–”— –‡†‘––‘ ”‡˜‡ƒŽ–Š‡–”‡ƒ–‡– ‘†‹–‹‘–Š‡›™‡”‡”ƒ†‘‹œ‡†–‘Ǥ ˆ”ƒ–‡”„Ž‹†‡•••–‹ŽŽ™ƒ•„”‘‡ǡˆ‘” ‡šƒ’Ž‡„‡ ƒ—•‡–Š‡’ƒ”–‹ ‹’ƒ–‹••’‘‡ǡ–Š‡ƒ••‡••‡–™ƒ•ƒ„‘”–‡†ƒ†–ƒ‡‘˜‡”„›

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another investigator blind to the patient’s treatment allocation. In three cases blindness was „”‘‡ƒ†‡ƒ•—”‡‡–•™‡”‡–ƒ‡‘˜‡”–‘ƒ•‡ ‘†”‡•‡ƒ” Šƒ••‹•–ƒ–™Š‘•–‹ŽŽ™ƒ•„Ž‹†–‘ –”‡ƒ–‡– ‘†‹–‹‘ǤŽŽ’ƒ–‹‡–•™‡”‡†‹ƒ‰‘•‡†ƒ ‘”†‹‰–‘Ǧ  ”‹–‡”‹ƒȋǡʹͲͲͲȌ„›ƒ ’•› Š‹ƒ–”‹•–’”‹‘”–‘’ƒ”–‹ ‹’ƒ–‹‘ǤŠ‹•†‹ƒ‰‘•‹•™ƒ•ƒŽ•‘˜‡”‹ˆ‹‡†„›”‡•‡ƒ” Šƒ••‹•–ƒ–•—•‹‰ –Š‡‘’”Randomization,‡Š‡•‹˜‡••‡••‡–‘ˆ›’–‘•ƒ† ‹•–‘”›ȋ Ǣ†”‡ƒ•‡‡–ƒŽǤǡͳͻͺʹǤȌ treatment allocation and rater blindness:  ƒ–‹‡–•™‡”‡ƒ••‹‰‡†ƒ– ”ƒ†‘–‘’Ž—•’‘”„›ƒ‹†‡’‡†‡–”‡•‡ƒ” Š ‘‘”†‹ƒ–‘”Ǥƒ†‘‹œƒ–‹‘ ˆ‘ŽŽ‘™‡† ‘•‡–ǡ‡”‘ŽŽ‡–ƒ†„ƒ•‡Ž‹‡ƒ••‡••‡–„›–Š‡Ž‘ ƒŽ”‡•‡ƒ” Šƒ••‹•–ƒ–Ǥ•‹‰ƒ ‘‹–‘••ǡ‡ƒ Š–‹‡–™‘’ƒ–‹‡–•™‡”‡•‹—Ž–ƒ‡‘—•Ž›”ƒ†‘‹œ‡†ƒ†ƒŽŽ‘ ƒ–‡†–‘–”‡ƒ–‡– ‘†‹–‹‘ǤŠ‡‹˜‡•–‹‰ƒ–‘”‹ˆ‘”‡†’ƒ–‹‡–•‘ˆ–Š‡‹”ƒ••‹‰‡–Ǥ•‹–™ƒ•‹’‘”–ƒ––Šƒ––Š‡ ”‡•‡ƒ” Šƒ••‹•–ƒ–•™Š‘’‡”ˆ‘”‡†ˆ‘ŽŽ‘™Ǧ—’‡ƒ•—”‡‡–•”‡ƒ‹‡†„Ž‹†–‘–”‡ƒ–‡– allocation, they were not informed of the participants’ allocation and participants were ‹•–”— –‡†‘––‘”‡˜‡ƒŽ™Šƒ– ‘†‹–‹‘–Š‡›™‡”‡ƒŽŽ‘ ƒ–‡†–‘Ǥ ˆ”ƒ–‡”„Ž‹†‡••™ƒ•„”‘‡ǡˆ‘” ‡šƒ’Ž‡„‡ ƒ—•‡ƒ’ƒ”–‹ ‹’ƒ–‹••’‘‡ǡ–Š‡”‡•‡ƒ” Šƒ••‹•–ƒ–™ƒ•‹•–”— –‡†–‘•–‘’–Š‡ ƒ••‡••‡–ǤŠ‡‡–‹”‡ƒ••‡••‡–™ƒ•–Š‡”‡†‘‡„›ƒ•‡ ‘†”‡•‡ƒ” Šƒ••‹•–ƒ–ǤTherapy.  Treatment as usual.

ƒ–‹‡–•”‡ ‡‹˜‡†–”‡ƒ–‡–ƒ ‘”†‹‰–‘–Š‡—– Š—Ž–‹et al Ǧ †‹• ‹’Ž‹ƒ”›‰—‹†‡Ž‹‡ˆ‘”• Š‹œ‘’Š”‡‹ƒȋ˜ƒŽ’Š‡ ǤʹͲͳʹȌƒ†ƒ ‘”†‹‰–‘–Š‡•‘Ǧ ƒŽŽ‡† ‘FŽ‡š‹„Ž‡ Assertive Community Treatment’ (FACT) model. FACTǦ–‡ƒ• ‘•‹•–‘ˆ—”•‡•ǡ ’•› Š‘Ž‘‰‹•–•ǡƒ†’•› Š‹ƒ–”‹•–•ǤMBTp.  ‘•‹•–•‘ˆ‹†‹˜‹†—ƒŽƒ†‰”‘—’’•› Š‘–Š‡”ƒ’›Ǥƒ‹•–‘‹’”‘˜‡ ‡–ƒŽ‹œ‹‰ ƒ’ƒ ‹–›ǡ‡•’‡ ‹ƒŽŽ›—†‡”•–”‡••ˆ—Ž ‘†‹–‹‘•ƒ†ǡ„›†‘‹‰•‘ǡ‹•‡š’‡ –‡†–‘ ”‡†— ‡’•› Š‘’ƒ–Š‘Ž‘‰›ƒ†‹’”‘˜‡ˆ— –‹‘‹‰ȋ ‘ƒ‰›Ƭƒ–‡ƒǡʹͲͲ͸ȌǤŠ‡ —””‡–•–—†› —•‡†–Š‡‘”‹‰‹ƒŽ–”‡ƒ–‡–ƒ—ƒŽˆ‘”ǡ™‹–Š–Š‡”ƒ’‹•–•ˆ‘ —•‹‰‘ƒˆˆ‡ –ǡ–Š‡ ‡•–ƒ„Ž‹•Š‡–‘ˆƒ•‡ —”‡–”‡ƒ–‡–”‡Žƒ–‹‘•Š‹’ǡ„ƒŽƒ ‹‰–Š‡ ‘’Ž‡š‹–›‘ˆ‡–ƒŽ‹œƒ–‹‘ interventions and stress, and adopting a ‘notǦknowing’ therapeutic stance. TŠ‡Ž‡‰–Š‘ˆ–Š‡”ƒ’› –ͳͺ‘–Š•–”‡ƒ‹‡†— Šƒ‰‡†ǡ„—––Š‡‹–‡•‹–›‘ˆ–Š‡‘”‹‰‹ƒŽ’”‘‰”ƒ™ƒ••‹‰‹ˆ‹ ƒ–Ž› ”‡†— ‡†–‘ƒ‘‡ǦŠ‘—”‰”‘—’•‡••‹‘’‡”™‡‡ƒ†ƒŠƒŽˆǦŠ‘—”‹†‹˜‹†—ƒŽ•‡••‹‘‘ ‡’‡”–™‘ ™‡‡•Ǥ––Š‡•–ƒ”–‘ˆ–”‡ƒ–‡–ǡƒ”‘—†ˆ‘—”•‡••‹‘•™‡”‡’”‘˜‹†‡†–‘‡†— ƒ–‡’ƒ–‹‡–•ƒ„‘—– ‡›ƒ•’‡ –•‘ˆ‡–ƒŽ‹œ‹‰ǤŠ‡‹†‹˜‹†—ƒŽ–Š‡”ƒ’›•‡••‹‘•’”‘˜‹†‡†–Š‡‘’’‘”–—‹–›–‘‡š’Ž‘”‡ †‹ˆˆ‹ —Ž–‹‡•‡ ‘—–‡”‡††—”‹‰‰”‘—’•‡••‹‘•‘”‹†ƒ‹Ž›Ž‹ˆ‡„ƒ•‡†‘ˆ‹˜‡‰Ž‘„ƒŽƒ”‡ƒ•ǣ ‘‹–‡––‘–”‡ƒ–‡–ǡ’•› Š‹ƒ–”‹ •›’–‘•ǡ•‘ ‹ƒŽ‹–‡”ƒ –‹‘ǡ†‡•–”— –‹˜‡Ȁƒ˜‘‹†ƒ– „‡Šƒ˜‹‘”ǡƒ† ‘—‹–›ˆ— –‹‘‹‰ǤMBT therapists.   ”‘—’•‡••‹‘•™‡”‡‰‹˜‡„›–™‘–Š‡”ƒ’‹•–•ǡ™Š‘™‡”‡‡‹–Š‡” ’•› Š‹ƒ–”‹•–•ȋα͵Ȍǡ’•› Š‘Ž‘‰‹•–•ȋαʹȌǡ‘”—”•‡•ȋα͵Ȍ™‹–Šƒƒ˜‡”ƒ‰‡‘ˆˆ‹˜‡›‡ƒ”•‘ˆ’”‹‘” ‡š’‡”‹‡ ‡™‹–ŠǤŠ‡’”‘ˆ‡••‹‘ƒŽ•™Š‘’”‘˜‹†‡†‹†‹˜‹†—ƒŽ–Š‡”ƒ’›™‡”‡‡‹–Š‡”

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’•› Š‘Ž‘‰‹•–•ȋαͳȌ‘”—”•‡•ȋαͳͳȌǤŽŽ‹˜‘Ž˜‡† Ž‹‹ ‹ƒ•ˆ‘ŽŽ‘™‡†ƒ–™‘Ǧ†ƒ›Ǧ–”ƒ‹‹‰ ’”‘‰”ƒŽ‡†„›ƒ ‡”–‹ˆ‹‡†•—’‡”˜‹•‘”–”ƒ‹‡”‹Š‡‡–Š‡”Žƒ†•ȋ–ȌǤ‘‡•—”‡ –”‡ƒ–‡–ˆ‹†‡Ž‹–›ƒ†ƒ†Š‡”‡ ‡–‘–Š‡–”‡ƒ–‡–ƒ—ƒŽǡ‡š’‡”‹‡ ‡†ƒ†”‡‰‹•–‡”‡† •—’‡”˜‹•‘”•’”‘˜‹†‡†™‡‡Ž›•—’‡”˜‹•‹‘Ǥ—”‹‰•—’‡”˜‹•‹‘ǡ‹–‡”˜‡–‹‘•™‡”‡†‹• —••‡†– ™Š‡”‡’‘••‹„Ž‡—•‹‰˜‹†‡‘Ǧ–ƒ’‡†•‡••‹‘•–ƒ†”‡ˆŽ‡ –‡†—’‘ǡ’ƒ”–‹ —Žƒ”Ž›”‡‰ƒ”†‹‰–Š‡‹” ƒ†Š‡”‡ ‡–‘–Š‡–”‡ƒ–‡–‘†‡Žƒ†–Š‡‹” ‘–”‹„—–‹‘–‘‡–ƒŽ‹œ‹‰Ǥ”‡‰‹•–‡”‡† •—’‡”˜‹•‘””ƒ–‡†ˆ‘—””ƒ†‘Ž›•‡Ž‡ –‡†˜‹†‡‘Ǧ–ƒ’‡†•‡••‹‘•ǡ—•‹‰–Š‡ƒ†Š‡”‡ ‡• ƒŽ‡ ȋƒ”–‡”—†‡–ƒŽǤǡʹͲͳ͵Ȍ, and found nthe therapist’s competence and adherence to the MBT model to be ‘good enough’ (4), ‘good’ (5, =2) and ‘very good’ (6). Note that in Karterud et al.’s (2013) • ƒŽ‡ƒ‘˜‡”ƒŽŽ• ‘”‡‹•ƒ––”‹„—–‡†–‘„‘–Šƒ†Š‡”‡ ‡ƒ† ‘’‡–‡ ‡ǤŠ‡• ‘”‡‹•ƒ‰Ž‘„ƒŽ ƒ••‡••‡–ǡ‘–ƒƒ”‹–Š‡–‹ ƒ˜‡”ƒ‰‡Ǥ  Assessment. ŽŽ‘—– ‘‡•‡–‹‘‡†„‡Ž‘™™‡”‡‘„–ƒ‹‡†ƒ––Š”‡‡’‘‹–•‹–‹‡ǣƒ– „ƒ•‡Ž‹‡ȋͲȌǡƒˆ–‡”ͳͺ‘–Š•ǡ‹‡†‹ƒ–‡Ž›’‘•–Ǧ–”‡ƒ–‡–ȋʹȌǡƒ†ƒ–ƒ͸Ǧ‘–Šˆ‘ŽŽ‘™ Ǧ—’ ȋ͵ȌǤŽ›–Š‡“—‡•–‹‘ƒ‹”‡•Diagnosis. ȋ•‡‡„‡Ž‘™Ȍ™‡”‡ƒŽ•‘ˆ‹ŽŽ‡†‘—–ƒ–ͻ‘–Š•ȋͳȌǤ ƒ„Ž‡ͳ•Š‘™•–Š‡Ǧ Ǧ†‹ƒ‰‘•‡•ȋǡʹͲͲͲȌ‡•–ƒ„Ž‹•Š‡†„› ’•› Š‹ƒ–”‹•–•’”‹‘”–‘’ƒ”–‹ ‹’ƒ–‹‘ǤŠ‡”‡•‡ƒ” Š‡”•ƒ••‡••‡†ƒŽŽ’ƒ–‹‡–•„‡ˆ‘”‡’ƒ”–‹ ‹’ƒ–‹‘et al. —•‹‰–Š‡‘’”‡Š‡•‹˜‡••‡••‡–‘ˆ›’–‘•ƒ† ‹•–‘”›ȋ Ǣ†”‡ƒ•‡ ͳͻͻʹȌǡ ƒ†‹ƒ‰‘•–‹ ‹–‡”˜‹‡™Ǥƒ”–‹ ‹’ƒ–•™Š‘Šƒ†„‡‡‰‹˜‡ƒ†‹ƒ‰‘•‹•‹–Š‡•’‡ –”—ƒŽ•‘ Šƒ†ƒ ‘”†‹‰–‘‹ˆ‘”ƒ–‹‘†‡”‹˜‡†ˆ”‘–Š‡ ǡƒŽ–Š‘—‰Š•’‡ ‹ˆ‹ Ǧ †‹ƒ‰‘•‡• ‘—Ž††‹ˆˆ‡”„‡–™‡‡ Ž‹‹ ‹ƒ•ƒ†”‡•‡ƒ” Š‡”•ǡ™‹–Šƒƒ ‡’–ƒ„Ž‡”ƒ–‡‘ˆƒ‰”‡‡‡–ȋ‘Š‡̵• 7 κ = 0.6).Primary  outcome. Social functioning.

et al. ‘ ‹ƒŽˆ— –‹‘‹‰™ƒ•‡ƒ•—”‡†—•‹‰–Š‡‘ ‹ƒŽ — –‹‘‹‰ ƒŽ‡ ȋ Ǣ‹” Š™‘‘† ͳͻͻͲȌǡƒ‘„•‡”˜‡””ƒ–‡†‹–‡”˜‹‡™–Šƒ–‡ƒ•—”‡••‡˜‡†‹‡•‹‘•‘ˆ •‘ ‹ƒŽˆ— –‹‘‹‰ǣ•‘ ‹ƒŽ‡‰ƒ‰‡‡–ǡ‹–‡”’‡”•‘ƒŽ„‡Šƒ˜‹‘”Ȁ ‘—‹ ƒ–‹‘ǡ‹†‡’‡†‡ ‡Ǧ ‘’‡–‡ ‡ǡ‹†‡’‡†‡ ‡Ǧ’‡”ˆ‘”ƒ ‡ǡ”‡ ”‡ƒ–‹‘ƒŽƒ –‹˜‹–‹‡•ǡ’”‘Ǧ•‘ ‹ƒŽƒ –‹˜‹–‹‡•ǡƒ† ‡’Ž‘›‡–Ȁ‘ —’ƒ–‹‘Ǥ—„• ƒŽ‡• ‘”‡•™‡”‡ƒ˜‡”ƒ‰‡†–‘ ”‡ƒ–‡ƒ‘˜‡”ƒŽŽ•‘ ‹ƒŽˆ— –‹‘‹‰ • ‘”‡ǡ™‹–ŠŠ‹‰Š‡”• ‘”‡•”‡’”‡•‡–‹‰Š‹‰Š‡”•‘ ‹ƒŽˆ— –‹‘‹‰ȋ’‘••‹„Ž‡”ƒ‰‡ǣͷͻǤ͹–‘ͳ͵ͶǤͻȌǤ The SFS is often referred to as ‘behaviorally anchored’ because it uses ‘ ”‡–‡‡šƒ’Ž‡•–‘”ƒ–‡ •‘ ‹ƒŽˆ— –‹‘‹‰ȋ‡Ǥ‰Ǥǡ–Š‡—„‡”‘ˆˆ”‹‡†•‘”–‹‡•’‡–ƒŽ‘‡Ȍƒ˜‘‹†‹‰–Š‡‡‡†ˆ‘” ‘”ƒ–‹˜‡Œ—†‰‡–ƒ†‡˜ƒŽ—ƒ–‹˜‡†‡ ‹•‹‘•ǤŠ‡• ƒŽ‡Šƒ•„‡‡ˆ‘—†–‘„‡”‡Ž‹ƒ„Ž‡ǡet al. ”‡•’‘•‹˜‡–‘ Šƒ‰‡ǡƒ†–‘Šƒ˜‡ƒ‰‘‘† ‘•–”— –˜ƒSecondary outcomes. Ž‹†‹–›ȋ‹” Š™‘‘† ͳͻͻͲȌǤ Mentalizing ability

™ƒ•ƒ••‡••‡†™‹–Š–Š‡Š‡ƒ–‹ ’’‡” ‡’–‹‘‡•–ȋǢ—””ƒ›ǡ ͳͻ͵ͺȌƒ†• ‘”‡†™‹–Š–Š‡‘ ‹ƒŽ‘‰‹–‹‘ƒ†„Œ‡ –‡Žƒ–‹‘•›•–‡ȋǢ‡•–‡ǡͳͻͻͳȌǤ

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146807_JonasWeijers_BNW_def.indd 137 28-10-2020 15:09 Chapter Seven

‘—”†‹‡•‹‘•‘ˆ•‘ ‹ƒŽ ‘‰‹–‹‘™‡”‡• ‘”‡†ǣ ‘’Ž‡š‹–›‘ˆ”‡’”‡•‡–ƒ–‹‘•‘ˆ’‡‘’Ž‡ȋ‹Ǥ‡Ǥǡ the ability to distinguish between one’s own and another’s perspective), understanding of social ƒ—•ƒŽ‹–›ȋ‹Ǥ‡Ǥǡ–Š‡ƒ„‹Ž‹–›–‘ ‘•–”— –ƒŽ‘‰‹ ƒŽƒ†’•› Š‘Ž‘‰‹ ƒŽŽ›‹†‡†‡š’Žƒƒ–‹‘of others’ „‡Šƒ˜‹‘”Ȍǡƒˆˆ‡ ––‘‡‘ˆ”‡Žƒ–‹‘•Š‹’•ȋ‹Ǥ‡Ǥǡ–Š‡†‡‰”‡‡–‘™Š‹ Š•‘ ‹ƒŽ‹–‡”ƒ –‹‘‹•˜‹‡™‡†–‘„‡ „ƒ•‹ ƒŽŽ›„‡‹‰‘”ƒŽ‡˜‘Ž‡–Ȍǡƒ† ƒ’ƒ ‹–›ˆ‘”‡‘–‹‘ƒŽ‹˜‡•–‡–ȋ‹Ǥ‡Ǥǡ–Š‡†‡‰”‡‡–‘™Š‹ Š ‘”ƒŽ•–ƒ†ƒ”†•Šƒ˜‡„‡‡†‡˜‡Ž‘’‡†ƒ†‘–Š‡”•ƒ”‡–”‡ƒ–‡†ƒ•‡†•”ƒ–Š‡”–Šƒ‡ƒ•ȌǤƒ Š †‹‡•‹‘‹•• ‘”‡†‘ƒˆ‹˜‡Ǧ’‘‹–• ƒŽ‡ǡ™‹–ŠŠ‹‰Š‡”• ‘”‡•”‡’”‡•‡–‹‰Š‹‰Š‡”‡–ƒŽ‹œ‹‰ ƒ„‹Ž‹–›Ǥ et al. Š‡‘”›‘ˆ‹†™ƒ•ƒ••‡••‡†—•‹‰–Š‡ ‹–‹‰ƒ•ȋ‘” ‘”ƒ ͳͻͻͷȌǡ• ‘”‡†‘ƒ ʹͲǦ’‘‹–• ƒŽ‡ǡ™‹Positive symptoms–ŠŠ‹‰Š‡”• ‘”‡•”‡’”‡•‡–‹‰„‡––‡”–Š‡‘”›‘ˆ‹†Ǥ / Negative symptoms / Depression / Anxiety / Lack of insight et al ™‡”‡ ‡ƒ•—”‡† —•‹‰–Š‡—– Š–”ƒ•Žƒ–‹‘ȋ‘Ž–Šƒ—• et al. ǤʹͲͲͲȌ‘ˆ–Š‡‘•‹–‹˜‡ƒ†‡‰ƒ–‹˜‡ ›†”‘‡ ƒŽ‡ȋǢƒ› ͳͻͺ͹Ȍ‘•‡˜‡et al.Ǧ’‘‹–‹‡”–• ƒŽ‡•Ǥ—„• ƒŽ‡•ƒ†‡ƒ Š ‘’”‹•‡†–Š‡ƒ˜‡”ƒ‰‡‘ˆ͹‹–‡•ȋ•‡‡‡‹Œ‡”•Quality of life ʹͲͳ͸ˆ‘”‘”‡†‡–ƒ‹Ž•ȌǤ et al. ™ƒ•‡ƒ•—”‡†™‹–Š–Š‡ƒ Š‡•–‡”Š‘”–••‡••‡–‘ˆ—ƒŽ‹–›‘ˆ‹ˆ‡ ȋ”‹‡„‡ExperiencͳͻͻͻȌǤe sampling variables. ƒ”–‹ ‹’ƒ–• ”‡ ‡‹˜‡†ƒ†‹‰‹–ƒŽ†‹ƒ”›–the ‘PsyMate’ ––‘ ˆƒ ‹Ž‹–ƒ–‡–Š‡•ƒ’Ž‹‰‘ˆ‡š’‡”‹‡ ‡•‹†ƒ‹Ž›Ž‹ˆ‡ǡ‹Ǥ‡Ǥǡ–Š‡š’‡”‹‡ ‡ƒ’Ž‹‰‡–Š‘†ȋȌǤ –Ͳǡͳǡʹǡƒ†͵ǡˆ‘”•‹š†ƒ›•ǡ–Š‡•›ƒ–‡„‡‡’‡†–‡–‹‡•ƒ†ƒ›ƒ–‹””‡‰—Žƒ”‹–‡”˜ƒŽ•–‘ ’”‘’–’ƒ”–‹ ‹’ƒ–•–‘ˆ‹ŽŽ‘—–†‹‰‹–ƒŽ“—‡•–‹‘ƒ‹”‡•Ǥ–‡ƒ Š„‡‡’ǡ’ƒ–‹‡–•”ƒ–‡†Š‘™— Š positive affect (an average score of “happy”, “satisfied”, “cheerful”, “relaxed”, and “enthusiastic”), negative affect (“anxious”, “lonely”, “insecure”, “irritated”, “down”, “guilty”, and “gloomy”), psychotic symptoms (‘I feel suspicious’, ‘I am afraid of losing control’, ‘I feel that others don’t like me’, ‘I feel that others want to hurt me’, ‘My thoughts are influenced by other people’, ‘I f‡‡Ž unreal’, and ‘I hear voices’), and social stress (“I would rather be alone” and “I like the present company” (reverse coded)) they experienced. All items were rated on 7Ǧ’‘‹–‹‡”–• ƒŽ‡•Ǥ  ‘”†‡”–‘‡ƒ•—”‡†”—‰—•‡ǡƒ–‡ƒ Š„‡‡’’ƒ–‹‡–•™‡”‡ƒ•‡†™Š‡–Š‡”–Š‡›Šƒ†—•‡† ƒƒ„‹•‘” ‘–Š‡”†”—‰••‹ ‡–Š‡Žƒ•–„‡‡’ǡ ‘†‡†Ͳ‘”ͳȋˆ‘”ƒ›†”—‰—•‡ȌǤModerators.  Personality organization and somatization of psychopathology.

••‡••‡–‘ˆ’‡”•‘ƒŽ‹–› ‘”‰ƒ‹œƒ–‹‘ƒ†–Š‡–‡†‡ ›–‘•‘ƒ–‹œ‡•‡˜‡”‡’•› Š‘’ƒ–Š‘Ž‘‰›™ƒ•‡ƒ•—”‡†—•‹‰–Š‡‘”›et al. †”‹˜‡ƒƒŽ›•‹•ȋ—”‡Ž‹‰•Ǧ‘–‡‘‡ ǡʹͲͳʹȌ‘ˆ–Š‡”‡•—Ž–•‘–Š‡—– Š•Š‘”– ‘”‘ˆ–Š‡  ȋ Ǣ—–‡‹ŒƬ‘ǡͳͻͺͷȌǤ ‘—”Ž‡˜‡Ž•‘ˆ‡”•‘ƒŽ‹–›”‰ƒ‹œƒ–‹‘ȋȌƒ”‡ †‹•–‹‰—‹•Š‡†ǣ‡—”‘–‹ ǡ‘”†‡”Ž‹‡ǡƒ” ‹••‹•–‹ ǡƒ†•› Š‘–‹ Ǥ Š‡ ‘ƒ–‹œƒ–‹‘•—„• ƒŽ‡‡ƒ•—”‡•–Š‡ƒ„‹Ž‹–›–‘„‡ƒ™ƒ”‡‘ˆƒ†–‘”‡’‘”– „‘†‹Ž›•‡•ƒ–‹‘•ǡ™Š‹Ž‡–Š‡•› Š‘’ƒ–Š‘Ž‘‰›•—„• ƒŽ‡‡ƒ•—”‡•–Š‡†‡‰”‡‡‘ˆ•‡˜‡”‡

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146807_JonasWeijers_BNW_def.indd 138 28-10-2020 15:09 Mentalization based treatment for psychotic disorder: a randomized controlled trial

’•› Š‘’ƒ–Š‘Ž‘‰›Ǥ ƒ˜‘”ƒ„Ž‡ƒˆˆ‡ –”‡‰—Žƒ–‹‘–Š”‘—‰Š•‘ƒ–‹œƒ–‹‘™‹ŽŽ„‡‡š’”‡••‡†ƒ•–Š‡ ”‡Žƒ–‹˜‡’‘•‹–‹‘‘ˆ• ‘”‡•‘–Š‡•—„• ƒŽ‡•‘ƒ–‹œƒ–‹‘–‘–Šƒ–‘–Š‡’•› Š‘’ƒ–Š‘Ž‘‰›•—„• ƒŽ‡ ȋ—”‡Ž‹‰•ChildhoodǦ‘–‡‘‡Ƭ‘‡Ž‡ǡʹͲͲ͹ȌǤ trauma.  et al. Š‡Š‹Ž†Š‘‘†š’‡”‹‡ ‡‘ˆƒ”‡ƒ†„—•‡ȋǢ‹ˆ—Ž ‘ ͳͻͻͶȌ‹•ƒ•‡‹Ǧ•–”— –—”‡†‹–‡”˜‹‡™–Šƒ–ƒ‹•–‘ƒ••‡••†‡–ƒ‹Ž•ƒ†–Š‡–‹‡Ǧ•‡“—‡ ‡‘ˆ –”ƒ—ƒ–‹  Š‹Ž†Š‘‘†‡š’‡”‹‡ ‡•Ǥ –ƒ••‡••‡•Žƒ ‘ˆ ƒ”‡ȋ‡‰Ž‡ –ǡƒ–‹’ƒ–Š›Ȍǡ’Š›•‹ ƒŽƒ„—•‡ǡ •‡š—ƒŽƒ„—•‡ǡƒ†’•› Š‘Ž‘‰‹ ƒŽƒ„—•‡ǤAdherence to pharmacological treatment.  †Š‡”‡ ‡–‘–Š‡’”‡• ”‹„‡†‡†‹ ƒ–‹‘™ƒ•et al. ‡ƒ•—”‡†™‹–Š–Š‡‡†‹ ƒ–‹‘†Š‡”‡ ‡—‡•–‹‘ƒ‹”‡ȋǢ‘”‹•›Duration of illness. ͳͻͺ͸ȌǤ  Š‹•™ƒ•†‡ˆ‹‡†ƒ†‡ƒ•—”‡†„ƒ•‡†‘–Š‡—„‡”‘ˆ›‡ƒ”••‹ ‡ –Š‡‘•‡–‘ˆ–Š‡ˆ‹”•–’•› Š‘–‹ ‡’‹•‘†‡ǤStatistical analyses.  Main analyses

Ǥ ‹”•–ǡ”‡’‡ƒ–‡†‡ƒ•—”‡•ƒƒŽ›•‡•‘–Š‡„ƒ•‹•‘ˆ–Š‡‹–‡–‹‘Ǧ–‘Ǧ–”‡ƒ– ’”‹ ‹’Ž‡–™‹–Š•‘ ‹ƒŽˆ— –‹‘‹‰ƒ–Ͳƒ†‡‹–Š‡”ʹ‘”͵–™‡”‡—•‡†–‘†‡–‡”‹‡ Šƒ‰‡ ‘˜‡”–‹‡‹•‘ ‹ƒŽˆ— –‹‘‹‰ˆ‘”„‘–Š–Š‡ƒ†’‰”‘—’•Ǥ‡ ‘†ǡˆ‘”ƒŽŽ’”‹ƒ”›ƒ† •‡ ‘†ƒ”›‘—– ‘‡•ǡ•–™‹–Š–”‡ƒ–‡– ‘†‹–‹‘ƒ•„‡–™‡‡Ǧ•—„Œ‡ –•˜ƒ”‹ƒ„Ž‡ǡƒ† –Š‡’‡”ˆ‘”ƒ ‡‘–Š‡˜ƒ”‹ƒ„Ž‡•ƒ–‡‹–Š‡”ʹ‘”͵ƒ•†‡’‡†‡–˜ƒ”‹ƒ„Ž‡•–™‡”‡—•‡†ǡ ƒ†Œ—•–‡†ˆ‘”„ƒ•‡Ž‹‡Ž‡˜‡Ž•Ǥ ‘”†‹‰–‘–Š‡—”‘’‡ƒ‡†‹ ‹‡•‰‡ ›‰—‹†‡Ž‹‡•ȋʹͲͳ͹Ȍǡ †‹˜‹†‹‰‘—– ‘‡•‹–‘’”‹ƒ”›ƒ†•‡ ‘†ƒ”›‘—– ‘‡•‹•ƒ™ƒ›–‘ ‘–”‘Ž–Š‡›’‡ ‡””‘” ”ƒ–‡Ǥ ‘™‡˜‡”ǡ‹–Š‹•™ƒ›ǡ•‡ ‘†ƒ”›‘—– ‘‡• ƒ‘Ž›„‡ ‘•‹†‡”‡†ƒ•‹†‹ ƒ–‹‘•–‘– ‡˜‹†‡ ‡Handling–‘ˆ’‘–‡–‹ƒŽ–”‡ƒ–‡–‡ˆˆ‡ –•Ǥ of missing data.  7 Š‡ƒƒŽ›•‡•‘ˆ–Š‡’”‹ƒ”›ƒ†•‡ ‘†ƒ”›‘—– ‘‡•™‡”‡ carried out with imputed data, allowing for the use of a proper ‘intentionǦ–‘Ǧtreat’ analysis. ‹••‹‰†ƒ–ƒ™‡”‡Šƒ†Ž‡†„›—Ž–‹’Ž‡‹’—–ƒ–‹‘ȋ Šƒˆ‡”ǡͳͻͻͻȌ—•‹‰‹†‡’‡†‡–˜ƒ”‹ƒ„Ž‡• –Šƒ–™‡”‡Ž‹‡Ž›–‘’”‡†‹ –†”‘’Ǧ‘—–ǣƒŽƒ ‘ˆ‹•‹‰Š–ǡ’‘•‹–‹˜‡•›’–‘•ǡƒ‰‡ǡ‰‡†‡”ǡƒŠ‹•–‘”› ‘ˆ†”—‰ƒ„—•‡ǡ—‡’Ž‘›‡–ǡ–”‡ƒ–‡–ƒŽŽ‘ ƒet al. –‹‘ǡƒ†’‘‘”•‘ ‹ƒŽˆ— –‹‘‹‰ƒ–Ͳȋ•‡‡‘•‡ ʹͲͲ͵ˆ‘”ƒ‘˜‡”˜‹‡™ȌǤ ‘”‡ƒ ŠƒƒŽ›•‹•ǡͷ‹’—–‡††ƒ–ƒ•‡–•™‡”‡ ”‡ƒ–‡†—•‹‰ƒˆ—ŽŽ› ‘†‹–‹‘ƒŽƒ”‘˜ Šƒ‹‘–‡ƒ”Ž‘ȋȌƒ’’”‘ƒ ŠǤ‡•—Ž–•ˆ”‘ƒƒŽ›•‡• ‘†— –‡†™‹–Š –Š‡‹’—–‡††ƒ–ƒ•‡–•Mediation analyses.were combined using Rubin’s rules. ‘–‡•–™Š‡–Š‡”–Š‡‡ˆˆ‡ –‘ˆ–”‡ƒ–‡– ‘†‹–‹‘‘•‘ ‹ƒŽ ˆ— –‹‘‹‰™ƒ•‡†‹ƒ–‡†„›‡–ƒŽ‹œ‹‰ƒ„‹Ž‹–›ǡ™‡ ‘†— –‡†‡†‹ƒ–‹‘ƒƒŽ›•‡•™‹–Šƒ›‘ˆ –Š‡• ƒŽ‡•‘ˆ–Š‡‘”–Š‡Š‹–‹‰–ƒ•ƒ•‡†‹ƒ–‘”•ǡ’”‘˜‹†‡†–Š‡›™‡”‡•‹‰‹ˆ‹ ƒ–Ž› affected by treatment condition. SPSS version 22 combined with Hayes’s PROCESS macro ȋ”‡ƒ Š‡”Ƭ ƒ›‡•ǡʹͲͲͶȌ™ƒ•—•‡†ˆ‘”–Š‡‡†‹ƒ–‹‘ƒƒŽ›•‡•ǤŠ‡’”‘ ‡••ƒ ”‘—•‡•‘Ǧ ’ƒ”ƒ‡–”‹ „‘‘–•–”ƒ’’‹‰ǡ™Š‹ Š‹˜‘Ž˜‡•”ƒ†‘”‡•ƒ’Ž‹‰‘ˆ‘„•‡”˜ƒ–‹‘•™‹–Š”‡’Žƒ ‡‡– –‘‘„–ƒ‹ ‘ˆ‹†‡ ‡‹–‡”˜ƒŽ•ˆ‘”–Š‡‹†‹”‡ –‡ˆˆ‡ –ȋƒ†ˆ— –‹‘•–Š‡”‡‘ˆȌǤŠ‡„‘‘–•–”ƒ’

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146807_JonasWeijers_BNW_def.indd 139 28-10-2020 15:09 Chapter Seven

‘ˆ‹†‡ ‡‹–‡”˜ƒŽ•™‡”‡„ƒ•‡†‘ͷͲͲͲ”‡•ƒ’Ž‡•Ǥ‡†‹ƒ–‹‘‡ˆˆ‡ –•ƒ”‡ ‘•‹†‡”‡† •‹‰‹ˆ‹ ƒ–‹ˆ–Š‡ ‘ˆ‹†‡ ‡‹–‡”˜ƒŽ†‘‡•‘– ‘–ƒ‹ͲǤŽŽ‡†‹ƒ–‹‘ƒƒŽ›•‡•‹ Ž—†‡† –”‡ƒ–‡– ‘†‹–‹‘ƒ•‹†‡’‡†‡–˜ƒ”‹ƒ„Ž‡ǡ•‘ ‹ƒŽˆ— –‹‘‹‰ƒ–‡‹–Š‡”ʹ‘”͵ƒ•†‡’‡†‡– ˜ƒ”‹ƒ„Ž‡•ǡ‡–ƒŽ‹œƒ–‹‘ƒ–ʹ‘”͵ƒ•ƒ‡†‹ƒ–‘”ƒ†„ƒ•‡Ž‹‡•‘ ‹ƒŽˆ— –‹‘‹‰ƒ•ƒ ‘˜ƒ”Moderation analyses. et al. ‹ƒ–‡Ǥ •†‡• ”‹„‡†‹‡‹Œ‡”• ȋʹͲͳ͸Ȍǡ™‡ƒŽ•‘•‘—‰Š––‘‡šƒ‹‡ ’‘–‡–‹ƒŽ‘†‹ˆ‹‡”•‘ˆ–Š‡–”‡ƒ–‡–‡ˆˆ‡ –ǡ‹ Ž—†‹‰ǣ•‡˜‡”‹–›‘ˆ Š‹Ž†Š‘‘†–”ƒ—ƒǡ–›’‡‘ˆ ’‡”•‘ƒŽ‹–›‘”‰ƒ‹œƒ–‹‘ȋȌǡ–Š‡†‡‰”‡‡‘ˆ•‘ƒ–‹œƒ–‹‘‘ˆ’•› Š‘’ƒ–Š‘Ž‘‰›ǡƒ†Š‡”‡ ‡–‘ ’Šƒ”ƒ ‘Ž‘‰‹ ƒŽ–”‡ƒ–‡–ǡ–‘–ƒŽ—„‡”‘ˆŠ‘—”•‘ˆƒ––‡†‡†’•‡••‹‘•ǡƒ††—”ƒ–‹‘‘ˆ ‹ŽŽ‡••Ǥ‘†‡”ƒ–‹‘ƒƒŽ›•‡•‹ Ž—†‡†–”‡ƒ–‡– ‘†‹–‹‘ƒ•‹†‡’‡†‡–˜ƒ”‹ƒ„Ž‡ǡ–Š‡ ‘†‡”ƒ–‘”ƒ†‹–•‹–‡”ƒ –‹‘™‹–Š–”‡ƒ–‡– ‘†‹–‹‘ƒ•‹†‡’‡†‡–˜ƒ”‹ƒ„Ž‡•ǡ•‘ ‹ƒŽ ˆ— –‹‘‹‰ƒ–Ͳƒ• ‘˜ƒ”‹ƒ–‡ǡƒ†•‘ ‹ƒŽˆ— –‹‘‹‰ƒ–ʹ‘”͵ƒ•†‡’‡†‡–˜ƒ”‹ƒ„Ž‡Ǥ‹ ‡ ‹•ƒ ƒ–‡‰‘”‹ ƒŽ˜ƒ”‹ƒ„Ž‡ǡ‹–™ƒ•†—›Ǧ ‘†‡† ”‡ƒ–‹‰ˆ‘—”‡™†‹ Š‘–‘‘—•˜ƒ”‹ƒ„Ž‡•ȋˆ‘” ‡—”‘–‹ ǡ„‘”†‡”Ž‹‡ǡ’•› Š‘–‹ ǡƒ†ƒ” ‹••‹•–‹ ȌǤ††‹–‹‘ƒŽŽ›ǡ•‹ ‡•‘ ‹ƒŽˆ— –‹‘‹‰ †‡–‡”‹‘”ƒ–‡•‘•–‹–Š‡ˆ‹”•–ͷ›‡ƒ”•ƒˆ–‡”‘•‡–‘ˆ‹ŽŽ‡••ȋ‹” Š™‘‘†Ƭƒ ‹ŽŽƒǡͳͻͻ͵Ȍƒ† –Š‡ˆ‹”•–ˆ‹˜‡›‡ƒ”•‘ˆƒ”‡ ‘•‹†‡”‡†ƒ ”— ‹ƒŽ’‡”‹‘†ˆ‘”‹–‡”˜‡–‹‘ȋ‹” Š™‘‘†Ƭet al. ƒ ‹ŽŽƒǡͳͻͻ͵Ǣ ‘””› ʹͲͳͲȌǡ†—”ƒ–‹‘‘ˆ‹ŽŽ‡••™ƒ•†‹ Š‘–‘‹œ‡†ȋδαͷ›‡ƒ”•‘”εͷ ›‡ƒ”•ȌǤ‘ƒ–‹œƒ–‹‘‘ˆ’•› Š‘’ƒ–Š‘Ž‘‰›‹•ƒ†‹ Š‘–‘‘—•• ‘”‡”‡’”‡•‡–‹‰ƒ‡‹–Š‡” ˆƒ˜‘”ƒ„Ž‡ȋ”‡Žƒ–‹˜‡Ž›Š‹‰Š†‡‰”‡‡‘ˆ•‘ƒ–‹œƒ–‹‘™‹–ŠŠ‹‰Š’•› Š‘’ƒ–Š‘Ž‘‰›Ȍ‘”—ˆƒ˜‘”ƒ„Ž‡ ’‡”•‘ƒŽ‹–› Šƒ”ƒ –‡”‹•–‹ ȋ”‡Žƒ–‹˜‡Ž›Ž‘™•‘ƒ–‹œƒ–‹‘™‹–ŠŠ‹‰Š†‡‰”‡‡‘ˆ’•› Š‘’ƒ–Š‘Ž‘‰›ȌǤMultilevel analyses.  Š‡Š‹‡”ƒ” Š‹ ƒŽŽ›•–”— –—”‡†‡ƒ•—”‡‡–• ‘ŽŽ‡ –‡†™‹–Š ‡ ‡••‹–ƒ–‡ƒ—Ž–‹Ž‡˜‡ŽƒƒŽ›•‹•ǡ„‡ ƒ—•‡–Š‡”‡ƒ”‡—Ž–‹’Ž‡‡ƒ•—”‡‡–•’‡”†ƒ›ǡˆ‘”—’–‘•‹š †ƒ›•ˆ‘”‡ƒ Š’ƒ–‹‡–Ǥ ’ƒ”–‹ —Žƒ”ǡˆ‘”‡ƒ Š•—„Œ‡ –ǡ—’–‘͸Ͳ‡ƒ•—”‡‡–•™‡”‡ƒ˜ƒ‹Žƒ„Ž‡ˆ‘” ‡ƒ Š‘—– ‘‡‘ˆ‹–‡”‡•–ƒ–‡ƒ Š–‹‡’‘‹–ƒ†Š‡ ‡—’–‘ʹͶͲ‡ƒ•—”‡‡–•‘˜‡”ƒŽŽǤŽŽ ƒ˜ƒ‹Žƒ„Ž‡‡ƒ•—”‡‡–•™‡”‡‹ Ž—†‡†‹–et al. Š‡•‡ƒƒŽ›•‡•Ǥ ‘™‡˜‡”ǡƒ•‹’”‡˜‹‘—••–—†‹‡• ȋ‡Ǥ‰Ǥǡ‹’’‡ ʹͲͳ͹Ȍǡ’ƒ”–‹ ‹’ƒ–•™‡”‡‹ Ž—†‡†‹–Š‡•‡ƒƒŽ›•‡•‘Ž›‹ˆ–Š‡›Šƒ†ˆ‹ŽŽ‡†‘—– ƒ–Ž‡ƒ•–ʹͲ“—‡•–‹‘ƒ‹”‡•ƒ–„ƒ•‡Ž‹‡Ǥ‡—•‡†–Š‡•ƒ‡ ”‹–‡”‹‘ˆ‘”ˆ‘ŽŽ‘™Ǧ—’‡ƒ•—”‡‡–•Ǥ ‹ˆˆ‡”‡ ‡•‹ Šƒ‰‡•„‡–™‡‡–”‡ƒ–‡– ‘†‹–‹‘•‘˜‡”–‹‡ȋ‹Ǥ‡Ǥǡƒ ”‘••–Š‡†‹ˆˆ‡”‡– ‡ƒ•—”‡‡–’‡”‹‘†•Ȍ”‡‰ƒ”†‹‰•‘ ‹ƒŽ•–”‡••ǡ’•› Š‘–‹ ‡š’‡”‹‡ ‡•ǡ‡‰ƒ–‹˜‡ƒˆˆ‡ –ǡƒ† ’‘•‹–‹˜‡ƒˆˆ‡ –™‡”‡ƒƒŽ›œ‡†—•‹‰‹š‡†Ǧ‡ˆˆ‡ –•”‡‰”‡••‹‘‘†‡Ž•Ǥ‹ˆˆ‡”‡ ‡•‹ Šƒ‰‡• „‡–™‡‡–”‡ƒ–‡– ‘†‹–‹‘•‘˜‡”–‹‡”‡‰ƒ”†‹‰‹ŽŽ‹ ‹–†”—‰—•‡™‡”‡ƒƒŽ›œ‡†—•‹‰ƒ „‹‘‹ƒŽŽ‘‰‹•–‹ ‹š‡†Ǧ‡ˆˆ‡ –•”‡‰”‡••‹‘‘†‡ŽǤŠ‡‘†‡Ž•‹ Ž—†‡†–”‡ƒ–‡– ‘†‹–‹‘ǡ –‹‡ȋ ‘†‡†ƒ•Ͳ–‘͵ˆ‘”Ͳ–Š”‘—‰Š͵ǡ”‡•’‡ –‹˜‡Ž›Ȍǡƒ†–Š‡‹”‹–‡”ƒ –‹‘–‡”ƒ•’”‡†‹ –‘”•ǡ ™‹–Š‡‹–Š‡”’•› Š‘–‹ ‡š’‡”‹‡ ‡•ǡ•‘ ‹ƒŽ•–”‡••ǡ‡‰ƒ–‹˜‡ƒˆˆ‡ –ǡ’‘•‹–‹˜‡ƒˆˆ‡ –ǡ‘”†”—‰—•‡ƒ• †‡’‡†‡–˜ƒ”‹ƒ„Ž‡•ƒ†”ƒ†‘‹–‡” ‡’–•ƒ†”ƒ†‘•Ž‘’‡•ˆ‘”–‹‡ƒ––Š‡•—„Œ‡ –Ž‡˜‡ŽǤ –‡”‡•–™ƒ•ˆ‘ —•‡†‘–Š‡ ‘†‹–‹‘š–‹‡‹–‡”ƒ –‹‘ȋ‹Ǥ‡Ǥǡ‹†–Š‡‘—– ‘‡‘ˆ‹–‡”‡•– Šƒ‰‡ †‹ˆˆ‡”‡–‹ƒŽŽ›ˆ‘”–Š‡–™‘‰”‘—’•‘˜‡”–Š‡ ‘—”•‡‘ˆ–Š‡ˆ‘—”‡ƒ•—”‡‡–‘ ƒ•‹‘•ǫȌǤ

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‡ƒ –‹˜‹–›–‘•‘ ‹ƒŽ•–”‡••™ƒ• ‘ ‡’–—ƒŽ‹œ‡†ƒ•–Š‡ƒ••‘ ‹ƒ–‹‘„‡–™‡‡•‘ ‹ƒŽ•–”‡•• ȋ’”‡†‹ –‘”Ȍƒ†‡‰ƒ–‹˜‡ƒˆˆ‡ –ǡ’‘•‹–‹˜‡ƒˆˆ‡ –ǡ‘”’•› Š‘–‹ ‡š’‡”‹‡ ‡•ȋ‘—– ‘‡•ȌǤƒŽ›•‡•‘ˆ –”‡ƒ–‡–‡ˆˆ‡ –‘•–”‡••”‡ƒ –‹˜‹–›‹ Ž—†‡†–”‡ƒ–‡– ‘†‹–‹‘ǡ–‹‡ǡ•‘ ‹ƒŽ•–”‡••ǡƒ†–Š‡‹” –™‘Ǧƒ†–Š”‡‡Ǧ™ƒ›‹–‡”ƒ –‹‘–‡”•ƒ•’”‡†‹ –‘”•ǡ™‹–Š‡‹–Š‡”’•› Š‘–‹ ‡š’‡”‹‡ ‡•ǡ‡‰ƒ–‹˜‡ ƒˆˆ‡ –ǡ‘”’‘•‹–‹˜‡ƒˆˆ‡ –ƒ•†‡’‡†‡–˜ƒ”‹ƒ„Ž‡•ǤŠ‡•‡‘†‡Ž•‹ Ž—†‡†”ƒ†‘‹–‡” ‡’–•ƒ† ”ƒ†‘•Ž‘’‡•ˆ‘”–‹‡ƒ†•‘ ‹ƒŽ•–”‡••ƒ––Š‡•—„Œ‡ –Ž‡˜‡ŽǤ ‡”‡ǡ™‡™‡”‡•’‡ ‹ˆ‹ ƒŽŽ› ‹–‡”‡•–‡†‹–Š‡–Š”‡‡Ǧ™ƒ›‹–‡”ƒ –‹‘ȋ‹Ǥ‡Ǥǡ‹†–Š‡ƒ••‘ ‹ƒ–‹‘„‡–™‡‡ƒ‘—– ‘‡‘ˆ‹–‡”‡•– ƒ†•‘ ‹ƒŽ•–”‡•• Šƒ‰‡†‹ˆˆ‡”‡–‹ƒŽŽ›ˆ‘”–Š‡–™‘‰”‘—’•‘˜‡”–Š‡ ‘—”•‡‘ˆ–Š‡ˆ‘—” ‡ƒ•—”‡‡–‘ ƒ•‹‘•ǫȌǤComparison of medication type and dosage. ‘ ‘’ƒ”‡‡†‹ ƒ–‹‘–›’‡ǡƒŽŽ‡†‹ ƒ–‹‘ ™ƒ• Žƒ••‹ˆ‹‡†ƒ•‡‹–Š‡”ˆ‹”•–‰‡‡”ƒ–‹‘ƒ–‹’•› Š‘–‹ ȋ ‘†‡†ͳȌǡ•‡ ‘†‰‡‡”ƒ–‹‘ ƒ–‹’•› Š‘–‹ ȋ ‘†‡†ʹȌ‘” Ž‘œƒ’‹‡ȋ ‘†‡†͵ȌǤ—Ž–‹‘‹ƒŽ”‡‰”‡••‹‘ƒƒŽ›•‡•™‡”‡ ‘†— –‡†™‹–Š–”‡ƒ–‡– ‘†‹–‹‘ƒ•‹†‡’‡†‡–˜ƒ”‹ƒ„Ž‡ƒ†‡†‹ ƒ–‹‘–›’‡ƒ–Ͳǡʹ‘” ͵ƒ•†‡’‡†‡–˜ƒ”‹ƒ„Ž‡•Ǥ‘•ƒ‰‡•™‡”‡ ‘’ƒ”‡†„›ˆ‹”•– ƒŽ —Žƒ–‹‰†‘•‡‡“—‹˜ƒŽ‡–•™‹–Š ŠŽ‘”’”‘ƒœ‹‡ȋͳͲͲ‰Ȍƒ•ƒ„ƒ•‡Ž‹‡ ‘’ƒ”ƒ–‘”ǡƒ ‘”†‹‰–‘–Š‡‰—‹†‡Ž‹‡•‘ˆ†”‡ƒ•‡‡– ƒŽǤȋʹͲͳͲȌǤŠ‡ǡˆ‘”‡ƒ Š‡ƒ•—”‡‡–’‡”‹‘†ȋͲǡʹǡ͵ȌȋȌ•™‡”‡ ‘†— –‡†™‹–Š †‘•‡‡“—‹˜ƒŽ‡–ƒ•†‡’‡†‡–˜ƒ”‹ƒ„Ž‡ƒ†–”‡ƒ–‡– ‘†‹–‹‘ƒ•‹†‡’‡†‡–˜ƒ”‹ƒ„Ž‡Ǥ –Š‡ ƒƒŽ›•‡•”‡‰ƒ”†‹‰ʹƒ†͵ǡ†‘•‡‡“—‹˜ƒŽ‡–ƒ–Ͳ™ƒ•ƒ††‡†ƒ•ƒ ‘˜ƒ”‹ƒ–‡Ǥ  Results Demographics and patient characteristics.

”‹––‡‹ˆ‘”‡† ‘•‡–™ƒ•‘„–ƒ‹‡† 7 ˆ”‘ͻͲ’ƒ”–‹ ‹’ƒ–•Ǥ™‘’ƒ”–‹ ‹’ƒ–•ˆƒ‹Ž‡†–‘ ‘’Ž‡–‡–Š‡„ƒ•‡Ž‹‡‡ƒ•—”‡‡–ǡ‘‡ ’ƒ–‹‡–†”‘’’‡†‘—–„‡ˆ‘”‡”ƒ†‘‹œƒ–‹‘ƒ††‹†‘–™ƒ–Š‹•†ƒ–ƒ•–‘”‡†ǤŠ”‡‡‘–Š‡” ’ƒ–‹‡–•™‡”‡‡š Ž—†‡††—”‹‰–Š‡–”‹ƒŽǣ–™‘’ƒ”–‹ ‹’ƒ–•™‡”‡†‹ƒ‰‘•‡†™‹–Š•—„•–ƒ ‡—•‡ †‹•‘”†‡”•†—”‹‰–Š‡–”‹ƒŽƒ†™‡”‡—™‹ŽŽ‹‰–‘‡–‡”‹’ƒ–‹‡–†‡–‘š‹ˆ‹ ƒ–‹‘’”‘‰”ƒ•ǡƒ† ‘‡’ƒ–‹‡––—”‡†‘—––‘„‡–‘‘‘Ž†ȋͷ͹›‡ƒ”•ȌǤŠ‡›™‡”‡‡š Ž—†‡†ˆ”‘–Š‡•–—†›Ǥ ‘•‡“—‡–Ž›ǡ‹–‡–‹‘Ǧ–‘Ǧ–”‡ƒ–ƒƒŽ›•‡•™‡”‡ ‘†— –‡†™‹–ŠͺͶ’ƒ–‹‡–•Ǥ Š‡”‡™‡”‡‘•‹‰‹ˆ‹ ƒ–†‹ˆˆ‡”‡ ‡•„‡–™‡‡‰”‘—’•‘ƒ›‘ˆ–Š‡†‡‘‰”ƒ’Š‹ p ˜ƒ”‹ƒ„Ž‡•‘”„ƒ•‡Ž‹‡‡ƒ•—”‡‡–•ǡ‡š ‡’–ˆ‘”ƒš‹‡–›ƒ††‡’”‡••‹‘ȋ αǤͲͶͻˆ‘”„‘–ŠȌǡ ™Š‹ Š™‡”‡Š‹‰Š‡”‹–Š‡’‰”‘—’Ǥ‡‡ƒ„Ž‡ʹǤ –Š‡’‰”‘—’ƒ–‘–ƒŽ‘ˆʹͳ’ƒ–‹‡–•Šƒ†before ”‡ ‡‹˜‡†‘‰‹–‹˜‡‡Šƒ˜‹‘”ƒŽŠ‡”ƒ’›ȋȌƒ–•‘‡’‘‹– –Š‡–”‹ƒŽǡ‘’’‘•‡†–‘ʹ͵during ’ƒ–‹‡–•‹–Š‡‰”‘—’Ǥ‡’ƒ–‹‡–‹–Š‡’‰”‘—’”‡ ‡‹˜‡† –Š‡–”‹ƒŽǡƒ• ‘’’‘•‡†–‘•‡˜‡’ƒ”–‹ ‹’ƒ–•‹–Š‡‰”‘—’ǤŠ‡”‡™‡”‡‘•‹‰‹ˆ‹ ƒ–†‹ˆˆ‡”‡ ‡•„‡–™‡‡p p p ‰”‘—’•‹ƒ–‹’•› Š‘–‹ ‡†‹ ƒ–‹‘ƒ†Š‡”‡ ‡ȋƒŽŽ ’s > .31), type (all ’s > .27) or dosage (all ’s εǤʹͷȌƒ–‡‹–Š‡”Ͳǡʹ‘”͵Ǥ

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Table 1. Demographics and clinical characteristics of patients at baseline participating in a randomized trial to test the effectiveness of mentalization-based treatment for psychotic disorder. Variable TAU, mean (SD) N MBT-P, mean (SD) N p*

 ‰‡‹›‡ƒ”• ͵ͳǤͺͺȋͻǤͶ͵Ȍ Ͷʹ ͵ͳǤʹͳȋ͹ǤͺͲȌ Ͷʹ Ǥ͹͵  ‰‡‘ˆ‘•‡– ʹ͸Ǥ͹ͳȋͻǤͳͳȌ Ͷʹ ʹͷǤ͹͸ȋ͹ǤͷͳȌ Ͷʹ Ǥ͸Ͳ       —”ƒ–‹‘‘ˆ‹ŽŽ‡•• ͷǤͳ͹ȋ͵Ǥ͵ʹȌ Ͷʹ ͷǤͶͷȋ͵ǤͷͶȌ Ͷʹ Ǥ͹Ͳ       ‡†‡”     Ǥͳʹ  ƒŽ‡ǡ͓  ͵Ͳ  ʹ͵    ‡ƒŽ‡ǡ͓  ͳʹ  ͳͻ   ‹ƒ‰‘•‹•ȋǦ ǦȌ     Ǥ͹͸   Š‹œ‘’Š”‡‹ƒ  ʹͺ  ʹ͸    Š‹œ‘ƒˆˆ‡ –‹˜‡†‹•‘”†‡”  Ͷ  ͹   •› Š‘–‹ †‹•‘”†‡”ǤǤǤ  ͸  ͹   ”‹‡ˆ•› Š‘–‹ ‹•‘”†‡”  ʹ  ʹ   ‡Ž—•‹‘ƒŽ‹•‘”†‡”  ʹ  Ͳ   ‡”•‘ƒŽ‹–›”‰ƒ‹œƒ–‹‘     Ǥ͸ͷ  ‡—”‘–‹  Ͷ  ʹ   ‘”†‡”Ž‹‡  ʹͷ  ʹͺ   ƒ” ‹••‹•–‹  ͳͲ  ͸   •› Š‘–‹  ͵  ͷ   ȗƒ•‡†‘‹†‡’‡†‡–•ƒ’Ž‡•– Ǧ–‡•–•ˆ‘” ‘–‹—‘—•˜ƒ”‹ƒ„Ž‡•ƒ† Š‹Ǧ•“—ƒ”‡–‡•–•ˆ‘” ƒ–‡‰‘”‹ ƒŽ‘‡•Ǥ Drop-out and non-compliance.

‡‡ ‹‰—”‡ͳǤƒ–‹‡–•‹–Š‡’ ‘†‹–‹‘ˆ‘ŽŽ‘™‡† ƒƒ˜‡”ƒ‰‡‘ˆʹͻǤͻ‰”‘—’•‡••‹‘•ȋ”ƒ‰‡ǣͲǦ͸ͺȌƒ†ƒƒ˜‡”ƒ‰‡‘ˆͺǤ͸Š‘—”•‘ˆ‹†‹˜‹†—ƒŽ –Š‡”ƒ’›ȋ”ƒ‰‡ǣͲǦʹͲȌǤ 

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7

Figure 1.  ‹ƒ‰”ƒ‘ˆ’ƒ”–‹ ‹’ƒ–ˆŽ‘™Ǥ

Safety. ‘ŽŽ‘™‹‰–Š‡ ”‡‰—Žƒ–‹‘•‘ˆ–Š‡‡†‹ ƒŽǦ–Š‹ •‘‹––‡‡‘ˆƒƒ•–”‹ Š– ‹˜‡”•‹–›ǡ•‡”‹‘—•ƒ†˜‡”•‡‡˜‡–••— Šƒ•Š‘•’‹–ƒŽ‹œƒ–‹‘™‡”‡”‡‰‹•–‡”‡†Ǥ‘‰–Š‘•‡ ’ƒ–‹‡–•ƒŽŽ‘ ƒ–‡†–‘’ǡ•‹š’ƒ–‹‡–•™‡”‡Š‘•’‹–ƒŽ‹œ‡††—‡–‘‡šƒ ‡”„ƒ–‹‘•‘ˆ•›’–‘•Ǥˆ

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–Š‘•‡‘Ž›‘‡™ƒ•ƒ –‹˜‡Ž›ˆ‘ŽŽ‘™‹‰’ƒ––Š‡–‹‡‘ˆŠ‘•’‹–ƒŽ‹œƒ–‹‘Ǥ ”‘–Š‡‰”‘—’ǡ ƒ–‘–ƒŽ‘ˆ•‡˜‡’ƒ–‹‡–•™‡”‡Š‘•’‹–ƒŽ‹œ‡†ǤMain Analyses.  Primary outcome.

‡’‡ƒ–‡†‡ƒ•—”‡•ƒƒŽ›•‡•‘–Š‡„ƒ•‹•‘ˆ–Š‡‹–‡–‹‘F Ǧ–‘Ǧ–”‡ƒ– 2 ’”‹ ‹’Ž‡™‹–Š‹’—–‡††ƒ–ƒ”‡˜‡p ƒŽ‡†–Šƒ–’ƒ–‹‡–•‹„‘–Š–Š‡’‰”‘—’ȋ ȋͳǡͶͳȌαʹͳǤͷʹǡηp ’‘‘Ž‡† αǤ͵Ͷǡ F δǤͲͲͳȌƒ†‹–Š‡‰”‘—’•Š‘™‡†•‹‰‹ˆ‹ ƒ–‹’”‘˜‡‡–•‹•‘ ‹ƒŽˆ— –‹‘‹‰p 2 ’‘‘Ž‡† ƒ–ʹȋ ȋͳǡͶͳȌα͹ǤͶ͹ǡηpαǤͳͷǡ αǤͲͳȌǤƒ•‡†‘–Š‡„‡ Šƒ”•‡•–ƒ„Ž‹•Š‡†„›‘Š‡ ȋͳͻͺͺǢǤͲͳᕏƒŽŽǢǤͲ͸Ꮡ†‡”ƒ–‡ǡǤͳͶαŽƒ”‰‡Ȍǡ–Š‡•‡‡ˆˆ‡ –• ƒ„‡ ‘•‹†‡”‡†Žƒ”‰‡Ǥ–͵ǡF p 2 ’‘‘Ž‡† Š‘™‡˜‡”ǡ–Š‡‡ˆˆ‡ –‹–Š‡‰”‘—’™ƒ•‘Ž‘‰‡”•‹‰‹ˆ‹ ƒ–ȋF ȋͳǡͶͳȌαʹǤʹͷǡηpαǤͲͷǡp α 2 ’‘‘Ž‡† ǤͳͶȌǡ™Š‹Ž‡–Š‡’‰”‘—’ ‘–‹—‡†–‘•Š‘™ƒŽƒ”‰‡‡ˆˆ‡ –ȋ ȋͳǡͶͳȌαʹͲǤͻͻǡηpαǤ͵Ͷǡ δ ǤͲͲͳȌǤ•‘–Š‡„ƒ•‹•‘ˆ–Š‡‹–‡–‹‘Ǧ–‘Ǧ–”‡ƒ–’”‹ ‹’Ž‡™‹–Š‹’—–‡††ƒ–ƒ”‡˜‡ƒŽ‡†–Šƒ– –Š‡‹’”‘˜‡‡–‹–Š‡’‰”‘—’™ƒ•‘–•‹‰‹ˆ‹ ƒ–Ž›‰”‡ƒ–‡”–Šƒ‹–Š‡‰”‘—’ƒ–ʹt p t 2 ’‘‘Ž‡† 2 pȋ ȋͺͲȌαͳǤͲͳǡηpαǤͲ͵ǡ αǤ͵ʹȌǡ„—–™ƒ••‹‰‹ˆ‹ ƒ–Ž›‰”‡ƒ–‡”ƒ–͵ȋ ȋͺͲȌαʹǤͳ͹ǡηpαǤͲ͸ǡ ’‘‘Ž‡† αǤͲ͵ȌǤSecondary outcomes. Ž‡ƒ•‡•‡‡ƒ„Ž‡ʹˆ‘”–”‡ƒ–‡–‡ˆˆ‡ –•‘–Š‡•‡ ‘†ƒ”›‘—– ‘‡ ˜ƒ”‹ƒ„Ž‡•Ǥ                   

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Table 2. Results of the intention-to-treat ANCOVAs* comparing the effectiveness of mentalization-based treatment for psychotic disorder (MBT-p) with treatment as usual (TAU). 7

 ȗ‘•–Ǧ–”‡ƒ–‡–ƒ†ˆ‘ŽŽ‘™Ǧ—’ƒƒŽ›•‡•™‡”‡ƒ†Œ—•–‡†ˆ‘”„ƒ•‡Ž‹‡’‡”ˆ‘”ƒ ‡Ǥ 

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Mediation analyses.

Ž›”‡‰ƒ”†‹‰–Š‡ˆ‘ŽŽ‘™Ǧ—’‡ƒ•—”‡‡–ȋ͵Ȍ†‹†–”‡ƒ–‡– ‘†‹–‹‘Šƒ˜‡ƒ•‹‰‹ˆ‹ ƒ–‡ˆˆ‡ –‘•‘ ‹ƒŽˆ— –‹‘‹‰Ǥ††‹–‹‘ƒŽŽ›ǡ–”‡ƒ–‡– ‘†‹–‹‘‘Ž› Šƒ†ƒ•‹‰‹ˆ‹ ƒ–‡ˆˆ‡ –‘—†‡”•–ƒ†‹‰‘ˆ•‘ ‹ƒŽ ƒ—•ƒŽ‹–›ƒ†‘–Š‡‘”›‘ˆ‹†Ǥ‡†‹ƒ–‹‘ ƒƒŽ›•‡•™‡”‡–Š‡”‡ˆ‘”‡‘Ž› ‘†— –‡†ˆ‘”–Š‡•‡–™‘‡†‹ƒ–‘”•ƒ†‘Ž›ƒ–͵Ǥ‘‘–•–”ƒ’’‡† ‡†‹ƒ–‹‘ƒƒŽ›•‡•‹–—””‡˜‡ƒŽ‡†–Šƒ–•‘ ‹ƒŽˆ— –‹‘b p ‹‰ƒ–͵™ƒ••‹‰‹ˆ‹ ƒ–Ž›’”‡†‹ –‡†„›b ’‘‘Ž‡† p–Š‡‘”›‘ˆ‹†ȋ αͲǤ͹ͻǡ αǤͲͶȌǡ„—–‘–„›—†‡”•–ƒ†‹‰‘ˆ•‘ ‹ƒŽ ƒ—•ƒŽ‹–›ȋ αͲǤ͵ͻǡ ’‘‘Ž‡† αǤʹͷȌǤƒ•–Ž›ǡ™Š‹Ž‡ƒ ‘—–‹‰ˆ‘”–Š‡‘”›‘ˆ‹†ǡ–Š‡‡ˆˆ‡ –‘ˆ–”‡ƒ–‡– ‘†‹–‹‘‘b p ’‘‘Ž‡† •‘ ‹ƒŽˆ— –‹‘‹‰„‡ ƒ‡‘•‹‰‹ˆ‹ ƒ–ȋ αͳǤͷͳǡ αǤʹ͹Ȍǡ•—‰‰‡•–‹‰–Š‡’”‡•‡ ‡‘ˆ ‡†‹ƒ–‹‘Ǥ ‘™‡˜‡”ǡ–Š‡ ‘ˆ‹†‡ ‡‹–‡”˜ƒŽ‘ˆ–Š‡‡†‹ƒ–‹‘‡ˆˆ‡ – ‘–ƒ‹‡†ͲȋͻͷΨ ȏǦ ͲǤͲͲʹǡͲǤ͵͵ȐȌǤModeration analyses. ‘†‡”ƒ–‹‘ƒƒŽ›•‡•†‹†‘–”‡˜‡ƒŽ‘†‡”ƒ–‹‘‡ˆˆ‡ –•‘ˆ ‡†‹ ƒ–‹‘ƒ†Š‡”‡ ‡ǡ–‘–ƒŽŠ‘—”•‘ˆ’ƒ––‡†ƒ ‡ǡ’‡”•‘ƒŽ‹–›‘”‰ƒ‹œƒ–‹‘ǡ•‘ƒ–‹œƒ–‹‘ǡp ‘” Š‹Ž†Š‘‘†–”ƒ—ƒ‘–”‡ƒ–‡–‡ˆˆ‡ –ƒ–ʹ‘”͵ȋƒŽŽ ’s > .07). However,F duration of illnessp •‹‰‹ˆ‹cantlyR moderated the treatmentp effect on social functioning at T3 (Δ ȋͳǡͷͺȌαͶǤͲͷǡ α .049, Δ ʹαǤͲͷȌǡ„—–‘–ƒ–ʹȋ αǤ͵ͺȌǤ‡Žƒ–‹˜‡Ž›”‡ ‡–‘•‡–’ƒ–‹‡–•ȋδαͷ›‡ƒ”•Ȍ‹–Š‡F p 2 ’‰”‘—’•Š‘™‡†•‹‰‹ˆ‹ ƒ–Ž›Š‹‰Š‡”Ž‡˜‡Ž•‘ˆ•‘ ‹ƒŽˆ— –‹‘‹‰ȋ M SD ȋͳǡ͵͵ȌαͳͲǤͷͲǡηp αǤͳ͹ǡ  αǤͲʹȌƒ–͵Mȋ αͳͳ͸ǤͷͺǡSD α͹Ǥͳ͹Ȍ–Šƒ–Š‡‘”‡ Š”‘‹ ’ƒ–‹‡–•ȋεͷ›‡ƒ”•Ȍ‹–Š‡’ M ‘†‹–‹‘ȋSD αͳͲͻǤͻͷǡF α͸ǤͲͶȌƒ†–Š‡”‡Žƒ–‹˜‡Ž›”‡ ‡–‘•‡–’ƒ–‹‡–•‹–Š‡‰”‘—’ȋp α 2 ͳͳͳǤͶͲǡMultilevelα͸Ǥ͹ͳǢ analysis.ȋͳǡ͵ͶȌα͸ǤͶͺǡ ηp αǤͳ͹ǡ αǤͲʹȌǤ ‘”•‘ ‹ƒŽ•–”‡••ǡ–”‡ƒ–‡– ‘†‹–‹‘‹–‡”ƒ –‡†•‹‰‹ˆ‹ ƒ–Ž›™‹–Š –Š‡–‹‡˜ƒ”‹ƒ„Ž‡ǡ™‹–Š’ƒ–‹‡–•‹–Š‡’ ‘†‹–‹‘•Š‘™‹‰ƒ‰”‡ƒ–‡”†‡ ”‡ƒ•‡‹”‡’‘”–‡†b p •‘ ‹ƒŽ•–”‡••‘˜‡”–Š‡ ‘—”•‡‘ˆˆ‘—”–‹‡’‘‹–•ȋ αǦͲǤ͵ʹǡͻͷΨ ȏǦͲǤͷͺǡǦͲǤͲͷͻȐǡ αǤͲʹȌǤ —”–Š‡”ƒƒŽ›•‡••Š‘™‡†‘•‹‰‹ˆ‹ ƒ–†‹ˆˆ‡”‡ ‡•‹ Šƒ‰‡‘˜‡”–‹‡‘’•› Š‘–‹  ‡š’‡”‹‡ ‡•ǡ‡‰ƒ–‹˜‡ƒˆˆ‡ –ǡ’‘•‹–‹˜‡ƒˆˆ‡ –ǡ‘”‹ŽŽ‹ ‹–†”—‰—•‡„‡–™‡‡–”‡ƒ–‡– ‘†‹–‹‘•ȋƒŽŽp ’s > .06). The interaction–‡”‘ˆ–”‡ƒ–‡– ‘†‹–‹‘ǡ–‹‡ǡƒ†•‘ ‹ƒŽ•–”‡••™ƒ•‘–ƒp •‹‰‹ˆ‹ ƒ–’”‡†‹ –‘”ˆ‘”’•› Š‘–‹ ‡š’‡”‹‡ ‡•ǡ‡‰ƒ–‹˜‡ƒˆˆ‡ –ǡ‘”’‘•‹–‹˜‡ƒˆˆ‡ –ȋƒŽŽ ’s > .12), ‡ƒ‹‰–Šƒ––Š‡”‡™‡”‡‘†‹ˆˆ‡”‡ ‡•‹Š‘™•‘ ‹ƒŽ•–”‡••”‡ƒ –‹˜‹–› Šƒ‰‡†‘˜‡”–‹‡ „‡–™‡‡–Š‡–™‘–”‡ƒ–‡– ‘†‹–‹‘•Ǥ Discussion Main findings.

Š‡ —””‡––”‹ƒŽ–‡•–‡†™Š‡–Š‡”ƒ††‹‰’–‘”‡•—Ž–‡†‹‰”‡ƒ–‡” ‹’”‘˜‡‡–‹•‘ ‹ƒŽˆ— –‹‘‹‰–ŠƒƒŽ‘‡Ǥ –‡–‹‘Ǧ–‘Ǧ–”‡ƒ–ƒƒŽ›•‡•”‡˜‡ƒŽ‡†–Šƒ– ’ƒ–‹‡–•‹„‘–Š–Š‡ƒ†’ ‘†‹–‹‘••Š‘™‡†Žƒ”‰‡ǡ•‹‰‹ˆ‹ ƒ–‹’”‘˜‡‡–•‘•‘ ‹ƒŽ ˆ— –‹‘‹‰’‘•–Ǧ–”‡ƒ–‡–ǤŠ‡”‡™ƒ•‘•‹‰‹ˆ‹ ƒ–†‹ˆˆ‡”‡ ‡„‡–™‡‡’ƒ†ƒ––Š‹• ’‘‹–‹–‹‡Ǥ ‘™‡˜‡”ǡ–Š‡‹’”‘˜‡‡–•™‡”‡‘”‡”‘„—•–‹–Š‡’‰”‘—’ƒ†•—’‡”‹‘”–‘

ǡ ”‡ƒ‹‹‰•‹‰‹ˆ‹ ƒ–ƒ–ƒ͸Ǧ‘–Šˆ‘ŽŽ‘™Ǧ—’Ǥ††‹–‹‘ƒŽŽ›ǡ‡˜‹†‡ ‡•—‰‰‡•–•–Šƒ–†—”ƒ–‹‘

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‘ˆ‹ŽŽ‡••‘†‡”ƒ–‡†–Š‡–”‡ƒ–‡–‡ˆˆ‡ –ƒ–ˆ‘ŽŽ‘™Ǧ—’ǡ‹’Ž›‹‰–Šƒ–”‡•—Ž–•ƒ›„‡‡•’‡ ‹ƒŽŽ› ”‘„—•–‹’ƒ–‹‡–•™‹–Šƒ”‡Žƒ–‹˜‡Ž›”‡ ‡–‘•‡–‘ˆ‹ŽŽ‡••ǤInterpretation and comparison to previous findings. –ƒ›‘– ‘‡ƒ•ƒ•—”’”‹•‡ –Šƒ–’ƒ–‹‡–•™Š‘”‡ ‡‹˜‡†ǡ’”‘˜‹†‡†ƒ ‘”†‹‰–‘–Š‡ Ǧ‘†‡Žǡ•Š‘™‡†‹’”‘˜‡‡– ‹•‘ ‹ƒŽˆ— –‹‘‹‰’‘•–Ǧ–”‡ƒ–‡–ǡ•‹ ‡ Ǧ–‡ƒ•‹ Ž—†‡•‡˜‡”ƒŽ’”‘ˆ‡••‹‘ƒŽ••’‡ ‹ƒŽ‹œ‡† ‹Š‡Ž’‹‰’ƒ–‹‡–•–‘•–”— –—”‡–Š‡‹”•‘ ‹ƒŽŽ‹˜‡•ǤŠ‹•ƒŽ•‘ ‘””‘„‘”ƒ–‡•‡ƒ”Ž‹‡”ˆ‹†‹‰•et al ȋ”—‡” ǤʹͲͳ͵ȌǤŠ‡ƒ††‹–‹‘‘ˆ‹†‹˜‹†—ƒŽ’Žƒ ‡‡–ƒ†•—’’‘”––ƒ‡˜‹†‡ ‡Ǧ„ƒ•‡† ‹–‡”˜‡–‹‘–Šƒ– ‘•‹•–•‘ˆ–ƒ”‰‡–‡†•—’’‘”–‹‡’Ž‘›‡–‘”‡et al et al †— ƒ–‹‘–ƒ›Šƒ˜‡ˆ—”–Š‡” ‘–”‹„—–‡†–‘•‘ ‹ƒŽˆ— –‹‘‹‰ȋ ‘ˆˆƒ ǤʹͲͳʹǢ‘• ǤʹͲͳͻȌǤ–‹ŽŽǡˆ— –‹‘ƒŽ”‡ ‘˜‡”› appeared to be more robust in the MBTp group, which may be attributed to the ‘sleeper effect’ ‘„•‡”˜‡†‹’”‡˜‹‘—••–—†‹‡• ‘ ‡”‹‰–Š‡Ž‘‰Ǧ–‡”‡ˆˆ‡ –•‘ˆǤƒ–‡ƒƒ† ‘ƒ‰› ȋʹͲͲͳȌƒ”‰—‡†–Šƒ–‹’”‘˜‡†‡–ƒŽ‹œ‹‰‡ƒ„Ž‡†’ƒ–‹‡–•–‘„‡––‡” ‘’‡™‹–Š–Š‡•–”‡••‡•‘ˆ ‡˜‡”›†ƒ›Ž‹ˆ‡‹–Š‡Ž‘‰”—Ǥ ‘™‡˜‡”ǡ–Š‡Žƒ ‘ˆ†‹ˆˆ‡”‡ ‡„‡–™‡‡–Š‡ ‘†‹–‹‘•’‘•–Ǧ–”‡ƒ–‡–ƒ†–Š‡ •‹‰‹ˆ‹ ƒ–†‹ˆˆ‡”‡ ‡ƒ–ˆ‘ŽŽ‘™Ǧ—’ƒ›ƒŽ•‘Šƒ˜‡†‹ˆˆ‡”‡–‘”‹‰‹•Ǥ ‹”•–ǡ‘”‡’ƒ–‹‡–•‹–Š‡ ‰”‘—’ȋα͹Ȍ”‡ ‡‹˜‡†„‡–™‡‡–Š‡’”‡Ǧƒ†’‘•–Ǧ–”‡ƒ–‡–‡ƒ•—”‡‡–ƒ•‘’’‘•‡† –‘–Š‡’‰”‘—’ȋαͳȌǤ‘‡”‡ ‡‹˜‡†‹–Š‡ˆ‘ŽŽ‘™Ǧ—’’‡”‹‘†Ǥ•Šƒ•„‡‡•Š‘™–‘ ’”‘†— ‡ƒ•‹‰‹ˆ‹ ƒ–„—–‘Ǧ”‘„—•–‡ˆˆ‡ –‘•‘ ‹ƒŽˆ— –‹‘‹‰ȋƒ™•‡–ƒŽǤʹͲͳͺȌǡƒ› –Š‡”‡ˆ‘”‡Šƒ˜‡ƒ†‡ƒ ‘–”‹„—–‹‘–‘–Š‡‘˜‡”ƒŽŽ‰ƒ‹‹•‘ ‹ƒŽˆ— –‹‘‹‰‹–Š‡‰”‘—’ „‡–™‡‡’”‡Ǧƒ†’‘•–n Ǧ–”‡ƒ–‡–™Š‹ Š†‹†‘–Žƒ•–ƒˆ–‡”•‹š‘–Š•Ǥ‡ ‘†ǡ‘”‡’ƒ”–‹ ‹’ƒ–•n ‹–Š‡Ǧ‰”‘—’ȋ αͷȌ–Šƒ‹–Š‡’‰”‘—’ȋ αͲȌǡ†‹• ‘–‹—‡† †—”‹‰–Š‡ˆ‘ŽŽ‘™Ǧ—’ 7 ’‡”‹‘†™Š‹ Šƒ›Šƒ˜‡ˆ—”–Š‡””‡†— ‡†ˆ— –‹‘ƒŽ‰ƒ‹•ƒ–ˆ‘ŽŽ‘™Ǧ—’Ǥ Interestingly, while the evidence for MBT’s p”‘’‘•‡†‡ Šƒ‹•‘ˆ Šƒ‰‡et al. ––Š‡ ‹’”‘˜‡‡–‘ˆ‡–ƒŽ‹œ‹‰ƒ„‹Ž‹–›–‹••–‹ŽŽ• ƒ” ‡ȋ‘••‘—™ ʹͲͳʹȌǡ–Š‡ —””‡–”‡•—Ž–• •—‰‰‡•––Šƒ–’ƒ–‹‡–•‹–Š‡’‰”‘—’†‹†’‡”ˆ‘”„‡––‡”‘•‡˜‡”ƒŽ‡ƒ•—”‡•‘ˆ‡–ƒŽ‹œ‹‰ ƒ„‹Ž‹–›ǡ‹ Ž—†‹‰–Š‡‘”›‘ˆ‹†ǡ—†‡”•–ƒ†‹‰‘ˆ•‘ ‹ƒŽ ƒ—•ƒŽ‹–›ǡƒ† ‘’Ž‡š‹–›‘ˆ ”‡’”‡•‡–ƒ–‹‘•ǤŠ‡›ƒŽ•‘•Š‘™‡†ƒ‹ ”‡ƒ•‡‹‹•‹‰Š–Ǥ ‘™‡˜‡”ǡ‡†‹ƒ–‹‘ƒƒŽ›•‡•‘ˆˆ‡”‡†drove ‘Ž›Ž‹‹–‡†‡˜‹†‡ ‡–Šƒ–ƒ‹’”‘˜‡‡–‘ˆ‡–ƒŽ‹œƒ–‹‘ –Š‹•–”‡ƒ–‡–‡ˆˆ‡ –Ǥ —”–Š‡”‘”‡ǡ‘–”‡ƒ–‡–‡ˆˆ‡ –•™‡”‡‘„•‡”˜‡†‘–Š‡ Ž‹‹ ƒŽ•›’–‘•‘ˆǤ ‘’ƒ”‹•‘–‘’”‡˜‹‘—••–—†‹‡•”‡˜‡ƒŽ‡†–Šƒ–‘—”•ƒ’Ž‡•—ˆˆ‡”‡†ˆ”‘”‡Žƒ–‹˜‡Ž›‹Ž† •›’–‘•ǡ™Š‹ Šƒ›ƒ ‘—–ˆ‘”–Š‡Žƒ ‘ˆ‘„•‡”˜‡†–”‡ƒ–‡–‡ˆˆ‡ –•Ǥ ‘”‡•ˆ‘” Ž‹‹ ƒŽet al symptoms atet baselineal. were similar to those for remitted patients (Češková ǤʹͲͲͷǢ ŠƒŠŽƒ†‹”ƒ ʹͲͳͺȌǤŠ‡•‡„ƒ•‡Ž‹‡• ‘”‡•Ž‹‡Ž›”‡ˆŽ‡ –ƒ”‡ ”—‹–‡–„‹ƒ•Ǥ—”‹‰–Š‡ •‡Ž‡ –‹‘’”‘ ‡†—”‡ǡ–”‡ƒ–‡–•–ƒˆˆ‡„‡”•™‡”‡ƒ•‡†–‘• ƒ–Š‡‹” ƒ•‡Ž‘ƒ†•ˆ‘”’ƒ–‹‡–• ™Š‘™‡”‡‡Ž‹‰‹„Ž‡ˆ‘”’ƒ”–‹ ‹’ƒ–‹‘Ǥ ‹˜‡–Šƒ–‘Ž›ƒ„‘—–ʹͲΨ‘ˆƒ˜ƒ‹Žƒ„Ž‡’ƒ–‹‡–•™‡”‡

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”‡ˆ‡””‡†–‘–Š‡‹–ƒ‡‘ˆ–Š‡–”‹ƒŽǡ‹–‹•’‘••‹„Ž‡–Šƒ–•–ƒˆˆ‡„‡”•ƒ’’”‘ƒ Š‡†–Š‡‘”‡•–ƒ„Ž‡ ’ƒ–‹‡–•Ǥ ††‹–‹‘ƒŽŽ›ǡ–Š‡‘„•‡”˜‡†‡ˆˆ‡ –•‘ˆ’‘•‘ ‹ƒŽˆ— –‹‘‹‰ƒ’’‡ƒ”–‘„‡‰”‡ƒ–‡•–‹ –Š‡•—„‰”‘—’‘ˆ”‡Žƒ–‹˜‡Ž›”‡ ‡–‘•‡–’ƒ–‹‡–•Ǥ‡ ‡–’ƒ–‹‡–•‹–Š‡’‰”‘—’•Š‘™‡†M ”‡Žƒ–‹˜‡Ž›Žƒ”‰‡‹’”‘˜‡‡–•ǡƒ Š‹‡˜‹‰Ž‡˜‡Ž•‘ˆˆ— –‹‘‹‰ȋM M αͳͳ͸ǤͷͺȌ–Šƒ–ƒ”‡„‡–™‡‡ –Š‘•‡‘ˆ’ƒ–‹‡–•ȋ αͳͲͺǤͲ͹Ȍƒ†Š‡ƒŽ–Š› ‘–”‘Ž•ȋ αͳʹ͵Ǥ͵͸Ȍǡƒ•‡•–ƒ„Ž‹•Š‡†„› ††‹‰–‘ƒ†††‹‰–‘ȋʹͲͲͺȌǤŠ‡•‡”‡•—Ž–•ƒ”‡‹Ž‹‡™‹–Šƒ‰”‘™‹‰„‘†›‘ˆŽ‹–‡”ƒ–—”‡ et •—‰‰‡•–‹‰–Šƒ–al. Ž‘‰et al.†—”ƒ–‹‘‘ˆ‹ŽŽ‡••‹•ƒ’”‡†‹ –‘”‘ˆ’‘‘”–”‡ƒ–‡–”‡•’‘•‡ȋ‹‡„‡”ƒ ʹͲͳ͵Ǣ‹ ‘Ž ʹͲͳͶȌƒ†–Šƒ––Š‡ˆ‹”•–ˆ‹˜‡›‡ƒ”•‘ˆ ‘•–‹–—–‡ƒ ”— ‹ƒŽ’‡”‹‘†ˆ‘”et al. ‹–‡”˜‡–‹‘ȋ‹” Š™‘‘†Ƭƒ ‹ŽŽƒǡͳͻͻ͵Ǣ ‘””› ʹͲͳͲȌǤ–‡†•–‘‹˜‘Ž˜‡ƒ —Ž–‹–—†‡‘ˆ’”‘„Ž‡•–Šƒ–ƒ› ‘’Ž‹ et al. ƒ–‡–Š‡”ƒ’›ƒ•–Š‡†‹•‘”†‡”’”‘‰”‡••‡•ǡ‹ Ž—†‹‰ et ‘‰‹–‹˜‡†‡ Ž‹‡ȋ›‡• al. ʹͲͳͳȌƒ†‰”‡ƒ–‡”†‹ˆˆ‹ —Ž–› ŠƒŽŽ‡‰‹‰Ž‘‰Š‡Ž†„‡Ž‹‡ˆ• ȋ‹ ‘Ž ʹͲͳͶȌǤ‘•‡“—‡–Ž›ǡ–Š‡ Š‘‹ ‡–‘‹ Ž—†‡’ƒ–‹‡–•–Šƒ–Šƒ†”‡ ‡‹˜‡†–”‡ƒ–‡–ˆ‘”—’–‘ –‡›‡ƒ”•„‡ˆ‘”‡‡”‘ŽŽ‡–‹–Š‡ —””‡–•–—†›ƒ›Šƒ˜‡Ž‹‹–‡†–Š‡‘˜‡”ƒŽŽ‡ˆˆ‡ –‘ˆ’ǡet al ™Š‹ Šƒ›„‡‘•–‡ˆˆ‡ –‹˜‡Ž›‹’Ž‡‡–‡†‹–Š‡‡ƒ”Ž›•–ƒ‰‡•‘ˆ–Š‡†‹•‘”†‡”ȋ‡„„ƒ± Ǥ ʹͲͳ͸ȌǤ Strength and limitations. Š‡ —””‡–•–—†›—•‡†ƒ”‹‰‘”‘—•”‡•‡ƒ” Š†‡•‹‰ǣ ”ƒ†‘‹œƒ–‹‘ǡ–ƒ‹‰‹–‘ƒ ‘—–„ƒ•‡Ž‹‡’‡”ˆ‘”ƒ ‡ǡƒ†–Š‡—•‡‘ˆ„Ž‹†‡†”ƒ–‡”•Ǥ ††‹–‹‘ƒŽŽ›ǡ‹–‹•–Š‡ˆ‹”•–•–—†›–‘‡šƒ‹‡–Š‡‡ˆˆ‡ –‹˜‡‡••‘ˆ‹ƒ†‹–‹•‘‡‘ˆ–Š‡ ˆ‡™•–—†‹‡•–‘‡šƒ‹‡™Š‡–Š‡”‹’”‘˜‡•‡–ƒŽ‹œ‹‰ƒ„‹Ž‹–›ȋ•‡‡‘••‘—™Ƭ ‘ƒ‰›ǡ ʹͲͳʹǡˆ‘”ƒ‘–Š‡”‡šƒ’Ž‡ȌǤƒ•–Ž›ǡ‹–‡•‹˜‡•—’‡”˜‹•‹‘™ƒ•’”‘˜‹†‡†–‘‡•—”‡–Šƒ– ’”‘ˆ‡••‹‘ƒŽ•ƒ†Š‡”‡†–‘–Š‡‘†‡ŽǤ ƒ–—”ƒŽŽ›ǡ•‡˜‡”ƒŽŽ‹‹–ƒ–‹‘•ƒ’’Ž›Ǥ ‹”•–ǡ–Š‡–™‘–”‡ƒ–‡– ‘†‹–‹‘• ƒ‘–„‡ †‡‡‡†‡“—ƒŽǡƒ‹‰‹–†‹ˆˆ‹ —Ž––‘†‡–‡”‹‡™Š‡–Š‡”‘„•‡”˜‡††‹ˆˆ‡”‡ ‡•™‡”‡ƒ –—ƒŽŽ› ƒ—•‡†„›–Š‡‹–‡”˜‡–‹‘•–Š‡•‡Ž˜‡•Ǥƒ”–‹ ‹’ƒ–•‹–Š‡’‰”‘—’”‡ ‡‹˜‡†‰”‘—’ –Š‡”ƒ’›Ǥ–Š‡‘–Š‡”Šƒ†ǡ’ƒ”–‹ ‹’ƒ–•‹–Š‡‰”‘—’”‡ ‡‹˜‡†‘”‡„‡–™‡‡–Š‡ „ƒ•‡Ž‹‡ƒ†’‘•––”‡ƒ–‡–‡ƒ•—”‡‡–•Ǥ‡ ‘†ǡ™‹–Šƒ†”‘’Ǧ‘—–”ƒ–‡‘ˆƒ”‘—†ʹͲΨǡ–Š‡ ”‡•—Ž–•‘ˆ‘—”•–—†›•Š‘—Ž†„‡–”‡ƒ–‡†™‹–Š ƒ—–‹‘ǤŠ‹”†ǡ–Š‡‘†‡”ƒ–‹‘ƒƒŽ›•‡•™‡”‡Ž‹‡Ž› underpowered. Fourth, except for the ‘complexity of representations’ dimension, we Š‹‡ˆŽ› ‡ƒ•—”‡†‘–Š‡”Ǧ‘”‹‡–‡†ǡ ‘‰‹–‹˜‡ˆ‘”•‘ˆ‡–ƒŽ‹œ‹‰Ǥ ‹ˆ–Šǡ™‡ƒ”‡’”‡ Ž—†‡†ˆ”‘†”ƒ™‹‰ ‘ Ž—•‹‘•ƒ„‘—––Š‡•‡ ‘†ƒ”›‘—– ‘‡•ǤŠ‡•‡•Š‘—Ž†„‡–”‡ƒ–‡†ƒ•‹†‹ ƒ–‹‘•‘ˆ–”‡ƒ–‡– ‡ˆˆ‡ –Ǥ‹š–Šǡƒ›’ƒ–‹‡–•ˆ‘—†‹–†‹ˆˆ‹ —Ž––‘ƒ––‡†™‡‡Ž›•‡••‹‘•ǤŠ‹•ƒ›Šƒ˜‡”‡†— ‡† –Š‡‡ˆˆ‡ –‹˜‡‡••‘ˆ–Š‡‹–‡”˜‡–‹‘Ǥ‘•‡“—‡–Ž›ǡ™‡–Š‹–Šƒ–ˆ—–—”‡‡ˆˆ‘”–••Š‘—Ž†‘–„‡ ƒ‹‡†ƒ–‹ ”‡ƒ•‹‰–Š‡ˆ”‡“—‡ ›‘ˆ•‡••‹‘•ǡ„—–’‡”Šƒ’•ƒ–Ž‡‰–Š‡‹‰–Š‡†—”ƒ–‹‘‘ˆ–Š‡ –”‡ƒ–‡–Ǧ’‡”‹‘†ǡƒ••‘‡’ƒ–‹‡–•™‡”‡†‹•ƒ’’‘‹–‡†–Šƒ––Š‡›Šƒ†–‘•–‘’ƒˆ–‡”ͳͺ‘–Š•Ǥ ‡˜‡–Šǡ–Š‡ ‹–‹‰ƒ•Šƒ•„‡‡ ”‹–‹ ‹œ‡†ˆ‘”ƒ ‡‹Ž‹‰‡ˆˆ‡ –ǡ‡•’‡ ‹ƒŽŽ›‹Š‹‰Šˆ— –‹‘‹‰

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’ƒ–‹‡–•ȋ‡Ǥ‰Ǥǡ‘„‡”–•Ƭ‡ǡʹͲͲͻȌǡ‡ƒ‹‰–Šƒ––Š‡’‡”–‹‡–”‡•—Ž–••Š‘—Ž†„‡‹–‡”’”‡–‡† ™‹–Š ƒ—–‹‘Ǥ  Conclusion

Š‡”‡•—Ž–•‘ˆ–Š‹••–—†›•—‰‰‡•––Šƒ–’ƒ›Ž‡ƒ†–‘‘”‡”‘„—•– Šƒ‰‡•‹•‘ ‹ƒŽ ˆ— –‹‘‹‰–ŠƒƒŽ‘‡Ǥ  Acknowledgements

‘‡Ǥ Financial support

Š‹•”‡•‡ƒ” Š”‡ ‡‹˜‡†‘•’‡ ‹ˆ‹ ‰”ƒ–ˆ”‘ƒ›ˆ—†‹‰ƒ‰‡ ›ǡ ‘‡” ‹ƒŽ‘”‘–Ǧˆ‘”Ǧ’”‘ˆ‹– •‡ –‘”•Ǥ Conflict of interest

‘‡Ǥ Ethical standards

Š‡ƒ—–Š‘”•ƒ••‡”––Šƒ–ƒŽŽ’”‘ ‡†—”‡• ‘–”‹„—–‹‰–‘–Š‹•™‘” ‘’Ž›™‹–Š–Š‡‡–Š‹ ƒŽ •–ƒ†ƒ”†•‘ˆ–Š‡”‡Ž‡˜ƒ–ƒ–‹‘ƒŽƒ†‹•–‹–—–‹‘ƒŽ ‘‹––‡‡•‘Š—ƒ‡š’‡”‹‡–ƒ–‹‘ƒ† ™‹–Š–Š‡ ‡Ž•‹‹‡ Žƒ”ƒ–‹‘‘ˆͳͻ͹ͷǡƒ•”‡˜‹•‡†‹ʹͲͲͺǤ  7 References Schizophrenia

††‹‰–‘research,ǡ Ǥǡ††‹‰–‘ǡ ǤȋʹͲͲͺȌǤ‘ ‹ƒŽƒ† ‘‰‹–‹˜‡ˆ— –‹‘‹‰‹’•› Š‘•‹•Ǥ ͻͻȋͳǦ͵Ȍǡͳ͹͸ǦͳͺͳǤ Diagnostic and statistical manual of mental disorders ‡”‹ ƒ•› Š‹ƒ–”‹ (4th ed., Text Revision)••‘ ‹ƒ–‹‘ǤȋʹͲͲͲȌǤ Ǥƒ•Š‹‰–‘ǡǣ—–Š‘”Ǥ †”‡ƒ•‡ǡǤǤǡ Žƒ—ǡǤǡƬ”†–ǤȋͳͻͻʹȌǤŠ‡‘’”‡Š‡•‹˜‡••‡••‡–‘ˆ›’–‘•ƒ†Archives of ‹•–‘”›ȋ Ȍǣ‹•–”—‡–ˆ‘”ƒ••‡••‹‰†‹ƒ‰‘•‹•ƒ†’•› Š‘’ƒ–Š‘Ž‘‰›ǤGeneral Psychiatry  ǡͶͻȋͺȌǡ͸ͳͷǦ͸ʹ͵Ǥ †”‡ƒ•‡ǡǤǤǡ”‡••Ž‡”ǡǤǡ‘’‘—Ž‘•ǡǤǡ‹ŽŽ‡”ǡǤǡ ‘ǡǤǤȋʹͲͳͲȌǤ–‹’•› Š‘–‹ †‘•‡ ‡“—‹˜ƒŽ‡–•ƒ††‘•‡Biological psychiatry,Ǧ›‡ƒ”•ǣƒ•–ƒ†ƒ”†‹œ‡†‡–Š‘†ˆ‘” ‘’ƒ”‹‰‡š’‘•—”‡–‘†‹ˆˆ‡”‡– †”—‰•Ǥ ͸͹ȋ͵ȌǡʹͷͷǦʹ͸ʹǤ ”‘Ǧ‹„‡ˆ‡Ž†ǡǤǡ ƒ••‘ǦŠƒ›‘ǡ Ǥǡƒ˜‹†‘”ǡǤǡ–œ‹ŽǦŽ‘‹ǡǤǡ›•ƒ‡”ǡǤ ǤȋʹͲͳ͹ȌǤŠ‡ ƒ••‘ ‹ƒ–‹‘„‡–™‡‡‡–ƒ ‘‰‹–‹˜‡ƒ„‹Ž‹–‹‡•ƒ†‘—– ‘‡‡ƒ•—”‡•ƒ‘‰’‡‘’Ž‡™‹–ŠEuropean Psychiatry • Š‹œ‘’Š”‡‹ƒǣ‡–ƒǦƒƒŽ›•‹•Ǥ ǡͶ͸ǡ͵͵ǦͶͳǤ

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ƒ–‡ƒǡǤǤǡƬ ‘ƒ‰›ǡǤȋͳͻͻͻȌǤˆˆ‡ –‹˜‡‡••‘ˆ’ƒ”–‹ƒŽŠ‘•’‹–ƒŽ‹œƒ–‹‘‹–Š‡–”‡ƒ–‡–‘ˆAmerican Journal of  Psychiatry„‘”†‡”Ž‹‡’‡”•‘ƒŽ‹–›†‹•‘”†‡”ǣ”ƒ†‘‹œ‡† ‘–”‘ŽŽ‡†–”‹ƒŽǤ156 ǡ ȋͳͲȌǡͳͷ͸͵Ǧͳͷ͸ͻǤ ƒ–‡ƒǡǤǤǡƬ ‘ƒ‰›ǡǤȋʹͲͲͳȌǤ”‡ƒ–‡–‘ˆ„‘”†‡”Ž‹‡’‡”•‘ƒŽ‹–›†‹•‘”†‡”™‹–ŠAmerican ’•› Š‘ƒƒŽ›–‹ ƒŽŽ›‘”‹‡–‡†’ƒ”–‹ƒŽŠ‘•’‹–ƒŽ‹œƒ–‹‘ǣͳͺJournal of Psychiatry Ǧ‘–Šˆ‘ŽŽ‘™Ǧ—’Ǥ ǡͳͷͺȋͳȌǡ͵͸ǦͶʹǤ Journal of ƒ–‡ƒPersonalityǡǤǤǡƬ ‘ƒ‰› DisordersǡǤȋʹͲͲͶȌǤ‡–ƒŽ‹œƒ–‹‘Ǧ„ƒ•‡†–”‡ƒ–‡–‘ˆǤ ǡͳͺȋͳȌǡ͵͸ǦͷͳǤ ƒ–‡ƒǡǤǤǡƬ ‘ƒ‰›ǡǤȋʹͲͲͺȌǤͺǦ›‡ƒ”ˆ‘ŽŽ‘™Ǧ—’‘ˆ’ƒ–‹‡–•–”‡ƒ–‡†ˆ‘”„‘”†‡”Ž‹‡ ’‡”•‘ƒŽ‹–›†‹•‘”†‡”ǣ‡–ƒŽ‹œƒ–‹‘American Journal of PsychiatryǦ„ƒ•‡†–”‡ƒ–‡–˜‡”•—•–”‡ƒ–‡–ƒ• —•—ƒŽǤ ǡͳ͸ͷȋͷȌǡ͸͵ͳǦ͸͵ͺǤ ‡ Š‹ǡǤǡ‘•‹ƒǡǤǡ—‘‘ ‘”‡ǡǤǡ‰‘•–‘‹ǡ Ǥǡ‘•‹‡ŽŽ‹ǡ Ǥǡ‹Ž˜‡•–”‹ǡǤǤǡǤǤǤƒ˜ƒŽŽƒ”‘ǡǤ ȋʹͲͳͻȌǤ–ƒ„‹Ž‹–›ƒ†‰‡‡”ƒŽ‹œƒ–‹‘‘ˆ ‘„‹‡†–Š‡‘”›‘ˆ‹†ƒ† ‘‰‹–‹˜‡Psychiatric rehabilitation ”‡‡†‹ƒ–‹‘‹–‡”˜‡–‹‘•‹• Š‹œ‘’Š”‡‹ƒǣ ‘ŽŽ‘™journal. Ǧ—’”‡•—Ž–•Ǥ

‹ˆ—Ž ‘ǡǤǡ”‘™ǡ ǤǤǡƬ ƒ””‹•ǡǤǤȋͳͻͻͶȌǤŠ‹Ž†Š‘‘†š’‡”‹‡ ‡‘ˆƒ”‡Journal of Childhood Psychology andƒ†„—•‡ Psychiatry,ȋȌǣ ”‡–”‘•’‡ –‹˜‡‹–‡”˜‹‡™‡ƒ•—”‡Ǥ ͵ͷǡ ͳͶͳͻ–͵ͷǤ ‹” Š™‘‘†ǡǤǡ‹–Šǡ ǤǤǡ‘ Š”ƒ‡ǡǤǡ‡––‘ǡǤǡƬ‘’‡•–ƒ‡ǡ ǤȋͳͻͻͲȌǤŠ‡‘ ‹ƒŽ — –‹‘‹‰ ƒŽ‡ǣŠ‡†‡˜‡Ž‘’‡–ƒ†˜ƒŽ‹†ƒ–‹‘‘ˆƒ‡™• ƒŽ‡‘ˆ•‘ ‹ƒŽƒ†Œ—•–‡–The British ˆ‘”—•‡‹ˆƒ‹Ž›‹–‡”˜‡–‹‘’”‘‰”ƒ‡•™‹–Š• Š‹œ‘’Š”‡‹ ’ƒ–‹‡–•ǤJournal of Psychiatry 157  ǡ ȋ͸Ȍǡͺͷ͵ǦͺͷͻǤ Australian and New ‹” Š™‘‘†ZealandǡǤǡƬ Journalƒ ‹ŽŽƒ of Psychiatryǡ Ǥȋͳͻͻ͵ȌǤƒ”Ž›‹–‡”˜‡–‹‘‹• Š‹œ‘’Š”‡‹ƒǤ ǡʹ͹ȋ͵Ȍǡ͵͹ͶǦ͵͹ͺǤ ”‡–ǡǤǤǡƬ ‘ƒ‰›ǡǤȋʹͲͳͶȌǤ‡–ƒŽ‹œƒ–‹‘Ǧ„ƒ•‡†–”‡ƒ–‡–ƒ’’”‘ƒ Š–‘†‹•–—”„ƒ ‡•‘ˆSocial cognition and metacognition in •‘ ‹ƒŽ—†‡”•–ƒ†‹‰‹• Š‹œ‘’Š”‡‹ƒǤ schizophrenia: Psychopathology and treatment approaches , ȋ†ǤǤ Ǥ›•ƒ‡”ǡ Ǥ ‹ƒ‰‰‹‘ǡƬǤ”ò‡Ȍ ’’ǤʹͶͷǦʹͷͻǤƒ‹‡‰‘ǣŽ•‡˜‹‡” ƒ†‡‹ ”‡•• ”Ú ‡”ǡǤǤǡƒ›‡”ǡǤǡ–—‡ǡ Ǥǡ —•–ǡǤǡ‡”–”ƒǡ Ǥǡ — ‡ǡ ǤǡǤǤǤƬ‘–ƒ‰ǡǤȋʹͲʹͲȌǤ‡˜‡Ž•‘ˆ •–”— –—”ƒŽ‹–‡‰”ƒ–‹‘‡†‹ƒ–‡–Š‡‹’ƒ –‘ˆ‡–ƒ ‘‰‹–‹‘‘ˆ— –‹‘‹‰‹‘Ǧ ƒˆˆ‡ –‹˜‡’•› Š‘•‹•ǣ††‹‰ƒ’•› Š‘†›ƒ‹ ’‡”•’‡ –‹˜‡–‘–Š‡‡–ƒ ‘‰‹–‹˜‡Frontiers in Psychology, ƒ’’”‘ƒ ŠǤ ͳͳǡʹ͸ͻǤ ”ò‡ǡǤǡ‹ƒ‰‰‹‘ǡ Ǥǡ›•ƒ‡”ǡǤȋʹͲͳͳȌǤ‡–ƒ ‘‰‹–‹‘ƒ†•‘ ‹ƒŽˆ— –‹‘‹‰‹ Current • Š‹œ‘’Š”‡‹ƒǣ˜‹†‡ ‡ǡ‡ Šƒ‹••‘ˆ‹ˆŽ—‡ ‡ƒ†–”‡ƒ–‡–‹’Ž‹ ƒ–‹‘•ǤPsychiatry Reviews ǡ͹ȋ͵Ȍǡʹ͵ͻǦʹͶ͹Ǥ

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ČeškováǡǤ, PřikrylǡǤ, KašpárekǡǤǡƬOndrušovƒǡǤȋʹͲͲͷȌǤ•› Š‘’ƒ–Š‘Ž‘‰›ƒ†–”‡ƒ–‡–Neuropsychiatric Disease ”‡•’‘•‹˜‡‡••‘ˆ’ƒ–‹‡–•™‹–Šˆ‹”•–and Treatment 1 Ǧ‡’‹•‘†‡• Š‹œ‘’Š”‡‹ƒǤ ǡ ȋʹȌǡͳ͹ͻǤ Statistical Power Analysis for the Behavioral Sciences ‘Š‡ǡ (2ǤȋͳͻͺͺȌǤŠ‡‡ˆˆ‡ –•‹œ‡‹†‡šǣ†Ǥ ǣnd ed.), ’’ǤʹͺͶǦʹͺͺǤ ‹ŽŽ•†ƒŽ‡ǣƒ™”‡ ‡”Ž„ƒ—••‘ ‹ƒ–‡•ǡ—„Ž‹•Š‡”•Ǥ ‘” ‘”ƒǡǤǡ‡” ‡”ǡ ǤǡƬ ”‹–ŠǡǤǤȋͳͻͻͷȌǤ Š‹œ‘’Š”‡‹ƒǡ•›’–‘ƒ–‘Ž‘‰›ƒ†•‘ ‹ƒŽSchizophrenia inference:Research 17 Investigating “theory of mind” in people with schizophrenia. ǡ ȋͳȌǡͷǦͳ͵Ǥ ‡„„ƒ±ǡǤǡƒŽƒ‹‹‘•ǡ Ǥǡ—›–‡ǡǤǡƒ†‘—†ǡǤǡ”ƒ†‘ǡǤǡ‘Ž‹†ƒ‘œœ‹ǡǤǤǤǤǡƬ”‡–ǡǤǤ ȋʹͲͳ͸ȌǤ––ƒ Š‡–ǡ‡—”‘„‹‘Ž‘‰›ǡƒ†‡–ƒŽ‹œ‹‰ƒŽ‘‰–Š‡’•› Š‘•‹• ‘–‹——ǤFrontiers in Human Neuroscience, 10 ǡͶͲ͸Ǥ  †‡‡—Ž‡‡‡•–‡”ǡǤǡƒ–‡‡Žƒ†–ǡǤǡ—›–‡ǡǤǡ‘™› ǡǤȋʹͲͳͺȌǤ‡–ƒŽ‹œ‹‰ƒ•ƒ ‡ Šƒ‹•‘ˆ Šƒ‰‡‹–Š‡–”‡ƒ–‡–‘ˆ’ƒ–‹‡–•™‹–Š„‘”†‡”Ž‹‡’‡”•‘ƒŽ‹–›†‹•‘”†‡”ǣPersonality Disorders: Theory, Research, ’ƒ”ƒŽŽ‡Ž’”‘ ‡••‰”‘™–Š‘†‡Ž‹‰ƒ’’”‘ƒ ŠǤand Treatment ǡͻȋͳȌǡʹʹǤ ”—‡”ǡǤǡ‹••‡”ǡǤǡ›–‡ƒǡǤǡƒ•ǡ ǤȋʹͲͳ͵ȌǤ Ž‡š‹„Ž‡ƒ••‡”–‹˜‡ ‘—‹–›–”‡ƒ–‡–ǣ ‡˜‡”‹–›‘ˆ•›’–‘•ƒ†’•› Š‹ƒ–”‹ Š‡ƒŽ–Š•‡”˜‹ ‡—•‡Ǣƒ”‡ƒŽŽ‹ˆ‡‘„•‡”˜ƒ–‹‘ƒŽ•–—†›ǤClinical Practice & Epidemiology in Mental Health ǡͻǡʹͲʹ–ʹͲͻǤ —”‡Ž‹‰•Ǧ‘–‡‘‡ǡǤ Ǥǡ‡‡ǡ Ǥǡ‘–‡„‘‘ǡǤǡŽ‡ƒǡǤǡƬ‡‡”ǡ ǤȋʹͲͳʹȌǤ‹ˆˆ‡”‡–‹ƒŽ –”‡ƒ–‡–”‡•’‘•‡‘ˆ•—„–›’‡•‘ˆ’ƒ–‹‡–•™‹–Š„‘”†‡”Ž‹‡’‡”•‘ƒŽ‹–›‘”‰ƒ‹œƒ–‹‘ǡƒ• 7 ƒ••‡••‡†™‹–Š–Š‡‘”›JournalǦ†”‹˜‡’”‘ˆ‹Ž‡•‘ˆ–Š‡—– Š•Š‘”–ˆ‘”‘ˆ–Š‡ ǣƒ–—”ƒŽ‹•–‹  of Personality Assessment 94 ˆ‘ŽŽ‘™Ǧ—’•–—†›Ǥ ǡ ȋͶȌǡ͵ͺͲ–ͻʹǤ —”‡Ž‹‰•Ǧ‘–‡‘‡ǡǤ ǤǤǡƬ‘‡Ž‡ǡ ǤǤȋʹͲͲ͹ȌǤ‡‘ƒ–‹•ƒ–‹‡Ǧ”•–‹‰‡•› Š‘’ƒ–Š‘Ž‘‰‹‡ ‘„‹ƒ–‹‡„‹‡†‡–Š‡‘”‹‡‰‡•–——”†‡’”‘ˆ‹‡Ž‹–‡”’”‡–ƒ–‹‡˜ƒ†‡ǣTijdschrift ‘ƒ–‹•ƒ–‹‡Klinische Psychologie,ƒŽ•ƒˆˆ‡ –”‡‰—Žƒ–‘”‡ƒƒ–˜‘‘”•‘ ‹ƒŽ‡ȋ‹Ȍ ‘’‡–‡–‹‡Ǥ 37 ȋʹȌǡͳͲ͹Guideline–ʹʹǤ on multiplicity issues in clinical trials. —”‘’‡ƒ‡†‹ ‹‡•ƒ‰‡ ›ȋʹͲͳ͹ȌǤ ‡–”‹‡˜‡† ˆ”‘Š––’•ǣȀȀ™™™Ǥ‡ƒǤ‡—”‘’ƒǤ‡—Ȁ‡Ȁ—Ž–‹’Ž‹ ‹–›Ǧ‹••—‡•Ǧ Ž‹‹ ƒŽǦ–”‹ƒŽ•ǡƒ ‡••‡† —‡ ͳͲʹͲͳͻǤ ‡––ǡǤǤ Ǥǡ‹‡ Š–„ƒ—‡”ǡǤǡ‡ǡǤǤǡ˜ƒ•ǡ ǤǡƬ”ƒ„„‡†ƒǡǤȋʹͲͳͳȌǤŠ‡”‡Žƒ–‹‘•Š‹’ „‡–™‡‡‡—”‘ ‘‰‹–‹‘ƒ†•‘ ‹ƒŽ ‘‰‹–‹‘™‹–Šˆ— –‹‘ƒŽ‘—– ‘‡•‹Neuroscience & Biobehavioral Reviews 35 • Š‹œ‘’Š”‡‹ƒǣ‡–ƒǦƒƒŽ›•‹•Ǥ ǡ ȋ͵Ȍǡͷ͹͵ǦͷͺͺǤ ‘ƒ‰›ǡǤǡƬJournalƒ–‡ƒ ofǡ ClinicalǤǤȋʹͲͲ͸ȌǤ‡ Šƒ‹••‘ˆ Šƒ‰‡‹‡–ƒŽ‹œƒ–‹‘„ƒ•‡†–”‡ƒ–‡–‘ˆ Psychology 62 Ǥ ǡ ȋͶȌǡͶͳͳǦͶ͵ͲǤ

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ƒ‰‡ǡǤǤǡƒŽœƒŽƒǡǤǤǡ ‘ ŠŠ‡‹•‡”ǡ Ǥǡƒ”–‹ǡǤǤǡƬ›•ƒ‡”ǡǤ ǤȋʹͲͳͻȌǤ‡–ƒ ‘‰‹–‹˜‡ †‡ˆ‹ ‹–•ƒ†•‘ ‹ƒŽˆ— –‹‘‹‰‹• Journal of Experimental PsychopathologyŠ‹œ‘’Š”‡‹ƒƒ ”‘•••›’–‘’”‘ˆ‹Ž‡•ǣŽƒ–‡– Žƒ•• ƒƒŽ›•‹•Ǥ ǡͳͲȋͳȌǡͳǦͳͳǤ ‘ˆˆƒǡ Ǥǡ ¡ ‡ŽǡǤǡ Žƒ—•‡”ǡǤǡ—’’‡”ǡActaǤȋʹͲͳʹȌǤ”ƒ†‘‹•‡† Psychiatrica Scandinavica ‘–”‘ŽŽ‡†–”‹ƒŽ‘ˆ–Š‡ ‡ˆˆ‹ ƒ ›‘ˆ•—’’‘”–‡†‡’Ž‘›‡–Ǥ ǡͳʹͷȋʹȌǡͳͷ͹Ǧͳ͸͹Ǥ ƒ”–‡”—†ǡǤǡ‡†‡”•‡ǡ Ǥǡ‰‡ǡǤǡ ‘Šƒ•‡ǡǤǤǡ ‘Šƒ••‘ǡǤǤǡ ŠŽò–‡”ǡǤǡ‡–ƒŽǤȋʹͲͳ͵ȌǤ Š‡†Š‡”‡ ‡ƒ†‘’‡–‡ ‡ ƒŽ‡ȋǦȌǣ†‡˜‡Ž‘’‡–ǡ•–”— –—”‡ƒ† ”‡Ž‹ƒ„‹Ž‹–›Ǥ•› Š‘–Š‡”ƒ’›‡•‡ƒ” Šǡʹ͵ȋ͸Ȍǡ͹Ͳͷ–͹ͳ͹Ǥ ƒ›ǡǤǤǡ ‹•œ„‡‹ǡǤǡƬ’Schizophreniaˆ‡”ǡǤǤȋͳͻͺ͹ȌǤŠ‡’‘•‹–‹˜‡ƒ†‡‰ƒ–‹˜‡•›†”‘‡• ƒŽ‡ȋȌ Bulletin 13 ˆ‘”• Š‹œ‘’Š”‡‹ƒǤ ǡ ȋʹȌǡʹ͸ͳǦʹ͹͸Ǥ ‘ŠŽ‡”ǡǤ ǤǡƒŽ‡”ǡ ǤǤǡƒ”–‹ǡǤǤǡ ‡ƒŽ›ǡǤǤǡ‘„‡”‰ǡSchizophreniaǤ ǤȋʹͲͳͲȌǤ ƒ ‹ƒŽ‡‘–‹‘’‡” ‡’–‹‘ Bulletin, ‹• Š‹œ‘’Š”‡‹ƒǣƒ‡–ƒǦƒƒŽ›–‹ ”‡˜‹‡™Ǥ ͵͸ȋͷȌǡͳͲͻ–ͳͳͻǤ ƒ™•ǡǤǤǡƒ”Ž‹‰–‘ǡǤǡ‘†‡ŽǡǤǤ‡–ƒŽǤȋʹͲͳͺȌǤ‘‰‹–‹˜‡‡Šƒ˜‹‘—”ƒŽŠ‡”ƒ’›ˆ‘” • Š‹œ‘’Š”‡‹ƒBMC PsychologyǦ‘—– ‘‡•ˆ‘”ˆ— –‹‘‹‰ǡ†‹•–”‡••ƒ†“—ƒŽ‹–›‘ˆŽ‹ˆ‡ǣƒ‡–ƒǦƒƒŽ›•‹•Ǥ ǡ͸ȋ͵ʹȌǡͳǦͳͲǤ ‹‡„‡”ƒǡ ǤǤǡ‹š‘ǡǤǤǡƬ ‘Ž†ƒǡ Ǥ ǤȋʹͲͳ͵ȌǤJAMAƒ”Ž›†‡–‡ –‹‘ƒ†‹–‡”˜‡–‹‘‹ 310 • Š‹œ‘’Š”‡‹ƒǣ‡™–Š‡”ƒ’‡—–‹ ‘†‡ŽǤ ǡ ȋ͹Ȍǡ͸ͺͻǦ͸ͻͲǤ ‹ ‘ŽǡǤǤǡ‹‡ˆǡǤǡ‡•–‡”ƒǡǤǡ‹‡‰Ž‡”ǡǤǡ‡•–‹‰ǡǤǤǡ ‡‹„ƒ ŠǡǤǡƬ‡ŠŽǡǤȋʹͲͳͶȌǤ Š‘•–ƒ›•ǡ™Š‘„‡‡ˆ‹–•ǫ”‡†‹ –‹‰†”‘’‘—–ƒ† Šƒ‰‡‹ ‘‰‹–‹˜‡„‡Šƒ˜‹‘—”–Š‡”ƒ’›Psychiatry Research, 216 ˆ‘”’•› Š‘•‹•Ǥ NVM, Nederlandse ȋʹȌǡͳͻͺVerkorteǦʹͲͷǤ MMPI, handleiding, herziene —–‡‹Œǡversie. Ǥǡ‘ ǡǤǤȋͳͻͺͷȌǤ ‹••‡ǡ–Š‡‡–Š‡”Žƒ†•ǣ™‡–•Ƭ‡‹–Ž‹‰‡”Ǥ  ‘””›ǡǤǤǡ‡Ž•‘ǡǤǡ ‘Ž†•–‘‡ǡǤǡƬ—‰ǡǤǤȋʹͲͳͲȌǤŽ‹‹ ƒŽ•–ƒ‰‹‰ǣŠ‡—”‹•–‹ ƒ† ’”ƒ –‹ ƒŽ•–”ƒ–‡‰›ˆ‘”‡™”‡•‡ƒ” Šƒ†„‡––‡”Š‡ƒŽ–Šƒ†•‘ ‹ƒŽ‘—– ‘‡•ˆ‘”’•› Š‘–‹ The Canadian Journal of Psychiatry 55 ƒ†”‡Žƒ–‡†‘‘††‹•‘”†‡”•Ǥ ǡ ȋͺȌǡͶͺ͸ǦͶͻ͹Ǥ ‘”‹•›ǡǤǤǡ ”‡‡ǡǤǤǡ‡˜‹‡ǡǤǤȋͳͻͺ͸ȌǤ‘ —””‡–ƒ†’”‡†‹ –‹˜‡˜ƒŽ‹†‹–›‘ˆƒMedical Care, 24  •‡ŽˆǦ”‡’‘”–‡†‡ƒ•—”‡‘ˆ‡†‹ ƒ–‹‘ƒ†Š‡”‡ ‡ǤExplorations in personality. ȋͳȌǡ͸͹–͹ͶǤ —””ƒ›ǡ ǤǤȋͳͻ͵ͺȌǤ ‡™‘”ǡǣšˆ‘”†‹˜‡”•‹–›”‡••Ǥ ‘•±ǡǤǡƒ”„—‹ǡǤǡ ”ƒ›ǡǤǡƬƒ•‡ŽŽƒǡǤȋʹͲͲ͵ȌǤŽ‹‹ ƒŽ‹–‡”˜‡–‹‘•ˆ‘”–”‡ƒ–‡–‘The British Journal of Psychiatry 183 Ǧ ƒ†Š‡”‡ ‡‹’•› Š‘•‹•ǣ‡–ƒǦƒƒŽ›•‹•Ǥ ǡ ȋ͵Ȍǡͳͻ͹Ǧ ʹͲ͸Ǥ ̵”‹• ‘ŽŽǡǤǡƒ‹‰ǡ ǤǡƬƒ•‘ǡǤȋʹͲͳͶȌǤ‘‰‹–‹˜‡‡‘–‹‘”‡‰—Žƒ–‹‘•–”ƒ–‡‰‹‡•ǡƒŽ‡š‹–Š›‹ƒClinical Psychology ƒ††‹••‘ ‹ƒ–‹‘Review, 34 ‹• Š‹œ‘’Š”‡‹ƒǡƒ”‡˜‹‡™ƒ†‡–ƒǦƒƒŽ›•‹•Ǥ ȋ͸ȌǡͶͺʹǦͶͻͷǤ

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ŠƒŠŽƒ†‹”ƒǡǤǡ•ƒŽǡǤǡ‹Ž‹ƒǡǤǡŠ‹Ž‹œƒǡǤǡ Š‡ˆˆŽ‡”ǡ Ǥǡ— Š‘ˆˆǡ ǤǤǡǤǤǤƬ•Ž‡›ǡǤȋʹͲͳͺȌǤ Šƒ‰‡•‹‹•‹‰Š–‘˜‡”–Š‡ˆ‹”•–ʹͶ‘–Š•‘ˆ–”‡ƒ–‡–‹• Š‹œ‘’Š”‡‹ƒ•’‡ –”—Schizophrenia research , 206, †‹•‘”†‡”•Ǥ  ͵ͻͶǦ͵ͻͻǤ ‘•ǡǤǡ ”ƒ‡ǡǤǡ‹–ǡ Ǥǡ‹Œ‡ǡǤ Ǥǡ–ƒ”‹‰ǡǤǤǡƒ†‡” ƒƒ‰ǡǤǡǤǤǤ Š‹”„‡ ǡ ǤȋʹͲͳͻȌǤ ‘‰‹–‹˜‡„‡Šƒ˜‹‘”ƒŽ–Š‡”ƒ’›ˆ‘”•‘ ‹ƒŽƒ –‹˜ƒ–‹‘‹”‡ ‡–Journal of consulting and clinicalǦ‘•‡–’•› Š‘•‹•ǣ psychology ƒ†‘‹œ‡† ‘–”‘ŽŽ‡†–”‹ƒŽǤ ǡͺ͹ȋʹȌǡͳͷͳǤ ”‡ƒ Š‡”ǡǤ ǤǡƬ ƒ›‡•ǡǤ ǤȋʹͲͲͶȌǤƒ†’”‘ ‡†—”‡•ˆ‘”‡•–‹ƒ–‹‰‹†‹”‡ –‡ˆˆ‡ –•‹Behavior Research Methods, Instruments, & Computers 36 •‹’Ž‡‡†‹ƒ–‹‘‘†‡Ž•Ǥ ǡ ǡ ͹ͳ͹Ǧ͹͵ͳǤ ”‹‡„‡ǡǤǡ —šŽ‡›ǡǤǡ‹‰Š–ǡǤǡƬ˜ƒ•ǡǤȋͳͻͻͻȌǤ’’Ž‹ ƒ–‹‘ƒ†”‡•—Ž–•‘ˆ–Š‡ƒ Š‡•–‡”International Journal of Social Š‘”–••‡••‡–‘ˆ—ƒŽ‹–›‘ˆ‹ˆ‡ȋȌǤPsychiatry 45  ǡ ȋͳȌǡ͹ǦͳʹǤ ‘„‡”–•ǡǤǤǡ‡ǡǤǤȋʹͲͲͻȌǤ‘ ‹ƒŽ ‘‰‹–‹‘ƒ†‹–‡”ƒ –‹‘–”ƒ‹‹‰ȋ Ȍˆ‘”‘—–’ƒ–‹‡–•Psychiatry Research ™‹–Š• Š‹œ‘’Š”‡‹ƒǣ’”‡Ž‹‹ƒ”›•–—†›Ǥ ǡͳ͸͸ǡͳͶͳ–ͳͶ͹Ǥ ‘••‘—™ǡǤ ǤǡƬ ‘ƒ‰›ǡǤȋʹͲͳʹȌǤ‡–ƒŽ‹œƒ–‹‘Journal of theǦ„ƒ•‡†–”‡ƒ–‡–ˆ‘”•‡Žˆ American Academy of ǦChildŠƒ”‹ƒ†‘Ž‡• ‡–•ǣ & Adolescent ”ƒ†‘‹œ‡† ‘–”‘ŽŽ‡†–”‹ƒŽǤPsychiatry 51  ǡ ȋͳʹȌǡͳ͵ͲͶǦͳ͵ͳ͵Ǥ Statistical methods in medical research 8  Šƒˆ‡”ǡ ǤǤȋͳͻͻͻȌǤ—Ž–‹’Ž‡‹’—–ƒ–‹‘ǣ’”‹‡”Ǥ ǡ ȋͳȌǡ ͵ǦͳͷǤ ‹’’‡ǡǤǡ‹‡ Š–„ƒ—‡”ǡǤǡ ‡• Š™‹†ǡǤǡŽ‹’’‡ŽǡǤǡ‡ ‘‰‡ǡǤǡƬ‹ Š‡”•ǡǤȋʹͲͳ͹ȌǤŠ‡ ‹’ƒ –‘ˆ–”‡ƒ–‡–•ˆ‘”†‡’”‡••‹‘‘–Š‡†›ƒ‹ ‡–™‘”•–”— –—”‡‘ˆ‡–ƒŽ•–ƒ–‡•ǣScientific Reports 7 ™‘”ƒ†‘‹œ‡† ‘–”‘ŽŽ‡†–”‹ƒŽ•Ǥ ǡ͹ǡͶ͸ͷʹ͵Ǥ ’”‘‰ǡǤǡ Š‘–Š‘”•–ǡǤǡ‘•ǡǤǡ ‘šǡThe ǤǡƬ Britishƒ‰‡Žƒ† Journal ǡof PsychiatryǤȋʹͲͲ͹ȌǤŠ‡‘”›‘ˆ‹†‹191 • Š‹œ‘’Š”‡‹ƒǣ‡–ƒǦƒƒŽ›•‹•Ǥ ǡ ȋͳȌǡͷǦͳ͵Ǥ ˜ƒŽ’Š‡MultidisciplinaireǡǤǡ‡”ƒƒŽ richtlijnǡǤǡŽƒ‡ schizofrenieǡǤǡ‘‘•–”ƒǡǤǡ‘—ƒ•ǡ ǤǡƬ”—‰‰‡ƒǡǤȋʹͲͳʹȌǤ Ǥ–”‡ Š–ǡ–Š‡‡–Š‡”Žƒ†•ǣ‡‹Œ†•–”‘‘Ǥ ‡‹Œ‡”•ǡ Ǥǡ–‡ƒ–‡ǡǤǡ—”‡Ž‹‰•Ǧ‘–‡‘‡ǡǤǡ‹‡ Š–„ƒ—‡”ǡǤǡƒ’ƒƒ”–ǡǤǡƒ–‡ƒǡǤǤǡƬ ‡Ž–‡ǡ ǤǤȋʹͲͳ͸ȌǤ‡–ƒŽ‹œƒ–‹‘BMCǦ „ƒ•‡†–”‡ƒ–‡–ˆ‘”’•› Š‘–‹ †‹•‘”†‡”ǣ”‘–‘ ‘Ž‘ˆƒPsychiatry 16 ”ƒ†‘‹œ‡† ‘–”‘ŽŽ‡†–”‹ƒŽǤ ǡ ȋͳȌǡͳͻͳǤ ‡‹Œ‡”•ǡ Ǥ Ǥǡ–‡ƒ–‡ǡǤǡ‡„„ƒ±ǡǤǡƒ–‡ƒǡǤǤǡ†‡ ‘‰ǡǤǡ‡Ž–‡ǡ ǤǤǡ—”‡Ž‹‰•Ǧ ‘–‡‘‡ǡǤ ǤǤȋʹͲʹͲȌǤ‡–ƒŽ‹œƒ–‹‘ƒ†•› Š‘•‹•ǣƒ–‹‘ƒŽ‡ˆ‘”–Š‡•‡‘ˆ Journal ‡–ƒŽ‹œƒ–‹‘Š‡‘”›–‘†‡”•–ƒ†ƒ†”‡ƒ–‘of Contemporary Psychotherapy Ǧƒˆˆ‡ –‹˜‡•› Š‘–‹ ‹•‘”†‡”Ǥ ǡͳǦͳͲǤ Journal of Personality ‡•–‡ǡAssessmentǤȋͳͻͻͳȌǤŽ‹‹ ƒŽƒ••‡••‡–‘ˆ‘„Œ‡ –”‡Žƒ–‹‘•—•‹‰–Š‡Ǥ 56  ǡ ȋͳȌǡͷ͸Ǧ͹ͶǤ

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‘Ž–Šƒ—•ǡ ǤǤǤǡ‹‰‡ƒ•ǡǤǤǤ Ǥǡ Š‡‡ǡǤ Ǥǡ‹•œ‡ǡǤ Ǥǡ‡‰–‡”‹‰ǡ Ǥǡ ‘Ž–Šƒ—•‡ǡ ǤǤǤǡǤǤǤƬ ‹ŒƒǡǤȋʹͲͲͲȌǤ‘’‘‡–•–”— –—”‡‘ˆ–Š‡’‘•‹–‹˜‡ƒ†‡‰ƒ–‹˜‡ •›†”‘‡• ƒŽ‡ȋȌ‹’ƒ–‹‡–•™‹–Š”‡ ‡–Psychopharmacology 150 Ǧ‘•‡–• Š‹œ‘’Š”‡‹ƒƒ†•’‡ –”— †‹•‘”†‡”•Ǥ ǡ ȋͶȌǡ͵ͻͻǦͶͲ͵Ǥ ›‡•ǡǤǡ —††›ǡǤǡ‡ŽŽƒ”†ǡǤǡ —”ǡǤǤǡƬœ‘„‘”ǡǤȋʹͲͳͳȌǤ‡–ƒAmericanǦƒƒŽ›•‹•‘ˆ ‘‰‹–‹˜‡ Journal of ”‡‡†‹ƒ–‹‘ˆ‘”• Š‹œ‘’Š”‡‹ƒǣ‡–Š‘†‘Ž‘‰›ƒ†‡ˆˆ‡ –•‹œ‡•ǤPsychiatry 168  ǡ ȋͷȌǡͶ͹ʹǦͶͺͷǤ

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PART IV:

‘ Ž—•‹‘

CONCLUSION

IV Part

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Chapter Eight:

—ƒ”›ƒ†‰‡‡”ƒŽ†‹• —••‹‘

SUMMARY AND GENERAL DISCUSSION 8

J.G. Weijers

Chapter

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Introduction.

–Š‹•†‹••‡”–ƒ–‹‘™‡‡š’Ž‘”‡†–Š”‡‡ƒ‹–‘’‹ •ǣ Š‹Ž†Š‘‘†ƒ„—•‡ǡ‡–ƒŽ‹œƒ–‹‘ƒ† ’•› Š‘•‹•ǤŠ‹Ž†Š‘‘†ƒ„—•‡ƒ†‹’ƒ‹”‡†‡–ƒŽ‹œ‹‰Šƒ˜‡”‡ ‡‹˜‡†‹ ”‡ƒ•‡†ƒ––‡–‹‘‹ ‘–‡’‘”ƒ”›’•› Š‘•‹•”‡•‡ƒ” ŠǤŠ‘•–‘ˆ”‡ ‡–ƒ”–‹ Ž‡•Šƒ˜‡—†‡”• ‘”‡†–Šƒ– Š‹Ž†Š‘‘† ƒ„—•‡ ‘–”‹„—–‡•–‘–Š‡†‡˜‡Ž‘’‡–ƒ†•‡˜‡”‹–›‘ˆ’•› Š‘•‹•ȋ•‡‡ƒ”‡•‡‡–ƒŽǡʹͲͳʹǢ‡ŽŽ‡Š‡” ‡–ƒŽǤǡʹͲͳ͵Ȍƒ†–Šƒ–‡‘–‹‘”‡‰—Žƒ–‹‘†‹ˆˆ‹ —Ž–‹‡•ȋ›‹Ǧ ‡”‡›•Ƭ˜ƒ•ǡʹͲͲ͹Ǣ”‹•–‘„ƒŽǦ ƒ˜ƒ‡œ‡–ƒŽǤǡʹͲͳ͸Ȍƒ†‹’ƒ‹”‡†‡–ƒŽ‹œ‹‰ȋ‡ƒ†ǡ˜ƒ•ǡ‘””‹•‘ǡƬ‘••ǡʹͲͲͷǢ’”‘‰ǡ  Š‘–Š‘”•–ǡ‘•ǡ ‘šǡƬƒ‰‡Žƒ†ǡʹͲͲ͹Ȍƒ›‡š’Žƒ‹•— Šƒ”‡Žƒ–‹‘•Š‹’Ǥ ‹—Ž–ƒ‡‘—•Ž›–Š‡”‡‹•ƒ‹ ”‡ƒ•‡†ˆ‘ —•‘ Š‹Ž†Š‘‘†ƒ„—•‡ƒ†’•› Š‘•‹•™‹–Š‹ ‡–ƒŽ‹œƒ–‹‘–Š‡‘”›ȋ‡Ǥ‰Ǥ”‡–Ƭ ‘ƒ‰›ǡʹͲͳͶǢ‡„„ƒ±‡–ƒŽǤʹͲͳ͸ȌǤ‡–ƒŽ‹œƒ–‹‘–Š‡‘”› holds that the level of security in a child’s rearing environment determines how well the ability –‘‡–ƒŽ‹œ‡ƒ†–‘”‡‰—Žƒ–‡‡‘–‹‘•‹•†‡˜‡Ž‘’‡†Ǥ‡–ƒŽ‹œ‹‰ƒ„‹Ž‹–›‹–—”ǡ‹•–Š‘—‰Š––‘„‡ ƒ‹’‘”–ƒ–ˆƒ –‘”‹–Š‡ˆ‘”ƒ–‹‘‘ˆ’•› Š‘’ƒ–Š‘Ž‘‰›Ǥ‡–ƒŽ‹œ‹‰†‡ˆ‹ ‹–•ƒ› ‘–”‹„—–‡–‘ –Š‡†‡˜‡Ž‘’‡–‘ˆ„‘–Š’‘•‹–‹˜‡ƒ†‡‰ƒ–‹˜‡•›’–‘•‹Ǥ ‘”‡šƒ’Ž‡ǡ‹– ƒ„‡ ƒ”‰—‡†–Šƒ–†‡Ž—•‹‘•‘ˆ’‡”•‡ —–‹‘ƒ†”‡ˆ‡”‡ ‡ƒ”‡„›†‡ˆ‹‹–‹‘‹•‰—‹†‡†ƒ––”‹„—–‹‘•‘ˆ ‡–ƒŽ•–ƒ–‡•–‘‘–Š‡”•ȋ ”‹–ŠǡͳͻͻʹȌǤ††‹–‹‘ƒŽŽ›ǡ‡‰ƒ–‹˜‡•›’–‘•Ž‹‡ˆŽƒ––‡‡†ƒˆˆ‡ –‹˜‡ ‡š’”‡••‹‘ƒ›”‡ˆŽ‡ –ƒ†‹•‘”†‡”‘ˆ ‘—‹ ƒ–‹‘ ƒ—•‡†„›ƒ‹ƒ„‹Ž‹–›–‘—†‡”•–ƒ†–Šƒ– ‰‡•–—”‡•ǡ‹–‘ƒ–‹‘ƒ†‡š’”‡••‹‘ ‘˜‡›‡–ƒŽ•–ƒ–‡•ȋ ”‹–ŠǡͳͻͻʹȌǤ ‡š––‘•–—†›‹‰–Š‡‹–‡””‡Žƒ–‡†‡••‘ˆ Š‹Ž†Š‘‘†–”ƒ—ƒǡ‡–ƒŽ‹œ‹‰ƒ†’•› Š‘•‹•ǡ ™‡ƒŽ•‘•‘—‰Š––‘†‡–‡”‹‡™Š‡–Š‡”‡–ƒŽ‹œƒ–‹‘„ƒ•‡†–”‡ƒ–‡–ȋȌ‹•ƒ‡ˆˆ‡ –‹˜‡ –”‡ƒ–‡––‘‹’”‘˜‡•‘ ‹ƒŽˆ— –‹‘‹‰ƒ†‡–ƒŽ‹œ‹‰ ƒ’ƒ ‹–›ǤŠ‡‘•–†‹•–‹ –‹˜‡ˆ‡ƒ–—”‡ ‘ˆ‹•–Šƒ–‹– ‡–”ƒŽ‹œ‡•–Š‡‡Šƒ ‡‡–‘ˆ‡–ƒŽ‹œ‹‰ƒ•ƒ‡ Šƒ‹•‘ˆ Šƒ‰‡Ǥ Summary of Findings Aim I: To outline how mentalization theory may contribute to understanding and treatment of NAPD.

 Šƒ’–‡”ʹ™‡ ‘ —””‡†™‹–Š —””‡– ‘ ‡’–—ƒŽ‹œƒ–‹‘•‘ˆ’•› Š‘•‹•’ƒ–Š‘‰‡‡•‹•ƒ† ƒ”‰—‡†–Šƒ–ƒ•‡•‹–‹œƒ–‹‘‘ˆ–Š‡‡•‘Ž‹„‹ †‘’ƒ‹‡”‰‹ •›•–‡–†—‡–‘ ‘•–‹–—–‹‘ƒŽ ˜—Ž‡”ƒ„‹Ž‹–›ǡ‡—”‘†‡˜‡Ž‘’‡–ƒŽ‹•—Ž–•ƒ†Ȁ‘”•‘ ‹ƒŽƒ†˜‡”•‹–›– ‘–”‹„—–‡•–‘–Š‡ †‡˜‡Ž‘’‡–‘ˆƒ„‡””ƒ––Š‘—‰Š–•ƒ†’‡” ‡’–—ƒŽ‡š’‡”‹‡ ‡•ǡ Šƒ”ƒ –‡”‹•–‹ ‘ˆǤ —”–Š‡”‘”‡ǡ—•‹‰‡–ƒŽ‹œƒ–‹‘–Š‡‘”›ƒ•ƒ ‘ ‡’–—ƒŽˆ”ƒ‡™‘”ǡ™‡‘ˆˆ‡”‡†ƒƒ”‰—‡–‘ˆ ™Š›ƒ„‡””ƒ–‡š’‡”‹‡ ‡•ƒ”‡‹–‡”’”‡–‡†‹’•› Š‘–‹ ™ƒ›•ƒ†™Š›‹•ƒ••‘ ‹ƒ–‡†™‹–Š •‘ ‹ƒŽ†›•ˆ— –‹‘Ǥ•ƒ†‡˜‡Ž‘’‡–ƒŽ–Š‡‘”›‘ˆ’•› Š‘’ƒ–Š‘Ž‘‰›ǡ‡–ƒŽ‹œƒ–‹‘–Š‡‘”› ’”‘’‘•‡•–Šƒ––Š‡ƒ„‹Ž‹–‹‡•–‘‡–ƒŽ‹œ‡ƒ†”‡‰—Žƒ–‡‡‘–‹‘•ƒ”‡†‡˜‡Ž‘’‡†–Š”‘—‰Š•‡ —”‡ ‹–‡”ƒ –‹‘™‹–Š ƒ”‡‰‹˜‡”•ƒ†’‡‡”•Ǥ –’”‘’‘•‡•–Šƒ– Š‹Ž†”‡ƒ•™‡ŽŽƒ•ƒ†—Ž–•Šƒ˜‡ƒ‹‡” ‡‡†ˆ‘”•‘ ‹ƒŽ”‡Žƒ–‡†‡••–‘Š‡Ž’ ‘Ǧ”‡‰—Žƒ–‡–Š‡‹”‡‘–‹‘•Ǥ ˆ ƒ”‡‰‹˜‡”•ƒ”‡•‡•‹–‹˜‡ƒ†

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responsive to their child’•‡‘–‹‘•ǡ–Š‹•™‹ŽŽŠ‡Ž’†‘™Ǧ”‡‰—Žƒ–‡‡‘–‹‘ƒŽ†‹•–”‡••ǡƒ†ƒ‹†• –Š‡†‡˜‡Ž‘’‡–‘ˆƒŽƒ•–‹‰–”—•––Šƒ–‘–Š‡”• ƒŠ‡Ž’ƒ––‡—ƒ–‡•— Š†‹•–”‡••ȋ‘™Ž„›ǡͳͻ͹͵ȌǤ †˜‡”•‡ Š‹Ž†Š‘‘†‡š’‡”‹‡ ‡••— Šƒ•ƒ„—•‡ƒ›—†‡”‹‡•— Š–”—•–ǡ–Š—•Ž‡ƒ†‹‰–‘ †‹ˆˆ‹ —Ž–›‹•— ‡••ˆ—ŽŽ› ‘Ǧ”‡‰—Žƒ–‹‰‡‘–‹‘•ǤŠ‹Ž†Š‘‘†ƒ„—•‡ǡ‡•’‡ ‹ƒŽŽ›™Š‡’‡”’‡–”ƒ–‡† „› ƒ”‡‰‹˜‡”•ǡ‹••‡‡ƒ•ƒ–‹–Š‡–‹ ƒŽ–‘ƒ•‡ —”‡”‡ƒ”‹‰‡˜‹”‘‡–Ǥ –‹•ƒ”‰—‡†–‘‹•–‹ŽŽƒ ’Š‘„‹ ˆ‡ƒ”‘ˆ–Š‡‹ƒ‰‹ƒ–‹˜‡‡š’Ž‘”ƒ–‹‘‘ˆ‘–Š‡”‹†•‡‡†‡†ˆ‘”–Š‡†‡˜‡Ž‘’‡–‘ˆ mentalizing ability. Imagining one’s parent’s hostile or uncaring mindǦ•–ƒ–‡‹•–Š‘—‰Š––‘„‡ ‘˜‡”™Š‡Ž‹‰Ž›’ƒ‹ˆ—Žƒ†‹•–Š—•ƒ˜‘‹†‡†„›–Š‡ Š‹Ž†Ǥ ††‹–‹‘ƒŽŽ›ǡƒ•ƒŠ‹‰Š‡”Ǧ‘”†‡” ‘‰‹–‹˜‡’”‘ ‡••ǡ‡–ƒŽ‹œ‹‰‹•—†‡”‹‡†„›‡š ‡•• ‡‘–‹‘ƒŽƒ”‘—•ƒŽǤ—”‹‰‡‘–‹‘ƒŽ†›•”‡‰—Žƒ–‹‘ǡŽ‹„‹ ’ƒ”–•‘ˆ–Š‡„”ƒ‹–ƒ‡ ‘–”‘Ž‘ˆ–Š‡ ‘” Š‡•–”ƒ–‹‘‘ˆ„”ƒ‹’”‘ ‡••‡•ƒ––Š‡‡š’‡•‡‘ˆ ‘‰‹–‹˜‡ ‘’Ž‡š‹–›ǡ”‡†‡”‹‰‹†‹˜‹†—ƒŽ• —ƒ„Ž‡–‘ƒ†‡“—ƒ–‡Ž›”‡ˆŽ‡ –‘–Š‡‹”‡‘–‹‘•ǤŠ‹• ”‡ƒ–‡•†‹ˆˆ‹ —Ž–›ˆ— –‹‘‹‰‹ ‘’Ž‡š •‘ ‹ƒŽ•‹–—ƒ–‹‘•ƒ†ƒ›Ž‡ƒ†–‘”‡Œ‡ –‹‘ƒ†•‘ ‹ƒŽ™‹–Š†”ƒ™ƒŽǤ‘”‡‘˜‡”ǡ„‡ ƒ—•‡•‘ ‹ƒŽ ”‡Žƒ–‡†‡••‹•˜‹‡™‡†–‘„‡‡ ‡••ƒ”›ˆ‘”ƒ†‡“—ƒ–‡‡‘–‹‘ƒŽ”‡‰—Žƒ–‹‘ǡŽ‘‡Ž‹‡••‹• ‹Š‡”‡–Ž›†‹•–”‡••‹‰ǡ ”‡ƒ–‹‰ƒ˜‹ ‹‘—• › Ž‡–Šƒ–•‡•‹–‹œ‡•–Š‡‡•‘Ž‹„‹ †‘’ƒ‹‡•›•–‡Ǥ ‡ƒŽ•‘ƒ”‰—‡†–Šƒ–‹’ƒ‹”‡†‡–ƒŽ‹œ‹‰ƒ›„‡†‹”‡ –Ž›”‡Žƒ–‡†–‘•‘‡‘ˆ–Š‡ ’‘•‹–‹˜‡•›’–‘•ƒ•™‡ŽŽǤ †‹˜‹†—ƒŽ•™Š‘Šƒ˜‡ƒ‹’ƒ‹”‡†ƒ„‹Ž‹–›–‘‡–ƒŽ‹œ‡Šƒ˜‡ †‹ˆˆ‹ —Ž–‹‡•„‡ ‘‹‰ ‘• ‹‘—•Ž›ƒ™ƒ”‡‘ˆ•‡•‘”›Ǧƒˆˆ‡ –‹˜‡•–ƒ–‡•ǡƒ‹‰‹–†‹ˆˆ‹ —Ž–ˆ‘”–Š‡ –‘ ”‹–‹ ƒŽŽ›”‡ˆŽ‡ –—’‘–Š‡Ǥ –Š‹•™ƒ›–Š‡›†‘‘––ƒ‡‹–‘ƒ ‘—––Š‡‹ˆŽ—‡ ‡–Šƒ––Š‡‹” ƒˆˆ‡ –‹˜‡•–ƒ–‡•Šƒ˜‡‘–Š‡‹”ƒ––‡–‹‘ǡ–Š‘—‰Š–ƒ†„‡Šƒ˜‹‘”Ǥ••— Šǡ–Š‡›ƒ›‡“—ƒ–‡–Š‡•‡ •‡•‘”›Ǧƒˆˆ‡ –‹˜‡•–ƒ–‡•™‹–Š‘—–‡””‡ƒŽ‹–›Ǥ ‘”‡šƒ’Ž‡ǡ™Š‡‘‡ˆƒ‹Ž•–‘„‡ ‘‡ ‘• ‹‘—•Ž› aware of one’s suspiciousness, one will fail to notice how thisar mentale state influences the

‡š’‡”‹‡ ‡‘ˆ”‡ƒŽ‹–›ǡ”‡•—Ž–‹‰‹–Š‡ ‘˜‹ –‹‘–Šƒ–‘–Š‡”• †‡ ‡‹–ˆ—Žƒ†‹ŽŽǦ‡ƒ‹‰Ǥ‘’—– 8 ‹–•‹’Ž›ǡ‡–ƒŽ‹œ‹‰Š‡Ž’•–‘‹†‡–‹ˆ›ˆ‡‡Ž‹‰•ƒ†–‘†‹ˆˆ‡”‡–‹ƒ–‡ˆƒ –ˆ”‘ˆ‡‡Ž‹‰Ǥ‡ƒ”‰—‡† –Šƒ––Š‹•’”‘ ‡••ƒŽ•‘ ƒ—•‡•ƒ„‡””ƒ–‡š’‡”‹‡ ‡•–‘„‡–”‡ƒ–‡†ƒ•ƒ•’‡ –•‘ˆ‘—–‡””‡ƒŽ‹–›ƒ† –Š—•–‘„‡ƒ––”‹„—–‡†–‘‘—–•‹†‡•‘—” ‡•ǡ”‡•—Ž–‹‰‹ŠƒŽŽ— ‹ƒ–‹‘’”‘’‡”Ǥ ƒ•–Ž›ǡ™‡ƒ”‰—‡†–Šƒ–ƒŽƒ ‘ˆ‡’‹•–‡‹ –”—•––‹Ǥ‡Ǥ–Š‡ƒ„‹Ž‹–›–‘–”‡ƒ–‡™‹ˆ‘”ƒ–‹‘ ˆ”‘‘–Š‡”•ƒ•’‘–‡–‹ƒŽŽ›™‡ŽŽǦ‹–‡–‹‘‡†ƒ†’‡”•‘ƒŽŽ›”‡Ž‡˜ƒ–ȋ ‘ƒ‰›‡–ƒŽǤǡʹͲͳ͹Ȍ– —–• ƒ‹†‹˜‹†—ƒŽ‘ˆˆˆ”‘•‘ ‹ƒŽŽ‡ƒ”‹‰ƒ†‹–‡”’‡”•‘ƒŽ‡ƒ‹‰ƒ‹‰Ǥ’‹•–‡‹ –”—•––Š‡‘”› Š‘Ž†•–Šƒ–’‡‘’Ž‡ƒ ‡’–‡™‹ˆ‘”ƒ–‹‘–‘„‡–”—‡‹‡‹–Š‡”‘‡‘ˆ–™‘™ƒ›•ǤŠ‡›ƒ›”‡Ž›‘ ‘–Š‡”•–Š‡›–”—•––‘„‡™‡ŽŽǦ‡ƒ‹‰ƒ†‘™Ž‡†‰‡ƒ„Ž‡–‘‹ˆ‘”–Š‡ǤŽ–‡”ƒ–‹˜‡Ž›ǡ–Š‡› ƒ –”›–‘†‡†— ‡ˆ‘”–Š‡•‡Ž˜‡•™Š‡–Š‡”‡™‹ˆ‘”ƒ–‹‘‹• ‘””‡ –ǡˆ‘”‡šƒ’Ž‡–Š”‘—‰Š• ‹‡–‹ˆ‹  ‡š’‡”‹‡–ƒ–‹‘ȋ ‘ƒ‰›ǡ—›–‡ǡŽŽ‹•‘Ƭƒ’„‡ŽŽǡʹͲͳ͹ȌǤ’‹•–‡‹ –”—•–‘ˆˆ‡”•ƒ Ž‡ƒ” –‡’‘”ƒŽƒ†˜ƒ–ƒ‰‡ǡƒ•• ‹‡–‹ˆ‹ †‡†— –‹‘‹•˜‡”›–‹‡Ǧ ‘•—‹‰Ǥ††‹–‹‘ƒŽŽ›ǡ‡’‹•–‡‹  –”—•–‹•‹’‘”–ƒ––‘ˆ‹–‹„‡ ƒ—•‡ —Ž–—”ƒŽ —•–‘•ƒ†˜ƒŽ—‡•ǡ™Š‘•‡ˆ— –‹‘•ƒ”‡‘ˆ–‡ ‘’ƒ“—‡ǡ ƒ‘–„‡ƒ “—‹”‡†–Š”‘—‰Š‡š’‡”‹‡–ƒ–‹‘ȋ ‘ƒ‰›ƬŽŽ‹•‘ǡʹͲͳͶȌǤ

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‘ƒ‰›ǡ—›–‡ǡƒ†ŽŽ‹•‘ȋʹͲͳ͹Ȍˆ—”–Š‡”ƒ‹–ƒ‹–Šƒ–‡’‹•–‡‹ –”—•–„‡–™‡‡ Š‹Ž† ƒ† ƒ”‡‰‹˜‡”†‡˜‡Ž‘’•™‹–Š‹•‡ —”‡ƒ––ƒ Š‡–”‡Žƒ–‹‘•Š‹’•Ǥ ‘”†‹‰–‘–Š‡ǡ‹ˆƒ Š‹Ž† ˆ‹†•‹–•‡Žˆ–‘„‡ƒ —”ƒ–‡Ž›”‡’”‡•‡–‡†ƒ†”‡•’‘†‡†–‘„›ƒ ƒ”‡‰‹˜‡”ƒ†„‡‹‰–”‡ƒ–‡†ƒ•ƒ –Š‹‹‰ƒ†ˆ‡‡Ž‹‰‹–‡–‹‘ƒŽ„‡‹‰–Š‹•Š‡Ž’•–Š‡ Š‹Ž†–‘ƒ••—‡–Šƒ––Š‡‹” ƒ”‡‰‹˜‡”•ƒ”‡ ™‡ŽŽǦ‡ƒ‹‰ƒ†‘–†‡ ‡‹–ˆ—ŽǤŠ‹•‹•–Š‘—‰Š––‘‡‰‡†‡”–Š‡•‡ —”‡ˆ‡‡Ž‹‰–Šƒ––Š‡ caregiver’s intentions are benign, which helps the child more readily accept shared informatio ƒ•–”—‡Ǥ ‘™‡˜‡”ǡ Š‹Ž†”‡™Š‘”‡’‡ƒ–‡†Ž›‡š’‡”‹‡ ‡–Šƒ––Š‡‹”‹–‡”ƒŽ•–ƒ–‡•ƒ”‡‡–™‹–Š †‹•–‘”–‡†‘”‹ƒ —”ƒ–‡ ƒ”‡‰‹˜‡””‡•’‘•‡•ƒ›„‡‹ ”‡ƒ•‹‰Ž›Ž‹‡Ž›–‘†‡˜‡Ž‘’‹•–”—•– regarding others’ messages. Given the high degree of social adversity ƒ† Š‹Ž†Š‘‘†–”ƒ—ƒ ‰‡‡”ƒŽŽ›”‡’‘”–‡†„›’ƒ–‹‡–•ȋ‡Ǥ‰Ǥƒ”‡•‡‡–ƒŽǤǡʹͲͳʹȌǡ‹–•‡‡•’Žƒ—•‹„Ž‡–Šƒ––Š‡› ‘’‡”ƒ–‡‘‹’Ž‹ ‹–™‘”‹‰‘†‡Ž•‹™Š‹ Š‘–Š‡”•ƒ”‡•‡‡ƒ•’‘–‡–‹ƒŽŽ›†‡ ‡‹–ˆ—ŽǤŠ‡‘‡ ƒ†‘’–•ƒ‰‡‡”ƒŽ•–ƒ ‡‘ˆ†‹•–”—•––‘™ƒ”†•‘–Š‡”ǡ•‘‡–‹‡•”‡ˆ‡””‡†‡’‹•–‡‹ Š›’‡”˜‹‰‹Žƒ ‡ǡ –Š‹•‹•–Š‘—‰Š––‘ —–‘‡‘ˆˆˆ”‘‹’‘”–ƒ–•‘—” ‡•‘ˆ‹ˆ‘”ƒ–‹‘ƒ„‘—––Š‡•‡Žˆ‹”‡Žƒ–‹‘–‘ ‘–Š‡”•Ǥƒ–‹‡–•™‹–Šoften show a ‘rigidity’ visǦǦ˜‹•ƒŽ–‡”ƒ–‡˜‹‡™’‘‹–•ǡ”‡†‡”‹‰–Š‡ Ž‡•• ƒ’ƒ„Ž‡–‘‘†‹ˆ›„‡Ž‹‡ˆ•’‡”–ƒ‹‹‰–‘•‡Žˆǡ‘–Š‡”•ǡƒ†–Š‡™‘”Ž†Ǥ‘–‹ ‹†‡–ƒŽŽ›ǡ–Š‡ †‡˜‡Ž‘’‡–‘ˆ’•› Š‘•‹•‘ˆ–‡ ‘‹ ‹†‡•™‹–ŠƒŽ‘••‘ˆ•‘ ‹ƒŽŽ› ‘•–”—‡†‡ƒ‹‰ǡƒ†‹• ”‡’Žƒ ‡†„›ƒ’‡”•‘ƒŽ ‘•–”—ƒŽ‘ˆ‡ƒ‹‰–Šƒ–ƒ‡••‡•‡–‘–Š‡‹†‹˜‹†—ƒŽǡ„—–‹•˜‹‡™‡†–‘ „‡‹†‹‘•› ”ƒ–‹ „›‘–Š‡”•ȋ‡Ǥ‰Ǥ‡”‡‹”ƒƬ‡„„ƒ±ǡʹͲͳͺȌǤ ‡ ‘ Ž—†‡† Šƒ’–‡”ʹ„›ƒ”‰—‹‰–Šƒ–‹’ƒ‹”‡†‡–ƒŽ‹œ‹‰ƒ‡•‹–†‹ˆˆ‹ —Ž––‘–”‡ƒ– ‡‘–‹‘•ƒ†ˆ‡‡Ž‹‰•ƒ•ƒ––‡”•‘ˆ’‡”•’‡ –‹˜‡ǡ ‘’Ž‹ ƒ–‹‰’•› Š‘–Š‡”ƒ’‡—–‹ ‹–‡”˜‡–‹‘Ǥ ‡–ƒŽ‹œƒ–‹‘„ƒ•‡†–”‡ƒ–‡–™ƒ•†‡•‹‰‡†–‘†‹”‡ –Ž›–ƒ”‰‡––Š‡•‡’”‘„Ž‡•ƒ†–Š—•ƒ› Š‡Ž’‘˜‡” ‘‡–Š‡•‡‘„•–ƒ Ž‡•‹–”‡ƒ–‡–Ǥ Aim II: To test several proposed hypotheses that may explain the relationship between childhood abuse and the severity of symptoms in adult patients with NAPD.

’ƒ”– ‘ˆ–Š‹•†‹••‡”–ƒ–‹‘™‡‡šƒ‹‡†’‘–‡–‹ƒŽ’ƒ–Š™ƒ›•–Š”‘—‰Š™Š‹ Š Š‹Ž†Š‘‘†ƒ„—•‡ ƒˆˆ‡ –•‘—– ‘‡‘ˆ‹ƒ†—Ž–Š‘‘†ǤŠ‡•–—†‹‡•†‡• ”‹„‡†‹’ƒ”– ƒ‹‡†–‘‹˜‡•–‹‰ƒ–‡ •‡˜‡”ƒŽŠ›’‘–Š‡•‡•–Šƒ–ƒ›Š‡Ž’‡š’Žƒ‹–Š‡”‡Žƒ–‹‘•Š‹’„‡–™‡‡ Š‹Ž†Š‘‘†ƒ„—•‡ƒ†–Š‡ •‡˜‡”‹–›‘ˆ•›’–‘•‹ƒ†—Ž–’ƒ–‹‡–•™‹–Šǡƒ‡Ž›ǣ‹ ”‡ƒ•‡†•–”‡••”‡ƒ –‹˜‹–›ǡƒ –‡†‡ ›ˆ‘”Ž‘‡Ž‹‡••ƒ†‹’ƒ‹”‡†‡–ƒŽ‹œ‹‰Ǥ  Šƒ’–‡”–Š”‡‡™‡‘„•‡”˜‡†–Šƒ–•–”‡••‹ƒ†—Ž–Š‘‘†‹•”‡Žƒ–‡†–‘–Š‡‹–‡•‹–›‘ˆ ‡‰ƒ–‹˜‡ƒˆˆ‡ –ƒ†’•› Š‘–‹ •›’–‘•‘ ‡’”‡•‡–Ǥ ‘™‡˜‡”ǡ‹ ‘–”ƒ•––‘’”‡˜‹‘—••–—†‹‡• ȋƒ”†‹‘‹•ǡƒ–ƒ•–‡”ǡMengelers, Van Os, & Myin‐Germeys, ʹͲͳͳǢ”‹•–‘„ƒŽǦƒ˜ƒ‡œ‡–ƒŽǤǡʹͲͳͺȌǡ‹– ™ƒ•‘–—‡“—‹˜‘ ƒŽŽ›•Š‘™–Šƒ–ƒŠ‹•–‘”›‘ˆ Š‹Ž†Š‘‘†ƒ„—•‡‘†‡”ƒ–‡†–Š‹•”‡Žƒ–‹‘•Š‹’Ǥ ‹˜‡”‰‡–•–ƒ–‹•–‹ ƒŽƒ’’”‘ƒ Š‡•ƒ›ƒ ‘—–ˆ‘”–Š‡‘„•‡”˜‡††‹ˆˆ‡”‡ ‡•„‡–™‡‡•–—†‹‡•Ǥ

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Šƒ’–‡”ˆ‘—”•Š‘™‡†–Šƒ–ƒ‹ ”‡ƒ•‡†’”‘‡‡••–‘Ž‘‡Ž‹‡••‹•ƒ’‘–‡–‹ƒŽ‡ Šƒ‹• „›™Š‹ Šƒ„—•‡‹ Š‹Ž†Š‘‘†ƒˆˆ‡ –•–Š‡•‡˜‡”‹–›‘ˆ’•› Š‘–‹ •›’–‘•‹ƒ†—Ž–Š‘‘†ƒ†–Šƒ– –Š‡”‡Žƒ–‹‘„‡–™‡‡Ž‘‡Ž‹‡••ƒ†’•› Š‘–‹ •›’–‘•‹–—” ƒ„‡‡š’Žƒ‹‡†„›‹ ”‡ƒ•‡† ƒš‹‘—•ƒ††‡’”‡••‹˜‡ˆ‡‡Ž‹‰•Ǥ Šƒ’–‡”ˆ‹˜‡•Š‘™‡†–Šƒ–͸͵ǤʹΨ‘ˆ‘—”’ƒ”–‹ ‹’ƒ–•”‡’‘”–‡†Šƒ˜‹‰‡š’‡”‹‡ ‡†•‘‡ ˆ‘”‘ˆ’ƒ”‡–ƒŽƒ„—•‡†—”‹‰–Š‡‹” Š‹Ž†Š‘‘†Ǥ‡ˆ—”–Š‡”‘„•‡”˜‡†–Šƒ––Š‡•‡˜‡”‹–›‘ˆ–Š‹• ”‡’‘”–‡†ƒ„—•‡™ƒ•ƒ••‘ ‹ƒ–‡†™‹–Š–Š‡•‡˜‡”‹–›‘ˆ’‘•‹–‹˜‡ƒ†‡‰ƒ–‹˜‡•›’–‘•‹ adulthood, and with an impaired ability to infer others’ mental states. Additionally, we observed that an impaired ability to infer others’ mental states may constitute a mechanism by which ƒ„—•‡ƒˆˆ‡ –•–Š‡•‡˜‡”‹–›‘ˆ‡‰ƒ–‹˜‡•›’–‘•‹ƒ†—Ž–Š‘‘†Ǥ ˜‡”ƒŽŽǡ–Š‡”‡•—Ž–•†‡• ”‹„‡†‹ƒ”– •—’’‘”––Š‡Š›’‘–Š‡•‹•–Šƒ– Š‹Ž†Š‘‘†ƒ„—•‡ ‘–”‹„—–‡•–‘–Š‡•‡˜‡”‹–›‘ˆ‘—– ‘‡‹–Š”‘—‰ŠŽ‘‡Ž‹‡••ǡ†›•”‡‰—Žƒ–‡†‡‰ƒ–‹˜‡ƒˆˆ‡ – ȋƒš‹‡–›ƒ††‡’”‡••‹‘Ȍƒ†‹’ƒ‹”‡†‡–ƒŽ‹œ‹‰Ǥ Aim III: To test whether mentalization based treatment for psychotic disorder (MBTp) is an effective addition to treatment as usual regarding social dysfunction and impaired mentalizing.

ƒ”– ǡ™‡–‡•–‡†™Š‡–Š‡”–Š‡ƒ††‹–‹‘‘ˆ‡–ƒŽ‹œƒ–‹‘„ƒ•‡†–”‡ƒ–‡–ˆ‘”’•› Š‘–‹  †‹•‘”†‡”ȋ’Ȍ–‘ Ž‡š‹„Ž‡••‡”–‹˜‡‘—‹–›”‡ƒ–‡–ȋ Ȍǡ™‘—Ž†”‡•—Ž–‹‰”‡ƒ–‡” ‹’”‘˜‡‡–‘ˆ•‘ ‹ƒŽˆ— –‹‘‹‰ƒ†‡–ƒŽ‹œ‹‰ƒ„‹Ž‹–›ǡƒ‘‰‘–Š‡”‘—– ‘‡˜ƒ”‹ƒ„Ž‡•Ǥ Šƒ’–‡”•‹š‘—–Ž‹‡•–Š‡Š›’‘–Š‡•‡•ƒ†‡–Š‘†•‘ˆ‘—””ƒ–‡”„Ž‹†‡†ǡ—Ž–‹ ‡–‡””ƒ†‘‹œ‡† ‘–”‘ŽŽ‡†–”‹ƒŽǡ™Š‡”‡ƒ• Šƒ’–‡”•‡˜‡†‡• ”‹„‡•–Š‡”‡•—Ž–•‘ˆ–Š‹•–”‹ƒŽǤ Š‡”‡•—Ž–••—‰‰‡•––Šƒ–’Ž‡ƒ†•–‘ƒ‘”‡”‘„—•–‹’”‘˜‡‡–‹•‘ ‹ƒŽˆ— –‹‘‹‰

–Šƒ ƒŽ‘‡ƒ†•‡‡•‡•’‡ ‹ƒŽŽ›‡ˆˆ‡ –‹˜‡‹ˆ‹’Ž‡‡–‡†‹–Š‡‡ƒ”Ž›’Šƒ•‡•‘ˆǤ 8 ƒ–‹‡–•™‹–Šƒ”‡Žƒ–‹˜‡Ž›”‡ ‡–‘•‡–‘ˆ’•› Š‘•‹•ǡ•Š‘™‡†ƒ‰”‡ƒ–‡”‹’”‘˜‡‡–‹•‘ ‹ƒŽ ˆ— –‹‘‹‰ƒ–ˆ‘ŽŽ‘™Ǧ—’–Šƒ‘”‡ Š”‘‹ ƒŽŽ›‹ŽŽ’ƒ–‹‡–•Ǥ˜‡”ƒŽŽǡ’ƒ–‹‡–•‹–Š‡’‰”‘—’ ’‡”ˆ‘”‡†„‡––‡”‘•‡˜‡”ƒŽƒ•’‡ –•‘ˆ‡–ƒŽ‹œ‹‰ƒ„‹Ž‹–›ǡ‹ Ž—†‹‰—†‡”•–ƒ†‹‰‘ˆ•‘ ‹ƒŽ causality (i.e. the ability to construct a logical and psychologically minded explanation of others’ „‡Šƒ˜‹‘”Ȍǡ–Š‡‘”›‘ˆ‹†ȋ‹Ǥ‡Ǥ–Š‡ƒ„‹Ž‹–›–‘‹ˆ‡”–Š‡‡–ƒŽ•–ƒ–‡•‘ˆ‘–Š‡”•Ȍǡ ‘’Ž‡š‹–›‘ˆ representations (i.e. the ability to distinguish between one’s own and another’s perspective), ƒ†‹•‹‰Š–‹–‘‘‡̵•†‹•‘”†‡”ȋ‹Ǥ‡Ǥƒ™ƒ”‡‡••‘ˆ–Š‡’”‡•‡ ‡ƒ†‹’ƒ –‘ˆ•›’–‘•ƒ†–Š‡ need for treatment). They also showed a greater decrease in social stress (i.e. disliking one’s ’”‡•‡– ‘’ƒ›ƒ†’”‡ˆ‡””‹‰–‘„‡ƒŽ‘‡ȌǤ‘•‹‰‹ˆ‹ ƒ–†‹ˆˆ‡”‡ ‡•™‡”‡ˆ‘—†‘–Š‡‘–Š‡” •‡ ‘†ƒ”›‘—– ‘‡‡ƒ•—”‡•ǡ‹ Ž—†‹‰ǣ’‘•‹–‹˜‡ǡ‡‰ƒ–‹˜‡ǡƒš‹‘—•ƒ††‡’”‡••‹˜‡•›’–‘•ǡ “—ƒŽ‹–›‘ˆŽ‹ˆ‡ǡ‡‘–‹‘ƒŽ‹˜‡•–‡–‹”‡Žƒ–‹‘•Š‹’•ǡƒˆˆ‡ –Ǧ–‘‡‘ˆ”‡Žƒ–‹‘•Š‹’•ǡ†ƒ‹Ž›’•› Š‘–‹  ‡š’‡”‹‡ ‡•ǡ‡‰ƒ–‹˜‡ƒ†’‘•‹–‹˜‡ƒˆˆ‡ –ǡ†”—‰—•‡ǡ•‘ ‹ƒŽ•–”‡••”‡ƒ –‹˜‹–›Ǥ 

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146807_JonasWeijers_BNW_def.indd 163 28-10-2020 15:09 Chapter Eight

Comparison to previous studies Mentalization, psychosis and childhood abuse.

Š‡”‡•—Ž–•‘ˆ–Š‡•–—†‹‡•‹’ƒ”–  ƒ††–‘ƒ‹ ”‡ƒ•‹‰„‘†›‘ˆ‡˜‹†‡ ‡–Šƒ– Š‹Ž†Š‘‘†ƒ„—•‡ ‘–”‹„—–‡•–‘ƒƒ†˜‡”•‡‘—– ‘‡how ‘ˆȋ‡Ǥ‰Ǥƒ”‡•‡‡–ƒŽǤǡʹͲͳʹȌǤŠ‡›ƒ††‹–‹‘ƒŽŽ›’”‘˜‹†‡’‘–‡–‹ƒŽ‡š’Žƒƒ–‹‘•ˆ‘”  Š‹Ž†Š‘‘†ƒ„—•‡ƒˆˆ‡ –•’•› Š‘–‹ ’•› Š‘’ƒ–Š‘Ž‘‰›ǤŠ‡”‡•—Ž–• ‘””‘„‘”ƒ–‡ƒ‰”‘™‹‰„‘†›‘ˆ ˆ‹†‹‰••Š‘™‹‰–Šƒ– Š‹Ž†Š‘‘†ƒ„—•‡ǡ‡‘–‹‘”‡‰—Žƒ–‹‘’”‘„Ž‡•ǡ•‘ ‹ƒŽ†‹ˆˆ‹ —Ž–›ǡ ‡–ƒŽ‹œ‹‰‹’ƒ‹”‡–ƒ†’•› Š‘•‹•ƒ”‡‹–‡””‡Žƒ–‡†ǤŠ‡•‡”‡•—Ž–•ƒ”‡‹Ž‹‡™‹–Š–Š‡˜‹‡™ –Šƒ––Š‡”‡‹•ƒƒˆˆ‡ –‹˜‡’ƒ–Š™ƒ› ‘‡ –‹‰ Š‹Ž†Š‘‘†ƒ„—•‡–‘’•› Š‘•‹•ȋ‡Ǥ‰Ǥǡ›‹Ǧ ‡”‡›• Ƭ˜ƒ•ǡʹͲͲ͹Ǣ”‹•–‘„ƒŽǦƒ”˜ƒ‡œ‡–ƒŽǤǡʹͲͳ͸ȌǤ ‘™‡˜‡”ǡ–Š‡›ƒŽ•‘•—‰‰‡•––Šƒ––Š‹•ƒˆˆ‡ –‹˜‡ ’ƒ–Š™ƒ›ƒ›‘–„‡‡–‹”‡Ž›‹–”ƒ’•› Š‹ ǡ„—–‹–‡”’‡”•‘ƒŽƒ•™‡ŽŽǡ•‹ ‡Ž‘‡Ž‹‡•••‡‡•–‘ ’Žƒ›ƒ‹’‘”–ƒ–ǡ‡†‹ƒ–‹‰”‘Ž‡Ǥ††‹–‹‘ƒŽŽ›ǡ•—’’‘”–‹‰ƒ––ƒ Š‡–ƒ†‡–ƒŽ‹œƒ–‹‘ –Š‡‘”›ǡ‡ƒ”Ž› Š‹Ž†Š‘‘†ƒ†˜‡”•‡‡š’‡”‹‡ ‡••‡‡’”‡†‹ –‹˜‡‘ˆ–Š‡“—ƒŽ‹–›‘ˆ‡‘–‹‘ ”‡‰—Žƒ–‹‘‹ƒ†—Ž–Š‘‘†ǡƒ•–Š‡›’”‡†‹ –ƒš‹‡–›ƒ††‡’”‡••‹‘‹ƒ†—Ž–Š‘‘†Ǥ —”–Š‡”‘”‡ǡ‘—”ˆ‹†‹‰••—‰‰‡•––Šƒ–‹’ƒ‹”‡–‹ ‘‰‹–‹˜‡ǡ‘–Š‡”Ǧ‘”‹‡–‡† ‡–ƒŽ‹œ‹‰ƒ› ‘•–‹–—–‡ƒ’ƒ–Š™ƒ›–Š”‘—‰Š™Š‹ Š Š‹Ž†Š‘‘†ƒ„—•‡ƒˆˆ‡ –•–Š‡•‡˜‡”‹–›‘ˆ ‡‰ƒ–‹˜‡•›’–‘•ǤŠ‹•‹•‹Ž‹‡™‹–Šƒ‰”‘™‹‰„‘†›‘ˆ”‡•‡ƒ” Š•—‰‰‡•–‹‰–Šƒ–ƒ‹’ƒ‹”‡† ‡–ƒŽ‹œ‹‰ƒ„‹Ž‹–›ƒ›„‡ƒ’ƒ–Š™ƒ›–Š”‘—‰Š™Š‹ Š Š‹Ž†Š‘‘†ƒ„—•‡ ‘–”‹„—–‡•–‘ƒŠ‘•–‘ˆ ’•› Š‘’ƒ–Š‘Ž‘‰›‹ƒ†—Ž–Š‘‘†ǡ‹ Ž—†‹‰†‡’”‡••‹‘ƒ†‡š–‡”ƒŽ‹œ‹‰„‡Šƒ˜‹‘”ȋ•‹‡–ƒŽǤǡ ʹͲͳ͹Ȍǡ’‘–‡–‹ƒŽˆ‘”˜‹‘Ž‡ ‡ȋƒ—„‡”ǡ‹‡”ƒǡƒ„‡”‰ǡƬ Š”Ú†‡”ǡʹͲͳ͸Ȍǡ‰‡‡”ƒŽ ’‡”•‘ƒŽ‹–›’ƒ–Š‘Ž‘‰›ȋŠ‹‡•ƒƬ ‘ƒ‰›ǡʹͲͳͶȌǡ†‹••‘ ‹ƒ–‹‘ȋ Š‹‡–‹‡–ƒŽǤǡʹͲͳ͹Ȍǡ‹’ƒ‹”‡† •‘ ‹ƒŽˆ— –‹‘‹‰ȋƒ ‹–‘•Š‡–ƒŽǤǡʹͲͳ͵Ȍƒ†• Š‹œ‘–›’ƒŽ’‡”•‘ƒŽ‹–›’ƒ–Š‘Ž‘‰›ȋ‡”–Š‡Ž‘–ǡ ‡‹‡—šǡ ƒ”‘Ǧ‹••‘‡––‡ǡƒ Šƒ”‹–±ǡƬ—œ‹ǡʹͲͳͻȌǤ‡‰ƒ”†‹‰•’‡ ‹ˆ‹ ƒŽŽ›ǡ”‡ ‡– •–—†‹‡•ˆ‘—†–Šƒ–‡š’‘•—”‡–‘ Š‹Ž†Š‘‘†ƒ„—•‡‹’ƒ–‹‡–•™‹–Š• Š‹œ‘’Š”‡‹ƒ™ƒ•ƒ••‘ ‹ƒ–‡† ™‹–Šˆ— –‹‘ƒŽƒŽ–‡”ƒ–‹‘•‘ˆ„”ƒ‹”‡‰‹‘•—†‡”Ž›‹‰‡–ƒŽ‹œ‹‰ƒ –‹˜‹–›ȋ—‹†±‡–ƒŽǤǡʹͲͳ͹Ȍ ƒ†–Šƒ–‹’ƒ‹”‡†‡–ƒ ‘‰‹–‹˜‡ƒ„‹Ž‹–›ǡƒ ‘•–”— – Ž‘•‡Ž›”‡Žƒ–‡†–‘‡–ƒŽ‹œ‹‰ȋ‹†‡‘—”‡– ƒŽǤǡʹͲͳͻȌǡ‹••–”‘‰Ž›ƒ••‘ ‹ƒ–‡†™‹–Š‡‰ƒ–‹˜‡•›’–‘•ƒ•™‡ŽŽȋ”ƒ—‡Ž•‡‡–ƒŽǤǡʹͲͳ͸ȌǤ ‘™‡˜‡”ǡ‘—”ˆ‹†‹‰•†‹†‘– ‘””‘„‘”ƒ–‡’”‡˜‹‘—•‘„•‡”˜ƒ–‹‘•–Šƒ–‹’ƒ‹”‡† ‡–ƒŽ‹œ‹‰‹•”‡Žƒ–‡†–‘’‘•‹–‹˜‡•›’–‘•ȋ‘” ‘”ƒǡ‡” ‡”ǡƬ ”‹–ŠǡͳͻͻͷǢwas Bartels‐Velthuis, Blijd‐Hoogewys, & Van Os, ʹͲͳͳǢŽ‡‡•‡ǡ‡–ƒŽǤǡʹͲͳ͸ȌǤ••— Š–Š‹• ‹Ž‹‡™‹–Šƒ› ‘–Š‡”•–—†‹‡•–Šƒ–†‹†‘–ˆ‹†•— Šƒ”‡Žƒ–‹‘•Š‹’‡‹–Š‡”ȋ•‡‡ ƒ”‡–›Ƭ ”‡‡ƒǡͳͻͻͻˆ‘”ƒ ‘˜‡”˜‹‡™Ǣ”ƒ—‡Ž•‡‡–ƒŽǤǡʹͲͳ͸ȌǤ ‘™‡˜‡”ǡ‹–—•–„‡—†‡”• ‘”‡†–Šƒ–‘•–•–—†‹‡•ǡ‹ Ž—†‹‰ ‘—”‘™ǡˆ‡ƒ–—”‡†‘Ž› ‘‰‹–‹˜‡ǡ‘–Š‡”Ǧ‘”‹‡–‡†‡–ƒŽ‹œ‹‰Ǥ ’ƒ‹”‡†•‡ŽˆǦ‘”‹‡–‡†ǡƒˆˆ‡ –‹˜‡ mentalizing, or the ability to detect and critically reflect upon one’s sensoryǦƒˆˆ‡ –‹˜‡ experiences sometimes referred to as ‘embodied mentalizing’ (Debbané & Toffel, 2019)ǡŠƒ• „‡‡•—‰‰‡•–‡†–‘„‡— Š‘”‡†‹”‡ –Ž›”‡Žƒ–‡†–‘’‘•‹–‹˜‡•›’–‘ƒ–‘Ž‘‰›Ǥ †‡‡†ǡ•‘Ǧ ƒŽŽ‡†

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146807_JonasWeijers_BNW_def.indd 164 28-10-2020 15:09 Summary and general discussion

•‘—” ‡‘‹–‘”‹‰‡””‘”•Šƒ˜‡„‡‡™‹†‡Ž›”‡Žƒ–‡†–‘˜—Ž‡”ƒ„‹Ž‹–›ˆ‘”ŠƒŽŽ— ‹ƒ–‘”› ‡š’‡”‹‡ ‡•ȋ‡Ǥ‰ǤMentalization”‘‘™‡ŽŽǡ‡–ƒŽŽƬƒ”‡•‡ǡʹͲͳ͵ based treatment for psychoticȌǤ disorder. —””ƒ†‘‹œ‡† ‘–”‘ŽŽ‡† –”‹ƒŽ•Š‘™‡†–Šƒ––Š‡ –”‡ƒ–‡–‘ˆ–Š‡ ‘†‹–‹‘‹ƒ†‘ˆ‹–•‡ŽˆƒŽ”‡ƒ†›•‡‡• •— ‡••ˆ—Žƒ–‹ ”‡ƒ•‹‰•‘ ‹ƒŽˆ— –‹‘‹‰‹’ƒ–‹‡–•ǤŽ–Š‘—‰Š‹’”‘˜‡‡–‹–Š‡’ ‰”‘—’™ƒ•Žƒ”‰‡”–Šƒ–Šƒ–‹–Š‡‰”‘—’ǡ–Š‡Žƒ”‰‡‹’”‘˜‡‡–•‹–Š‡‰”‘—’ƒ› Šƒ˜‡ƒ†‡–Š‡†‡–‡ –‹‘‘ˆ•–ƒ–‹•–‹ ƒŽ†‹ˆˆ‡”‡ ‡•„‡–™‡‡‰”‘—’•‘”‡†‹ˆˆ‹ —Ž–ǤŠ‡•‡”‡•—Ž–• ƒ›‘– ‘‡ƒ•ƒ•—”’”‹•‡Ǥ Ǧ–‡ƒ•Šƒ˜‡ƒƒ””ƒ›‘ˆ’”‘ˆ‡••‹‘ƒŽ•–Šƒ–ƒ”‡•’‡ ‹ƒŽ‹œ‡†‹ Š‡Ž’‹‰’ƒ–‹‡–•–‘•–”— –—”‡–Š‡‹”•‘ ‹ƒŽŽ‹˜‡•ǡ‹ Ž—†‹‰•‘ ‹ƒŽ™‡Žˆƒ”‡™‘”‡”•–Šƒ–’”‘˜‹†‡ Ž‡‰ƒŽƒ†•‘ ‹ƒŽƒ‹†ǡ‹†‹˜‹†—ƒŽ’Žƒ ‡‡–ƒ†•—’’‘”–ȋ Ȍ ‘ƒ Š‡•–Šƒ–Š‡Ž’’ƒ–‹‡–•–‘ ”‡‹–‡‰”ƒ–‡‹–‘•‘ ‹‡–›ƒ†ˆ‹†‡’Ž‘›‡–ƒ†’•› Š‹ƒ–”‹•–•ƒ†—”•‡•–Šƒ–‘ˆˆ‡”’•› Š‘Ǧ ‡†— ƒ–‹‘ǡ’Šƒ”ƒ ‘Ž‘‰‹ ƒŽ–”‡ƒ–‡–ƒ†•—’’‘”–‹˜‡–Š‡”ƒ’›ǤŠƒ––Š‡ ‘†‹–‹‘ ‹’”‘˜‡†•‘ ‹ƒŽˆ— –‹‘‹‰ ‘””‘„‘”ƒ–‡••‘‡‡ƒ”Ž‹‡”ˆ‹†‹‰•”‡‰ƒ”†‹‰ ȋ‡Ǥ‰Ǥ”—‡”ǡ ‹••‡”ǡ›–‡ƒǡƬƒ•ǡʹͲͳ͵Ȍǡ„—– ‘–”ƒ†‹ –•‘–Š‡”•ȋ›•–‡ƒǡ—†‡”‹ǡŽ‘‡‡”•ǡ ‘‘”†ƒǡƬ‹‡”•ƒǡʹͲͲ͹ȌǤ‘–‡–‹ƒŽŽ›ǡ‹ ”‡ƒ•‡†‡š’‡”‹‡ ‡™‹–Š–Š‡ ‘†‡Ž‹–Š‡ ‡–Š‡”Žƒ†•ȋ‹ŽŽƒ•’›‡–ƒŽǤǡʹͲͲ͸Ȍǡ”‡•—Ž–‡†‹ˆ— –‹‘ƒŽ”‡ ‘˜‡”›‹‘—”–”‹ƒŽǤ‘”‡‘˜‡”ǡ–Š‡ ƒ††‹–‹‘‘ˆ –ƒ‡˜‹†‡ ‡„ƒ•‡†‹–‡”˜‡–‹‘–Šƒ– ‘•‹•–•‘ˆ–ƒ”‰‡–‡†•—’’‘”–‹ ‡’Ž‘›‡–‘”‡†— ƒ–‹‘™‹–Š–Š‡ƒ‹–‘ƒ––ƒ‹ƒ•— Š•‘ ‹‡–ƒŽ”‡‹–‡‰”ƒ–‹‘ƒ•’‘••‹„Ž‡– ƒ›Šƒ˜‡ ‘–”‹„—–‡†–‘ƒ‘”‡’‘•‹–‹˜‡‡ˆˆ‡ –‘•‘ ‹ƒŽˆ— –‹‘‹‰ƒ•™‡ŽŽȋ ‘ˆˆƒǡ ¡ ‡Žǡ Žƒ—•‡”ǡƬ—’’‡”ǡʹͲͳʹǢ‘•‡–ƒŽǤǡʹͲͳͻȌǤ ‘™‡˜‡”ǡ‹’”‘˜‡‡–•‹•‘ ‹ƒŽˆ— –‹‘‹‰†‹†’”‘˜‡–‘„‡‰”‡ƒ–‡”‹–Š‡’ ‘†‹–‹‘ǡ™‹–Š’ƒ–‹‡–••Š‘™‹‰Žƒ”‰‡”‹’”‘˜‡‡–•‹•‘ ‹ƒŽˆ— –‹‘‹‰•‹š‘–Š•ƒˆ–‡”

–‡”‹ƒ–‹‘‘ˆ–”‡ƒ–‡–ǤŽ–Š‘—‰Š–Š‡ˆ‘ŽŽ‘™Ǧ—’’‡”‹‘†‘ˆ•‹š‘–Š•‹•–‘‘•Š‘”––‘ƒ””‹˜‡ƒ– 8 †‡ˆ‹‹–‹˜‡ ‘ Ž—•‹‘•ǡ–Š‡”‡•—Ž–•ƒ›‡ƒ–Šƒ–’’”‘˜‹†‡•–‘‘Ž•–‘•—•–ƒ‹ƒ„Ž›ƒ† ƒ—–‘‘‘—•Ž›†‡ƒŽ™‹–Š•‘ ‹ƒŽ’”‘„Ž‡•Ǥ— Š”‡•—Ž–•ƒ”‡‘–‘—–‘ˆ–Š‡‘”†‹ƒ”›ǡƒ•”‡•‡ƒ” Š afterŠƒ••Š‘™–Šƒ–’•› Š‘†›ƒ‹ –Š‡”ƒ’›‘ˆ–‡Ž‡ƒ†•–‘•—•–ƒ‹ƒ„Ž‡‘”‡˜‡‹’”‘˜‡†”‡ ‘˜‡”› termination of treatment, sometimes referred to as the ‘sleeper effect’. Several metaǦ ƒƒŽ›•‡•ƒ†”‡˜‹‡™•Šƒ˜‡ ‘ Ž—†‡†–Šƒ–•— Š•Ž‡‡’‡”‡ˆˆ‡ –•ƒ”‡™‹†‡Ž›‘„•‡”˜‡†ƒˆ–‡” ’•› Š‘†›ƒ‹ –”‡ƒ–‡–•™‹–Š”‡‰ƒ”†–‘ƒ™‹†‡”ƒ‰‡‘ˆ†‹•‘”†‡”•ȋ•‡‡†‡ƒƒ–ǡ†‡ ‘‰Š‡ǡ  Š‘‡˜‡”•ǡƬ‡‡”ǡʹͲͲͻǢŠ‡†Ž‡”ǡʹͲͳͲǢ‹†‰Ž‡›Ƭ‡‡†›ǡʹͲͳͳǢ‘™ǡ‡–ƒŽǤǡʹͲͳʹǢ”‘™ Ƭ”ƒ ›ǡʹͲͳͶǢ‡˜›ǡ‡‘ƒ•ƬƒŽ‹‰‘”ǡʹͲͳͶǢ‡‹ Š•‡”‹‰‡–ƒŽǤǡʹͲͳͷˆ‘”‘˜‡”˜‹‡™•Ȍǡ™Š‹Ž‡ –Š‡„‡‡ˆ‹–•‘ˆ‘–Š‡”–›’‡•‘ˆ–”‡ƒ–‡––‡†–‘†‹‹‹•Š‘˜‡”–‹‡ȋ—”ŠƒǡŠƒ„‡”•ǡƬ ‘™‡”ǡʹͲͲͷǢ†‡ƒƒ–ǡ‡‡”ǡ Š‘‡˜‡”•ǡƬ†‡ ‘‰Š‡ǡʹͲͲ͹ȌǤ‹–Š”‡‰ƒ”†–‘ˆ‘” „‘”†‡”Ž‹‡’‡”•‘ƒŽ‹–›†‹•‘”†‡”ȋȌǡ‹–™ƒ••Š‘™–Šƒ–™ƒ•ƒ••‘ ‹ƒ–‡†™‹–ŠƒŽ‘‰Ǧ Žƒ•–‹‰‹’”‘˜‡‡–‹†‡’”‡••‹˜‡•›’–‘•ǡ•—‹ ‹†ƒŽƒ†’ƒ”ƒǦ•—‹ ‹†ƒŽ„‡Šƒ˜‹‘”ǡ—„‡”‘ˆ †ƒ›•Š‘•’‹–ƒŽ‹œ‡†ƒ†•‘ ‹ƒŽƒ†‹–‡”’‡”•‘ƒŽˆ— –‹‘‹‰Ǥ –‡”‡•–‹‰Ž›ǡƒ–‡ƒƒ† ‘ƒ‰›

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146807_JonasWeijers_BNW_def.indd 165 28-10-2020 15:09 Chapter Eight

ȋʹͲͲͳǢʹͲͲͺȌˆ‘—†–Šƒ––”‡ƒ–‡–‡ˆˆ‡ –•Šƒ†ˆ—”–Š‡”‹ ”‡ƒ•‡†„‘–Šƒ–ͳͺ‘–Š•ƒ†ˆ‹˜‡ ›‡ƒ”ƒˆ–‡”–”‡ƒ–‡––‡”‹ƒ–‹‘ǤŽ–‹ƒ–‡Ž›‘Ž›ͳ͵Ψ‘ˆ’ƒ–‹‡–•™Š‘Šƒ†”‡ ‡‹˜‡†ǡ•–‹ŽŽ ‡––Š‡†‹ƒ‰‘•–‹  ”‹–‡”‹ƒˆ‘”ƒ•‘’’‘•‡†–‘ͺ͹Ψ‘ˆ’ƒ–‹‡–•™Š‘Šƒ†‘–ǤŠ‹• ‘•‹•–‡– ‘„•‡”˜ƒ–‹‘Šƒ•Ž‡†–‘–Š‡•—‰‰‡•–‹‘–Šƒ–’•› Š‘†›ƒ‹ –Š‡”ƒ’›ǡ‹ Ž—†‹‰ǡ—•Š‡”•‹ ’”‘ ‡••‡•–Šƒ– ‘–‹—‡–‘‹’”‘˜‡–Š‡Ž‹˜‡•‘ˆ’ƒ–‹‡–•Ǥ ‘™‡˜‡”ǡ–Š‡‡šƒ –ƒ–—”‡‘ˆ–Š‹• •Ž‡‡’‡”‡ˆˆ‡ –Šƒ•‘–„‡‡‡š’Žƒ‹‡†•ƒ–‹•ˆƒ –‘”‹Ž›Ǥ‡˜‡”ƒŽŠ›’‘–Š‡•‡•‡š‹•–ǡ–Š‘—‰ŠǤ ‹”•–Ž›ǡ’•› Š‘†›ƒ‹ –‡ Š‹“—‡ƒ›‘ˆˆ‡”ƒ‡š’Žƒƒ–‹‘Ǥ•› Š‘†›ƒ‹ –Š‡”ƒ’‹‡• Ž‹‡–‡†–‘•Šƒ”‡ ‘‘ƒ•’‡ –•‹ Ž—†‹‰ǣ—•–”— –—”‡†ǡ‘’‡Ǧ‡†‡††‹ƒŽ‘‰—‡„‡–™‡‡ patient and therapist; the identification of recurring pathological patterns in a patient’s ‡š’‡”‹‡ ‡‘ˆŠ‹•‡Žˆƒ†–Š‡™‘”Ž†ǢŠƒ˜‹‰ƒ†‡˜‡Ž‘’‡–ƒŽ’‡”•’‡ –‹˜‡–Šƒ–‰‹˜‡•‡ƒ‹‰–‘ a patient’s affects in relation to their past; pointing out and helpi‰–Š‡’ƒ–‹‡––‘ ‘ˆ”‘– –Š‘—‰Š–•ƒ†ˆ‡‡Ž‹‰•–Šƒ–ƒ”‡’‡” ‡‹˜‡†–‘„‡–‘‘†‹•–”‡••‹‰‘”—ƒ ‡’–ƒ„Ž‡Ǣƒ†ˆ‘ —•‹‰‘ —””‡–‡š’‡”‹‡ ‡•‘ˆ–Š‡”‡Žƒ–‹‘•Š‹’„‡–™‡‡’ƒ–‹‡–ƒ†–Š‡”ƒ’‹•–Ǥ  ‹†‡–ƒŽŽ›ǡ–Š‡•‡ ‡Ž‡‡–•Šƒ˜‡„‡‡‹†‡–‹ˆ‹‡†ƒ•†”‹˜‡”•ˆ‘”–Š‡”ƒ’›•— ‡••‹ƒ›ˆ‘”‘ˆ’•› Š‘–Š‡”ƒ’›ǡ ”‡‰ƒ”†Ž‡••‘ˆ–Š‡‘”‡–‹ ƒŽ‘”‹‡–ƒ–‹‘ȋŽƒ‰›•Ƭ ‹Ž•‡”‘–ŠǡʹͲͲͲȌǤ‡ ‘†Ž›ǡ–Š‡’”‹ƒ”›ƒ‹‘ˆ ’•› Š‘†›ƒ‹ –Š‡”ƒ’›‹•‘–ƒ”‡†— –‹‘‘ˆ•›’–‘•ǡ„—–”ƒ–Š‡”–Š‡‡•–ƒ„Ž‹•Š‡–‘ˆ‘”‡ •–”— –—”ƒŽƒ†ˆ— –ional ways to deal with life’s challenges. Compared to more symptom ‘”‹‡–ƒ–‡†–”‡ƒ–‡–•ǡ’•› Š‘†›ƒ‹ –”‡ƒ–‡–•ƒ‹–‘ Šƒ‰‡–Š‡‹’Ž‹ ‹–ǡƒ—–‘ƒ–‹ ƒ† ”‡ˆŽ‡š‹˜‡–or ‘unconscious’ –reactions to life’s stresses that are deemed dysfunctional (Shedlerǡ ʹͲͳͲȌǤŠ‹•ƒ’’”‘ƒ Šƒ›„‡‡•’‡ ‹ƒŽŽ›’‡”–‹‡–ˆ‘”’ƒ–‹‡–•™‹–Š ‘’Ž‡šƒ† Š”‘‹  †‹•‘”†‡”•™Š‘–‡†–‘Šƒ˜‡‹ˆŽ‡š‹„Ž‡™ƒ›•‘ˆ‹–‡”’‡”•‘ƒŽƒ†•‘ ‹‡–ƒŽˆ— –‹‘‹‰ǤŠ‹”†Ž›ǡ ‘’ƒ”‡†–‘’Šƒ”ƒ ‘Ž‘‰‹ ƒŽ–”‡ƒ–‡–•ƒ†•‘‡‘–Š‡”ˆ‘”•‘ˆ’•› Š‘–Š‡”ƒ’›ǡ ’•› Š‘†›ƒ‹ –Š‡”ƒ’‹‡•–‡†–‘ƒ––”‹„—–‡‡ƒ‹‰–‘‡‘–‹‘ƒŽ†‹•–”‡••ǡƒ‹‹‰–‘Š‡Ž’ ’ƒ–‹‡–•ˆ‹†„‡––‡”™ƒ›•–‘‡‡––Š‡‹”‡‘–‹‘ƒŽ‡‡†•ƒ†–Š—•Š‡Ž’–‘”‡‰—Žƒ–‡–Š‡‹”‡‘–‹‘• „‡––‡”ȋ‘Ž•ǡʹͲͳͺȌǤ ‘—”–ŠŽ›ǡ‹–•Š‘—Ž†ƒŽ•‘„‡‘–‡†–Šƒ––Š‡‘„•‡”˜‡†•Ž‡‡’‡”‡ˆˆ‡ –•ǡ —„‹“—‹–‘—•ƒ•–Š‡›ƒ”‡ǡƒ›„‡–Š‡”‡•—Ž–‘ˆƒƒ”–‹ˆƒ – ƒ—•‡†„›‡–Š‘†‘Ž‘‰‹ ƒŽ ‘ˆ‘—†• •— Šƒ•†”‘’‘—–”ƒ–‡•ǡ–Š‡Žƒ ‘ˆ‹–‡–‹‘Ǧ–‘Ǧ–”‡ƒ–ƒƒŽ›•‡•ǡ‘””‡ ‡‹˜‹‰ƒ††‹–‹‘ƒŽ ’•› Š‘Ž‘‰‹ ƒŽ–”‡ƒ–‡–ˆ—”–Š‡”†‘™–Š‡”‘ƒ†ȋ‡–‡–ƒŽǤǡʹͲͲͺȌǤ ‘ƒ‰›ƒ†ƒ–‡ƒ‹‹–‹ƒŽŽ›’”‘’‘•‡†–Šƒ––Š‡‡ˆˆ‡ –‹˜‡‡ Šƒ‹•‘ˆ Šƒ‰‡‹ǡ ƒ†ƒ’‘–‡–‹ƒŽ†”‹˜‡”‘ˆ–Š‡‘„•‡”˜‡†•Ž‡‡’‡”‡ˆˆ‡ –ǡ‹•–Š‡†‡˜‡Ž‘’‡–‘ˆ‡–ƒŽ‹œ‹‰ ƒ’ƒ ‹–› ȋ ‘ƒ‰›Ƭƒ–‡ƒǡʹͲͲ͸ȌǤ‡–ƒŽ‹œ‹‰ƒŽŽ‘™•ƒ’‡”•‘–‘‹–‡”’”‡–•‡•‘”›Ǧƒˆˆ‡ –‹˜‡ ‡š’‡”‹‡ ‡•ƒ†‹–‡‰”ƒ–‡–Š‡‹–‘ƒƒ””ƒ–‹˜‡‘ˆ–Š‡•‡Ž˜‡•ƒ†–Š‡•‘ ‹ƒŽ™‘”Ž†‹‘”†‡”–‘ †‡˜‹•‡„‡––‡”™ƒ›•‹‘”†‡”–‘‡‡–‡‘–‹‘ƒŽ‡‡†•ƒ†ˆ— –‹‘‹–‡”’‡”•‘ƒŽŽ›ȋƒ–‡ƒƬ ‘ƒ‰›ǡʹͲͲͳȌǤ †‡‡†ǡ”‡ ‡–”‡•‡ƒ” Š„›‘••‘—™ƒ† ‘ƒ‰›ȋʹͲͳʹȌƒ†‡—Ž‡‡‡•–‡”‡–ƒŽǤ ȋʹͲͳͺȌˆ‘—†ƒƒ••‘ ‹ƒ–‹‘„‡–™‡‡ƒ‹ ”‡ƒ•‡‹‡–ƒŽ‹œ‹‰ ƒ’ƒ ‹–›ƒ†ƒ†‡ ”‡ƒ•‡‹ ’•› Š‹ƒ–”‹ •›’–‘•Ǥ –‡”‡•–‹‰Ž›ǡ‹ Šƒ’–‡”͹™‡ƒŽ•‘ˆ‘—†‹†‹ ƒ–‹‘•–Šƒ–’ƒ–‹‡–•‹–Š‡

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146807_JonasWeijers_BNW_def.indd 166 28-10-2020 15:09 Summary and general discussion

’‰”‘—’†‹†’‡”ˆ‘”„‡––‡”‘•‡˜‡”ƒŽ‡ƒ•—”‡•‘ˆ‡–ƒŽ‹œ‹‰ƒ„‹Ž‹–›ǡƒ†–Šƒ–‹ ’ƒ”–‹ —Žƒ”–Š‡‘”›‘ˆ‹†™ƒ•”‡Žƒ–‡†–‘•‘ ‹ƒŽˆ— –‹‘‹‰ƒ–ˆ‘ŽŽ‘™Ǧ—’Ǥ ‘™‡˜‡”ǡ‡†‹ƒ–‹‘ ƒƒŽ›•‡•‘ˆˆ‡”‡†‹ ‘ Ž—•‹˜‡‡˜‹†‡ ‡‘ˆ‡†‹ƒ–‹‘‘ˆ–Š‡–”‡ƒ–‡–‡ˆˆ‡ –„›ƒ‹’”‘˜‡‡– ‹–Š‡‘”›‘ˆ‹†ǤŠ‹•”ƒ‹•‡•–Š‡“—‡•–‹‘ƒ•–‘™Š‡–Š‡”–Š‡‹’”‘˜‡‡–‘ˆˆ— –‹‘‹‰‹• ƒ—•ƒŽŽ›Ž‹‡†–‘ƒ‹’”‘˜‡‡–‹‡–ƒŽ‹œ‹‰ ƒ’ƒ ‹–›Ǥ‡ƒŽ–‡”ƒ–‹˜‡‡š’Žƒƒ–‹‘ˆ‘”–Š‡ ‘„•‡”˜‡†”‡•—Ž–•‹•–Šƒ–‘–Š‡”ˆ‘”•‘ˆ‡–ƒŽ‹œ‹‰ǡ•’‡ ‹ˆ‹ ƒŽŽ›•‡ŽˆǦ‘”‹‡–‡†ǡƒˆˆ‡ –‹˜‡ˆ‘”•‘ˆ ‡–ƒŽ‹œ‹‰ǡ†”‹˜‡–”‡ƒ–‡–‡ˆˆ‡ –•Ǥ‘–Š‡”’‘••‹„Ž‡‡š’Žƒƒ–‹‘‹•–Šƒ––Š‡”‡Žƒ–‹˜‡Ž›•ƒŽŽN •ƒ’Ž‡•‹œ‡ ‘’ƒ”‡†–‘‘–Š‡”•–—†‹‡•ȋ‡Ǥ‰Ǥ‡—Ž‡‡‡•–‡”‡–ƒŽǤǤǡʹͲͳͺǢ αͳ͹ͷȌƒ›Šƒ˜‡ ”‡•—Ž–‡†‹ƒŽƒ ‘ˆ’‘™‡”–‘‘„•‡”˜‡ƒ•ƒŽŽ–‘‘†‡”ƒ–‡‡†‹ƒ–‹‘‡ˆˆ‡ –ǤŠ‡‘„•‡”˜‡†p ƒ”‰‹ƒŽ•‹‰‹ˆ‹ ƒ ‡‘ˆ–Š‡‡†‹ƒ–‹‘‡ˆˆ‡ –ȋ αǤͲ͸Ȍ†‘‡•’‘‹–‹–Š‹•†‹”‡ –‹‘Ǥ–‹ŽŽǡ‡˜‡‹ˆ –Š‡‘„•‡”˜‡†‡ˆˆ‡ –™‡”‡•‹‰‹ˆ‹ ƒ–ǡ‹–™‘—Ž†‘Ž›‘ˆˆ‡”ƒ’ƒ”–‹ƒŽ‡š’Žƒƒ–‹‘‘ˆ–”‡ƒ–‡–‡ˆˆ‡ –Ǥ ‘–Š‡”’‘••‹„‹Ž‹–›‹•–Šƒ–‡–ƒŽ‹œ‹‰’Žƒ›•ƒ†‹ˆˆ‡”‡–”‘Ž‡‹’ƒ–‹‡–”‡ ‘˜‡”›–Šƒ ‹‹–‹ƒŽŽ› ‘ ‡’–—ƒŽ‹œ‡†Ǥ‡ ‡–†‡˜‡Ž‘’‡–•‹‡–ƒŽ‹œƒ–‹‘–Š‡‘”›Šƒ˜‡ Šƒ‰‡†ƒ†Šƒ˜‡ somewhat diminished the centrality of mentalizing’s hypothetical role as a d”‹˜‡”‘ˆ’ƒ–‹‡– ”‡ ‘˜‡”›Ǥ‡ ‡–Ž›ǡ‡„„ƒ±Ƭ‘ˆˆ‡ŽȋʹͲͳͻȌƒ”‰—‡†–Šƒ–‡–ƒŽ‹œ‹‰’Žƒ›•ƒ‘†‡”ƒ–‹‰”ƒ–Š‡” –Šƒƒ‡†‹ƒ–‹‰”‘Ž‡‹–Š‡†‡˜‡Ž‘’‡–‘ˆ’•› Š‘•‹•ǡ’”‘–‡ –‹‰ƒ‰ƒ‹•––Š‡ƒ –—ƒŽ ƒ‹ˆ‡•–ƒ–‹‘‘ˆˆŽ‘”‹†’•› Š‘•‹•‹–Š‡’”‡•‡ ‡‘ˆƒŽ”‡ƒ†›’”‡•‡–‰‡‡–‹ • Š‹œ‘–›’ƒŽ ˜—Ž‡”ƒ„‹Ž‹–›Ǥ –Š‹•˜‹‡™ǡƒ†‡“—ƒ–‡‡–ƒŽ‹œ‹‰ƒ›„‡˜‹‡™‡†ƒ•ƒ”‡•‹Ž‹‡ ‡ˆƒ –‘”ǡ„‡ ƒ—•‡‹– ƒŽŽ‘™•‹†‹˜‹†—ƒŽ•–‘”‡‡˜ƒŽ—ƒ–‡‘††„‡Ž‹‡ˆ•ǡƒ„‡””ƒ–‡š’‡”‹‡ ‡•‘”‹†‡ƒ•‘ˆ”‡ˆ‡”‡ ‡ ȋ‡„„ƒ±‡–ƒŽǤǡʹͲͳ͸ȌǤ †‡‡†ǡ–Š‡†‡˜‡Ž‘’‡–‘ˆ–Š‡‘”›‘ˆ‹†‹ Š‹Ž†”‡•‡‡•–‘•–›‹‡ –Š‡†‡˜‡Ž‘’‡–‘ˆ†‡Ž—•‹‘ƒŽ‹†‡ƒ–‹‘‹ Š‹Ž†”‡™‹–ŠŠƒŽŽ— ‹ƒ–‘”›‡š’‡”‹‡ ‡•ȋƒ”–‡Ž•Ǧ ‡Ž–Š—‹•ǡŽ‹Œ†Ǧ ‘‘‰‡™›•Ƭ˜ƒ•ǡʹͲͳͳȌǤ

Furthermore, in a recent reconceptualization of MBT’s mechanisms of Šƒ‰‡ǡ ‘ƒ‰›ǡ 8 —›–‡ƒ†ŽŽ‹•‘ȋʹͲͳ͹Ȍƒ”‰—‡†–Šƒ–‡’‹•–‡‹ –”—•–‹•ƒ‹’‘”–ƒ–†”‹˜‡”‘ˆ’ƒ–‹‡–”‡ ‘˜‡”› ƒ•™‡ŽŽǤ‘–†‹••‹‹Žƒ”–‘ ƒ”‡‰‹˜‡”•ǡ–Š”‘—‰Š‡–ƒŽ‹œƒ–‹‘ǡ–Š‡–Š‡”ƒ’‹•––”‹‡•–‘”‡•’‘† contingently to the patient’s emotions with mƒ”‡†”‡•’‘•‡•ǡ™‹–Š‘—–’—•Š‹‰ƒƒ””ƒ–‹˜‡ —’‘–Š‡’ƒ–‹‡–Ǥ›†‘‹‰•‘ǡ–Š‡–Š‡”ƒ’‹•––”‹‡•–‘ ‘—‹ ƒ–‡–Šƒ–Š‡‹•™‡ŽŽǦ‡ƒ‹‰ ƒ†–”‡ƒ–•–Š‡’ƒ–‹‡–ƒ•ƒ‹–‡–‹‘ƒŽƒ‰‡–ǡ™‹–Š‡ƒ‹‰ˆ—Ž‡š’‡”‹‡ ‡•Ǥ ‡‡Ž‹‰ƒ––‡†‡†–‘ ‹–Š‹•™ƒ›‹•–Š‘—‰Š––‘‡‰‡†‡”ƒ•‡•‡‘ˆ•‡ —”‹–›‹–Š‡’ƒ–‹‡––Šƒ–Š‡Ž’•Š‹–‘ƒ‰ƒ‹ „‡ ‘‡ˆŽ‡š‹„Ž‡‹Š‹• ‘‰‹–‹˜‡„‡Ž‹‡ˆ•ƒ†–‘„‡ ‘‡‘”‡‘’‡–‘ƒ†Ž‡ƒ”ˆ”‘‘–Š‡” perspectives about one’s self in relation to his social world. –Š‹•™ƒ›‡–ƒŽ‹œ‹‰ƒ›„‡•‡‡ as a tool to reinstate the patient’s trust that others are wellǦ‡ƒ‹‰ǡŠƒ˜‡•‘‡–Š‹‰”‡Ž‡˜ƒ– –‘•ƒ›ƒ„‘—––Š‡‹”‡š’‡”‹‡ ‡•ǡƒ† ƒŠ‡Ž’ ‘Ǧ”‡‰—Žƒ–‡‡‘–‹‘ƒŽ†‹•–”‡••Ǥ –‹•’‡”Šƒ’•–Š‹• –”—•––Šƒ–‹•–Š‡–”—‡†”‹˜‡”‘ˆ’ƒ–‹‡–”‡ ‘˜‡”›Ǥ‡ ƒ—•‡„—‹Ž†‹‰•— Š–”—•–‹•†‹ˆˆ‹ —Ž–ǡ›‡– Š›’‘–Š‡–‹ ƒŽŽ› ”— ‹ƒŽˆ‘”’ƒ–‹‡–”‡ ‘˜‡”›ǡ–Š‹•ƒ›‡š’Žƒ‹™Š›ƒ†‘–Š‡”’•› Š‘†›ƒ‹  –Š‡”ƒ’‹‡•ƒ”‡‘ˆ–‡–‹‡Ǧ ‘•—‹‰„—––‡†–‘›‹‡Ž†•—•–ƒ‹ƒ„Ž‡ Šƒ‰‡•Ǥ –Š‹••‡•‡‹–‹•

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146807_JonasWeijers_BNW_def.indd 167 28-10-2020 15:09 Chapter Eight

‹–‡”‡•–‹‰–Šƒ––™‘‡–ƒǦƒƒŽ›•‡• ‘ Ž—†‡†–Šƒ–’•› Š‘†›ƒ‹ –”‡ƒ–‡–•–‡†–‘„‡ ‡“—‹˜ƒŽ‡––‘‘–Š‡”–”‡ƒ–‡–ƒ’’”‘ƒ Š‡•‹ƒ›”‡•’‡ –•ǡ„—–•‹‰‹ˆ‹ ƒ–Ž›•—’‡”‹‘”ƒ– ‹’”‘˜‹‰ƒŽƒ†ƒ’–‹˜‡‹–‡”’‡”•‘ƒŽ”‡Žƒ–‹‘•Š‹’•ȋ‘™‡–ƒŽǤǡʹͲͳʹȌƒ†•‘ ‹ƒŽˆ— –‹‘‹‰ ȋ–‡‹‡”–ǡ—†‡”ǡƒ„—‰ǡ ‘›‡”ǡƬ‡‹ Š•‡”‹‰ǡʹͲͳ͹ȌǤ –Š‹•”‡‰ƒ”†•‡‡•‘†‹ˆˆ‡”‡–ǡ •‹‰‹ˆ‹ ƒ–Ž›‹ ”‡ƒ•‹‰•‘ ‹ƒŽˆ— –‹‘‹‰ȋƒ–‡ƒƬ ‘ƒ‰›ǡͳͻͻͻǢʹͲͲͳǢʹͲͲͺǢ ‘”‰‡•‡ǡ ʹͲͳ͵Ǣ‡‹Œ‡”•‡–ƒŽǤǡʹͲʹͲȌƒ††‡ ”‡ƒ•‹‰•‘ ‹ƒŽ•–”‡••ȋ‡‹Œ‡”•‡–ƒŽǤǡʹͲʹͲȌǤ ’‹•–‡‹ –”—•–ƒ•ƒ†”‹˜‡”ˆ‘”’ƒ–‹‡–”‡ ‘˜‡”›ƒ›ƒŽ•‘‡š’Žƒ‹™Š›™‡ˆ‘—†„‡––‡” ‡ˆˆ‡ –•‹”‡ ‡–‘•‡–’ƒ–‹‡–•Ǥ  Šƒ’–‡”•‡˜‡™‡‘„•‡”˜‡†–Šƒ–†—”ƒ–‹‘‘ˆ‹ŽŽ‡••™ƒ• •‹‰‹ˆ‹ ƒ–Ž›”‡Žƒ–‡†–‘•‘ ‹ƒŽ†›•ˆ— –‹‘ƒ†ƒˆˆ‡ –‡†–”‡ƒ–‡–‘—– ‘‡ǡ•—‰‰‡•–‹‰–Šƒ–ƒ patient’s ability to relate to others, participate in society and benefit from treatment †‡–‡”‹‘”ƒ–‡•ƒ•–Š‡†‹•‘”†‡”’”‘‰”‡••‡•Ǥ –‹•™‹†‡Ž›‘™–Šƒ–’•› Š‘•‹• ƒ„‡‡š–”‡‡Ž› †ƒƒ‰‹‰–‘‹–‡”’‡”•‘ƒŽ”‡Žƒ–‹‘•Š‹’•ƒ†•‘ ‹ƒŽ•–ƒ†‹‰Ǥ –Š‡ƒˆ–‡”ƒ–Š‘ˆƒ’•› Š‘–‹  ‡’‹•‘†‡ǡ’ƒ–‹‡–•‘ˆ–‡ˆ‹†–Š‡‹”•‘ ‹ƒŽ‡˜‹”‘‡–•†”ƒ•–‹ ƒŽŽ›ƒŽ–‡”‡†ǡ™Š‡–Š‡”†—‡–‘ƒŽ‘•• ‘ˆˆ”‹‡†•ǡ”‘ƒ–‹ ”‡Žƒ–‹‘•Š‹’•‘”‡’Ž‘›‡–Ǥ‡•‡ƒ” Š•Š‘™•–Šƒ–•‘ ‹ƒŽˆ— –‹‘‹‰ †‡–‡”‹‘”ƒ–‡•‘•–‹–Š‡ˆ‹”•–ˆ‹˜‡›‡ƒ”•ƒˆ–‡”‘•‡–ȋ‹” Š™‘‘†Ƭƒ ‹ŽŽƒǡͳͻͻ͵Ȍƒ†•— Š Ž‘••‡• ƒ„‡†‹ˆˆ‹ —Ž––‘”‡‰ƒ‹ǡƒ•Š‘•’‹–ƒŽ‹œƒ–‹‘•ǡ‡‰ƒ–‹˜‡•›’–‘•ǡ ‘‰‹–‹˜‡†‡ Ž‹‡ǡ ȋ•‡ŽˆȌ•–‹‰ƒƒ†‡†‹ ƒ–‹‘•‹†‡Ǧ‡ˆˆ‡ –• ‘•–‹–—–‡ˆ—”–Š‡”‘„•–ƒ Ž‡•–‘•‘ ‹ƒŽ”‡Šƒ„‹Ž‹–ƒ–‹‘ ȋ‡”‡‹”ƒƬ‡„„ƒ±ǡʹͲͳͺȌǤin‡–ƒŽ‹œƒ–‹‘–Š‡‘”›Š‘Ž†•–Šƒ–’ƒ–‹‡–”‡ ‘˜‡”›†‘‡•‘–’”‹ƒ”‹Ž›between †‡’‡†‘™Šƒ–Šƒ’’‡• –Š‡”ƒ’›•‡••‹‘•ǡ„—–‘”‡‹’‘”–ƒ–Ž›‘™Šƒ–Šƒ’’‡•  •‡••‹‘•Ǥ ‘ƒ‰›ǡƒ†ŽŽ‹•‘ȋʹͲͳͶȌƒ”‰—‡–Šƒ––Š”‘—‰Š‹’”‘˜‹‰‡–ƒŽ‹œ‹‰ƒ„‹Ž‹–›ƒ† ”‡‹†Ž‹‰‡’‹•–‡‹ –”—•–ǡ’ƒ–‹‡–•„‡ ‘‡‘–‹˜ƒ–‡†ƒ‰ƒ‹–‘‡‰ƒ‰‡‹‡ƒ‹‰ˆ—Ž ‘—‹ ƒ–‹‘™‹–Š–Š‡‹”•‘ ‹ƒŽ‡˜‹”‘‡–ǤŠ‹•‹–—”ƒ›ƒŽŽ‘™–Š‡–‘Œ—†‰‡–Š‡‹” •‹–—ƒ–‹‘•‘”‡ƒ —”ƒ–‡Ž›ƒ†‹ ”‡ƒ•‡–Š‡‹”™‹ŽŽ‹‰‡••–‘‘†‹ˆ› ‘‰‹–‹˜‡‘†‡Ž•‘ˆ –Š‡•‡Ž˜‡•ƒ†–Š‡™‘”Ž†„ƒ•‡†‘ˆ‡‡†„ƒ ˆ”‘‘–Š‡”•ǤŠ”‘‹ ’ƒ–‹‡–•™‹–Šǡ–‡†–‘ have smaller, more fragile social networks, and as a consequence may find themselves with ‘less to work with’.Š‹•ƒ›ƒŽ•‘‡š’Žƒ‹™Š› Š”‘‹ ’ƒ–‹‡–•‡š’‡”‹‡ ‡‰”‡ƒ–‡”†‹ˆˆ‹ —Ž–› ŠƒŽŽ‡‰‹‰Ž‘‰Š‡Ž†„‡Ž‹‡ˆ•ȋ‹ ‘Ž‡–ƒŽǤʹͲͳͶȌƒ†•Š‘™’‘‘”‡”–”‡ƒ–‡–”‡•’‘•‡ ȋ‹‡„‡”ƒǡ‹š‘Ƭ ‘Ž†ƒǡʹͲͳ͵Ǣ‹ ‘Ž‡–ƒŽǤʹͲͳͶȌǤ‘‡ƒ—–Š‘”•Šƒ˜‡–Š‡”‡ˆ‘”‡ƒ””‹˜‡† ƒ––Š‡ ‘ Ž—•‹‘n that the first years after onset comprise a ‘critical period’ for intervention ȋ‡Ǥ‰Ǥ ‹” Š™‘‘†Ƭƒ ‹ŽŽƒǡͳͻͻ͵Ǣ ‘””›ǡ‡Ž•‘ǡ ‘Ž†•–‘‡ǡƬ—‰ǡʹͲͳͲȌǡƒ†–Šƒ–’‹• ƒ›„‡„‡•–‹’Ž‡‡–‡†‹–Š‡’”‘†”‘ƒŽ‘”‡ƒ”Ž›•–ƒ‰‡•‘ˆMBTp in the therapeutic landscape. ȋ‡„„ƒ±‡–ƒŽǤǡʹͲͳ͸ȌǤ ‘’Žƒ ‡–Š‡•‡–”‹ƒŽ”‡•—Ž–•‹–‘’‡”•’‡ –‹˜‡ǡ‹–‹• ‹’‘”–ƒ––‘Œ—š–ƒ’‘•‡’ƒ‰ƒ‹•–‘–Š‡”’”‘‹‡––”‡ƒ–‡–•ˆ‘”’•› Š‘–‹ †‹•‘”†‡”ǤŠ‡ ”‡ ‡–†‡ ƒ†‡••ƒ™–Š‡†‡˜‡Ž‘’‡–‘ˆ—Ž–‹’Ž‡’•› Š‘Ž‘‰‹ ƒŽ–”‡ƒ–‡–‘†ƒŽ‹–‹‡•–Šƒ–ƒ‹–‘ –”‡ƒ–’•› Š‘•‹•Ǥ‘‰‹–‹˜‡‡Šƒ˜‹‘”ƒŽŠ‡”ƒ’›ȋȌǡ„‡‹‰–Š‡‘•–•–—†‹‡†ǡŠƒ•ƒ”‰—ƒ„Ž› „‡ ‘‡–Š‡‘•–’”‘‹‡–ƒ‘‰–Š‡ǤCBT for psychosis (CBTp), aims to increase a patient’s

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146807_JonasWeijers_BNW_def.indd 168 28-10-2020 15:09 Summary and general discussion

—†‡”•–ƒ†‹‰‘ˆ’•› Š‘–‹ •›’–‘•ƒ†–‘”‡†— ‡†‹•–”‡••ƒ†‹˜ƒŽ‹†ƒ–‹‘ ƒ—•‡†„›•— Š •›’–‘•Ǥ—Ž–‹’Ž‡”ƒ†‘‹œ‡† ‘–”‘ŽŽ‡†–”‹ƒŽ•Šƒ˜‡•—‰‰‡•–‡†–Šƒ–’Šƒ•„‡‡ˆ‹ ‹ƒŽ ‡ˆˆ‡ –•‘’‘•‹–‹˜‡•›’–‘•ȋ•‡‡‹‡”ƒǡ ƒ˜”‘†ǡ”‹‡—ǡƬ‘‹‹ǡʹͲͲͷˆ‘”ƒ ‘˜‡”˜‹‡™Ȍǡ–”ƒ—ƒǦ”‡Žƒ–‡†•›’–‘•ȋ˜ƒ†‡‡”‰‡–ƒŽǤǡʹͲͳͷǢ‹Ƭ’ƒ‹ǡʹͲͳ͹Ǣ”ƒ†ǡ  ‡”›ǡ‘••‡ŽŽǡ‡†ƒŽŽǡƬŠ‘ƒ•ǡǤǡʹͲͳͺȌǡƒš‹‡–›ȋ•‡‡ ‡ƒ˜‡•ǡ†‰‡”•ǡƬ ‘†‰‡‹•ǡ ʹͲͳͻˆ‘”ƒ‘˜‡”˜‹‡™Ȍǡƒ†•Ž‡‡’†‹•–—”„ƒ ‡ȋ ”‡‡ƒ‡–ƒŽǤǡʹͲͳͷȌǤ††‹–‹‘ƒŽŽ›ǡŠƒ•„‡‡ ’”‘˜‡‡ˆˆ‡ –‹˜‡‹ŠƒŽ–‹‰–”ƒ•‹–‹‘‹–‘’•› Š‘•‹•ˆ‘”–Š‘•‡ƒ–—Ž–”ƒǦŠ‹‰Š”‹•‘ˆ†‡˜‡Ž‘’‹‰ƒ ’•› Š‘–‹ ‡’‹•‘†‡ȋ˜ƒ†‡” ƒƒ‰ǡ˜ƒ†‡‡”‰ǡƬ •‹‰ǡʹͲͳ͹are ȌǤ ‹˜‡–Š‡•— ‡••‡•‘ˆ’ǡ™Š‹ Š ’Ž‡–‹ˆ—Žǡ‘‡ ‘—Ž†ƒ”‰—‡–Šƒ––Š‡”‡‹•Ž‹––Ž‡‡‡† ˆ‘”‘–Š‡”’•› Š‘–Š‡”ƒ’‡—–‹ ‹–‡”˜‡–‹‘•Ǥ ‘™‡˜‡”ǡ•‘‡ ”‹–‹ ƒŽ‘–‡• ƒƒ†•Š‘—Ž†„‡ ƒ†‡Ǥ‡ ‡–‡–ƒǦƒƒŽ›•‡•Šƒ˜‡ƒŽ•‘•Š‘™–Šƒ–‘•–‘ˆ–Š‡‡ˆˆ‡ –•‘„–ƒ‹‡†„›’–‡†–‘ „‡•ƒŽŽ‹•‹œ‡ȋ ƒ—Šƒ”‡–ƒŽǡʹͲͳͶȌǤ††‹–‹‘ƒŽŽ›ǡ•‘‡‡ˆˆ‡ –Ǧ•‹œ‡••‡‡–‘„‡ƒ”–‹ˆ‹ ‹ƒŽŽ› ‹ˆŽƒ–‡†„›”‡•‡ƒ” Š‡”„‹ƒ•ǡƒ•–Š‡‡ˆˆ‡ –•‘ˆ’‹”ƒ–‡”Ǧ„Ž‹†‡†–”‹ƒŽ•ƒ”‡•—„•–ƒ–‹ƒŽŽ› •ƒŽŽ‡”ȋ›‡•ǡ–‡‡Žǡ˜‡”‹––ǡƬƒ””‹‡”ǡʹͲͲͺǢ ƒ—Šƒ”‡–ƒŽǤǡʹͲͳͶȌǤ —”–Š‡”‘”‡ǡƒ‰”‘™‹‰ „‘†›‘ˆ‡˜‹†‡ ‡•Š‘™•–Šƒ–’ ƒ‘––”‡ƒ–‡‰ƒ–‹˜‡•›’–‘•‡ˆˆ‡ –‹˜‡Ž›ƒ††‘‡•‘– ’”‡˜‡–”‡Žƒ’•‡ȋ•‡‡ ƒ—Šƒ”ǡƒ™•Ƭ ‡ƒǡʹͲͳͻˆ‘”ƒ‘˜‡”˜‹‡™ȌǤ††‹–‹‘ƒŽŽ›ǡ’†‘‡• Ž‹––Ž‡–‘‹’”‘˜‡‘”‡‰‡‡”ƒŽ’ƒ–‹‡–ˆƒ –‘”•ǡ•— Šƒ•“—ƒŽ‹–›‘ˆŽ‹ˆ‡‘”•‘ ‹ƒŽˆ— –‹‘‹‰‹ ’ƒ–‹‡–•™‹–Š’•› Š‘–‹ †‹•‘”†‡”•ȋ•‡‡ƒ™•ǡƒ”Ž‹‰–‘ǡ‘†‡Žǡ ‡ƒǡƬ ƒ—Šƒ”ʹͲͳͺˆ‘”ƒ ‘˜‡”˜‹‡™Ȍ‘”–Š‘•‡ƒ–—Ž–”ƒǦŠ‹‰Š”‹•ȋ˜ƒ†‡” ƒƒ‰‡–ƒŽǤǡʹͲͳʹȌǤ— Š ”‹–‹ ‹•ǡŠ‘™‡˜‡”ǡƒ›„‡ deemed unfair, as CBT was never developed to take a ‘holistic’ approach to patient treatment, ˆ‘ —•‹‰‘•’‡ ‹ˆ‹ •›’–‘•‹•–‡ƒ†Ǥ More akin process to MBT, are the so called ‘third wave’contents cognitive behavioral therapies, which

ƒ‹–‘ƒŽ–‡”–Š‡ ‘ˆ ‘‰‹–‹‘”ƒ–Š‡”–Šƒ‹–• ǡƒ†‹ Ž—†‡‡–ƒ ‘‰‹–‹˜‡”ƒ‹‹‰ 8 ȋǢ‘”‹–œƬ‘‘†™ƒ”†ǡʹͲͲ͹Ȍǡ‹†ˆ—Ž‡••Ǧ„ƒ•‡† ‘‰‹–‹˜‡–Š‡”ƒ’›ȋǢ‡Ǥ‰Ǥ‡‰ƒŽǡ ‡ƒ•†ƒŽ‡ǡƬ‹ŽŽ‹ƒ•ǡʹͲͲͶȌǡ•‘ ‹ƒŽ ‘‰‹–‹˜‡–”ƒ‹‹‰’”‘‰”ƒ•ȋ•‡‡ ”‡‡Ƭ ‘”ƒǡʹͲͳͻˆ‘”ƒ ‘˜‡”˜‹‡™Ȍǡƒ†‡–ƒ ‘‰‹–‹˜‡ •‹‰Š–ƒ†‡ˆŽ‡ –‹‘Š‡”ƒ’›ȋ Ǣ†‡ ‘‰‡–ƒŽǤǡʹͲͳͺȌǤ ‹•ƒ‰”‘—’Ǧ„ƒ•‡†–”ƒ‹‹‰’”‘‰”ƒǡ™Š‹ Šƒ‹•–‘ƒ††”‡•• ‘‰‹–‹˜‡„‹ƒ•‡• —†‡”Ž›‹‰†‡Ž—•‹‘ƒŽ„‡Ž‹‡ˆ•ǡ•— Šƒ•Œ—’‹‰–‘ ‘ Ž—•‹‘•Ǥƒ–‹‡–•ƒ”‡‡†— ƒ–‡†ƒ„‘—– ‘‰‹–‹˜‡„‹ƒ•‡•ƒ†ƒ”‡ƒ•‡†–‘•Šƒ”‡‡šƒ’Ž‡•‘ˆ–Š‡‹”‘™„‹ƒ•‡•™‹–Š‹–Š‡•—’’‘”–‹˜‡ •‡––‹‰‘ˆ‰”‘—’–Š‡”ƒ’›ǤŠ‹•‹•–Š‘—‰Š––‘Š‡Ž’’ƒ–‹‡–• ‘ˆ”‘––Š‡‹”‘™„‹ƒ•‡•ƒ†Š‡Ž’ ’ƒ–‹‡–• ‘‡–‘‘”‡ƒ —”ƒ–‡”‡’”‡•‡–ƒ–‹‘•‘ˆ”‡ƒŽ‹–›Ǥ”‡ ‡–‡–ƒǦƒƒŽ›•‹•ǡŠ‘™‡˜‡”ǡ†‹† ‘–‘ˆˆ‡”‡˜‹†‡ ‡‘ˆƒ’‘•‹–‹˜‡‡ˆˆ‡ –‘ˆ‘’‘•‹–‹˜‡•›’–‘•ǡ†‡Ž—•‹‘•‘” ‘‰‹–‹˜‡ „‹ƒ•‡•ǡ•Š‘™‹‰‘Ž›•ƒŽŽǡ‘•‹‰‹ˆ‹ ƒ–‡ˆˆ‡ –•ǤŠ‡•‡‡ˆˆ‡ –•™‡”‡‡˜‡ˆ—”–Š‡”†‹‹‹•Š‡† ™Š‡ ‘ˆ‘—†‹‰ˆƒ –‘”••— Šƒ•’—„Ž‹ ƒ–‹‘ƒ†”‡•‡ƒ” Š‡”„‹ƒ•‡•™‡”‡ƒ ‘—–‡†ˆ‘”ȋ˜ƒ ‘•–‡”Š‘—–‡–ƒŽǤǡʹͲͳͷȌǤ –”‡ƒ‹•— Ž‡ƒ”‹ˆ ƒŠ‡Ž’ƒ‡Ž‹‘”ƒ–‡‹’ƒ‹”‡†•‘ ‹ƒŽ ‘‰‹–‹‘ ƒ†•‘ ‹ƒŽ†›•ˆ— –‹‘Ǥ

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146807_JonasWeijers_BNW_def.indd 169 28-10-2020 15:09 Chapter Eight

MBCT aims to help patients develop ‘mindfulness’, defined as the ability to be ’”‡•‡–‹ the here and now and to be aware of one’s thoughts and emotions without judgment. Embracing ’”‡•‡–‡š’‡”‹‡ ‡•‹–Š‡‘‡––”ƒ–Š‡”–Šƒ–”›‹‰–‘ƒ˜‘‹†‘”•—’’”‡••–Š‡–‹•–Š‘—‰Š– –‘„‡Š‡Ž’ˆ—Ž‹”‡‰—Žƒ–‹‰‡‰ƒ–‹˜‡‡‘–‹‘•ƒ†ƒŽŽ‡˜‹ƒ–‹‰–Š‡†‹•–”‡•• ƒ—•‡†„›’•› Š‘–‹  •›’–‘•ȋŠƒ†™‹ ǡƒ›Ž‘”ǡƬ„„ƒǡʹͲͲͷȌǤ‹––Ž‡”‡•‡ƒ” ŠŠƒ•„‡‡†‘‡ ‘ ‡”‹‰–Š‡ ‡ˆˆ‡ –•‘ˆ‘‡‹–Š‡”•‘ ‹ƒŽ ‘‰‹–‹‘‘”•‘ ‹ƒŽˆ— –‹‘‹‰‹’•› Š‘–‹ †‹•‘”†‡”ǡƒŽ–Š‘—‰Š ”‡•‡ƒ” Š•—‰‰‡•–•–Šƒ–ƒ‡•’ƒ–‹‡–•”‡•’‘†‘”‡‹†ˆ—ŽŽ›–‘•–”‡••ˆ—Ž‹–‡”ƒŽ ‡˜‡–•ȋƒ‰‡”ǡƒ‰ƒ•ǡƒŽ ‡†‘ǡƬ —‡–‡•ǡǤʹͲͳʹȌǡ‹’”‘˜‡•‘˜‡”ƒŽŽˆ— –‹‘‹‰ȋŠƒ†™‹ ‡– ƒŽǤǡʹͲͲͷȌƒ††‡ ”‡ƒ•‡•‡‰ƒ–‹˜‡•›’–‘•ȋŠ‘—”›ǡ‡ ‘–‡ǡ ƒ—†‹ƒ‘ǡƬƒ“—‹ǡʹͲͳ͵Ȍƒ† †‡’”‡••‹‘ȋŠƒ†™‹ ‡–ƒŽǤǡʹͲͳ͸ȌǤ ”‰—ƒ„Ž›‘•–ƒ‹–‘’‹• ǡ™Š‹ ŠƒŽ•‘ˆ‘ —•‡•‘–Š‡†‡˜‡Ž‘’‡–‘ˆŠ‹‰Š‡” order cognitive processing, or ‘metacognition’ in the case of MERIT. MERIT focuses on the ‹†‡–‹ˆ‹ ƒ–‹‘ƒ† ‘—‹ ƒ–‹‘‘ˆ‡–ƒŽ•–ƒ–‡•ƒ†Š‡Ž’•–Š‡’ƒ–‹‡––‘Ž‡ƒ”–‘†‹• ”‹‹ƒ–‡ „‡–™‡‡•—„Œ‡ –‹˜‡ȋ’•› Š‘–‹ Ȍ‡š’‡”‹‡ ‡ƒ†‘—–‡””‡ƒŽ‹–›Ǥ•ƒ–”‡ƒ–‡–ǡ •Šƒ”‡• ƒ›ƒ•’‡ –•™‹–Š’•— Šƒ•ƒ‹“—‹•‹–‹˜‡–Š‡”ƒ’‡—–‹ •–ƒ ‡–‘™ƒ”†•–Š‡’ƒ–‹‡–ǡƒ˜‘‹†‹‰ ’—•Š‹‰ƒƒ””ƒ–‹˜‡—’‘–Š‡’ƒ–‹‡–ƒ†Š‡Ž’‹‰–Š‡’ƒ–‹‡––‘‹–‡‰”ƒ–‡•—„Œ‡ –‹˜‡‡š’‡”‹‡ ‡ ‹–‘ ‘Š‡”‡–ƒ†‡ƒ‹‰ˆ—Ž’‡”•‘ƒŽƒ””ƒ–‹˜‡–Š”‘—‰Š‘’‡†‹ƒŽ‘‰—‡Ǥ ™ƒ•”‡ ‡–Ž› ‡šƒ‹‡†‹ƒǡƒ†‹–™ƒ•‘„•‡”˜‡†–Šƒ– †‹†‘–•—„•–ƒ–‹ƒŽŽ›‹ ”‡ƒ•‡ ‡–ƒ ‘‰‹–‹‘‘˜‡”†‹”‡ –Ž›’‘•–Ǧ–”‡ƒ–‡–ȋ†‡ ‘‰‡–ƒŽǤǡʹͲͳͺȌǤ ‘™‡˜‡”ǡ’ƒ–‹‡–•‹–Š‡   ‘†‹–‹‘†‹†’‡”ˆ‘”„‡––‡”‘‡–ƒ ‘‰‹–‹‘ȋ•‡ŽˆǦ”‡ˆŽ‡ –‹‘‹’ƒ”–‹ —Žƒ”Ȍ ‘’ƒ”‡† –‘ƒ–ƒ•‹š‘–Šˆ‘ŽŽ‘™Ǧ—’ǡƒŽ•‘•—‰‰‡•–‹˜‡‘ˆƒ•Ž‡‡’‡”‡ˆˆ‡ –‹–Š‡ ƒ•‡‘ˆ Ǥ‘ †‹ˆˆ‡”‡ ‡•™‡”‡‘„•‡”˜‡†„‡–™‡‡ ƒ†‘–Š‡‘”›‘ˆ‹†ǡ ‘‰‹–‹˜‡‹•‹‰Š–ǡ †‡’”‡••‹‘ǡ’•› Š‘–‹ •›’–‘•ƒ†•‘ ‹ƒŽˆ— –‹‘‹‰Ǥ ƒ•–Ž›ǡ”‡ ‡–†‡ ƒ†‡•Šƒ˜‡•‡‡–Š‡†‡˜‡Ž‘’‡–‘ˆ•‡˜‡”ƒŽ–”ƒ‹‹‰’”‘‰”ƒ•–Šƒ– –ƒ”‰‡–•’‡ ‹ˆ‹ ƒ•’‡ –•‘ˆ•‘ ‹ƒŽ ‘‰‹–‹‘™Š‹ Šƒ”‡–Š‘—‰Š––‘ ‘–”‹„—–‡–‘–Š‡ˆ‘”ƒ–‹‘‘ˆ psychotic symptoms, including theory of mind (i.e. the ability to infer other people’s mental •–ƒ–‡•Ȍǡˆƒ ‹ƒŽƒˆˆ‡ –”‡ ‘‰‹–‹‘ǡ‡‘–‹‘’”‘ ‡••‹‰ȋ‹Ǥ‡Ǥ†‡–‡ –‹‰ƒ†ƒƒ‰‹‰‡‘–‹‘•‹ ‘”†‡”–‘ˆƒ ‹Ž‹–ƒ–‡ˆ— –‹‘‹‰Ȍǡ•‘ ‹ƒŽ’‡” ‡’–‹‘ȋ‹Ǥ‡Ǥ–Š‡ƒ„‹Ž‹–›–‘†‡ ‘†‡ƒ†‹–‡”’”‡–•‘ ‹ƒŽ —‡•‘ˆ‘–Š‡”•Ȍǡƒ†ƒ––”‹„—–‹‘ƒŽ•–›Ž‡ȋ‹Ǥ‡Ǥ–Š‡™ƒ›‹™Š‹ Š’‡‘’Ž‡–‡†–‘ƒ––”‹„—–‡‡‰ƒ–‹˜‡ ‡˜‡–•–‘•‹–—ƒ–‹‘ƒŽ‘”‹–‡”ƒŽˆƒ –‘”•Ǣ•‡‡ƒƒ‡–ƒŽǤȋʹͲͳ͹Ȍˆ‘”ƒ‘˜‡”˜‹‡™ȌǤ‹˜‡”‰‹‰ˆ”‘  ‘”’ǡ•‘ ‹ƒŽ ‘‰‹–‹˜‡–”ƒ‹‹‰’”‘‰”ƒ•–‡†–‘•‘Ž‡Ž›ˆ‘ —•‘‘‡‘”–™‘‘ˆ–Š‡•‡ •‹ŽŽ•ƒ†–ƒ‡–Š‡ˆ‘”‘ˆ–”ƒ‹‹‰Ǧ•‡••‹‘•ƒ•‘’’‘•‡†–‘‘’‡Ǧ‡†‡†ǡ’•› Š‘–Š‡”ƒ’‡—–‹  †‹ƒŽ‘‰—‡Ǥ‘ ‹ƒŽ ‘‰‹–‹˜‡–”ƒ‹‹‰’”‘‰”ƒ••‡‡–‘Š‘Ž†•‘‡’”‘‹•‡ǣ–Š‡›Šƒ˜‡„‡‡•Š‘™ –‘’”‘†— ‡‘†‡”ƒ–‡Ǧ–‘ǦŽƒ”‰‡‡ˆˆ‡ –•‘ˆƒ ‹ƒŽƒˆˆ‡ –”‡ ‘‰‹–‹‘ƒ†•ƒŽŽ–‘Ǧ‘†‡”ƒ–‡‡ˆˆ‡ –• ‘–Š‡‘”›‘ˆ‹†ǡƒŽ–Š‘—‰Š–Š‡›Šƒ˜‡‡‰Ž‹‰‹„Ž‡‡ˆˆ‡ –•‘•‘ ‹ƒŽ —‡’‡” ‡’–‹‘ƒ† ƒ––”‹„—–‹‘ƒŽ•–›Ž‡Ǥ ‘™‡˜‡”ǡ–Š‡”‡‹• —””‡–Ž›Ž‹––Ž‡‡˜‹†‡ ‡–Šƒ–•‘ ‹ƒŽ ‘‰‹–‹˜‡–Š‡”ƒ’‹‡•

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‹’”‘˜‡•‘ ‹ƒŽˆ— –‹‘‹‰ǡ‘”™Š‡–Š‡”–Š‡›‹’”‘˜‡•‘ ‹ƒŽ ‘‰‹–‹‘•—•–ƒ‹ƒ„Ž›ȋis ”‡‡Ƭ ‘”ƒǡʹͲͳͻȌǡƒŽ–Š‘—‰Š‘‡”‡ ‡–•–—†›•Š‘™‡†–Šƒ––Š‹• ’‘••‹„Ž‡ȋ‡ Š‹‡–ƒŽǤǡʹͲͳͻȌǤ Clinical implications

 Š‡ Ž‹‹ ƒŽ‹•‹‰Š–•‰ƒ‹‡†ˆ”‘–Š‹•†‹••‡”–ƒ–‹‘‘ˆˆ‡”•‘‡•—‰‰‡•–‹‘•ƒ•–‘Š‘™ ’•› Š‘–Š‡”ƒ’‡—–‹ ‹–‡”˜‡–‹‘ˆ‘” ‘—Ž†„‡‹’”‘˜‡†Ǥ ‹”•–Ž›ǡ™‡„‡Ž‹‡˜‡‹–‹•ˆ”—‹–ˆ—Žˆ‘” Ž‹‹ ‹ƒ•–‘ƒ•ƒ„‘—––Š‡’”‡•‡ ‡‘ˆƒ„—•‡‹ Š‹Ž†Š‘‘†ǡƒ•™‡Šƒ˜‡•Š‘™‹––‘‹’ƒ ––Š‡ •‡˜‡”‹–›‘ˆ‘—– ‘‡‹•‡˜‡”ƒŽ™ƒ›•Ǥ•–ƒ„Ž‹•Š‹‰–Š‡‡š‹•–‡ ‡‘ˆ Š‹Ž†Š‘‘†ƒ„—•‡ƒ›’”‘˜‹†‡ „‘–Š’ƒ–‹‡–•ƒ† Ž‹‹ ‹ƒ•™‹–Š‘”‡‹•‹‰Š–‹–‘–Š‡’ƒ–Š‘‰‡‡•‹•‘ˆ–Š‡†‹•‘”†‡”ƒ†–Š‡”‘Ž‡ ‘ˆ’ƒ•–‡š’‡”‹‡ ‡•–Š‡”‡‹ǤŠ‡’”‡•‡ ‡‘ˆ Š‹Ž†Š‘‘†ƒ„—•‡ƒ›ƒŽ•‘•‹‰ƒŽ–Š‡‡‡†ˆ‘” •’‡ ‹ˆ‹ –”ƒ—ƒǦ–ƒ”‰‡–‡†‹–‡”˜‡–‹‘••— Šƒ•›‡‘˜‡‡–‡•‡•‹–‹œƒ–‹‘ƒ†‡’”‘ ‡••‹‰ Š‡”ƒ’›‘” ƒ‰‹ƒ”›š’‘•—”‡ǡ™Š‹ ŠŠƒ˜‡„‡‡•Š‘™–‘„‡‘ˆ‰”‡ƒ–„‡‡ˆ‹––‘–”ƒ—ƒ–‹œ‡† ’ƒ–‹‡–•™‹–Šȋ˜ƒ†‡‡”‰‡–ƒŽǤǡʹͲͳͷȌǤ ‡ ‘†Ž›ǡ™‡Š‘Ž†–Šƒ–‡–ƒŽ‹œƒ–‹‘–Š‡‘”›‡”‹ Š‡•–Š‡”ƒ’‡—–‹ ’”ƒ –‹ ‡ƒ†–Š‡‘”›ǡ ƒ†–Šƒ–•’‡ ‹ˆ‹ ‡Ž‡‡–•‘ˆ’ ƒ‡ƒ•‹Ž›„‡ƒ†‘’–‡†„›‘–Š‡”–”‡ƒ–‡–•ƒ•™‡ŽŽǤ ‘” ‡šƒ’Ž‡ǡ‹“—‹•‹–‹˜‡Ž‹•–‡‹‰™‹–Šƒ‘Œ—†‰‡–ƒŽǡ‘–Ǧ‘™‹‰ǡ›‡– ŠƒŽŽ‡‰‹‰•–ƒ ‡‰”‡ƒ–Ž› Š‡Ž’•–‘‡•–ƒ„Ž‹•Šƒ•‡ —”‡„‘†™‹–Š’ƒ–‹‡–•–Šƒ–ƒ”‡‰‡‡”ƒŽŽ›˜‹‡™‡†–‘„‡‘–‘”‹‘—•Ž›Šƒ”† to reach. At the same time, within such an ‘earned secure relationship’, dysfunctional beliefs can „‡‘”‡‡ƒ•‹Ž› ŠƒŽŽ‡‰‡†Ǥ –‹•‹’‘”–ƒ–ˆ‘” Ž‹‹ ‹ƒ•–‘ ‘•‹†‡”–Šƒ–ˆ‡‡Ž‹‰•‘ˆŽ‘‡Ž‹‡•• ƒ†ƒ†˜‡”•‡•‘ ‹ƒŽ‡š’‡”‹‡ ‡•ƒ›ƒ‡‹–†‹ˆˆ‹ —Ž–ˆ‘”’ƒ–‹‡–•–‘ƒ†‡“—ƒ–‡Ž›”‡‰—Žƒ–‡–Š‡‹” ‡‘–‹‘•ǡ ‘•‡“—‡–Ž›‹’‡†‹‰–Š‡‹”ƒ„‹Ž‹–›–‘‡–ƒŽ‹œ‡ƒ†–Š—• ‘—‹ ƒ–‡Ǥ ††‹–‹‘ƒŽŽ›ǡƒ›„‡™‡ŽŽ•—‹–‡†–‘„”‹†‰‡–Š‡‰ƒ’„‡–™‡‡–Š‡’•› Š‘†›ƒ‹ ƒ†

‘‰‹–‹˜‡ƒ’’”‘ƒ Š‡•–‘’•› Š‘’ƒ–Š‘Ž‘‰›–Šƒ–Šƒ˜‡†‹˜‹†‡†–Š‡ —””‡–Žƒ†• ƒ’‡‘ˆ‡–ƒŽ 8 Š‡ƒŽ–Š ƒ”‡Ǥ‹‡‘–Š‡”’•› Š‘†›ƒ‹ –Š‡”ƒ’‹‡•ǡ’”‹‘”‹–‹œ‡•ƒ––‡†ƒ ‡–‘–”ƒ•ˆ‡”‡ ‡ and countertransference and holds that early childhood experiences play a role in a patients’ —””‡–’•› Š‘’ƒ–Š‘Ž‘‰›ȋŽŽ‡ǡ‡–ƒŽǤʹͲͳʹȌǤ––Š‡•ƒ‡–‹‡ǡ•Šƒ”‡•‹’‘”–ƒ–‡Ž‡‡–• ™‹–Šǡ•— Šƒ•ƒˆ‘ —•‹‰‘’”‡•‡–‡‘–‹‘ƒŽ’”‘„Ž‡•ǡƒ†‘’–‹‰ƒ ŠƒŽŽ‡‰‹‰•–ƒ ‡ –‘™ƒ”†•Š‡Ž†„‡Ž‹‡ˆ•ƒ†ƒ–‹‡ǦŽ‹‹–‡†ǡƒ—ƒŽ‹œ‡†ƒ’’”‘ƒ Š–‘–”‡ƒ–‡–Ǥ‡„‡Ž‹‡˜‡–Šƒ––Š‡ •›‡”‰›‘ˆ–Š‡•‡ƒ’’”‘ƒ Š‡•ǡ‹Š‡”‡––‘ǡ‹•‘ˆ‰”‡ƒ–„‡‡ˆ‹––‘’ƒ–‹‡–•Ǥ Š‹”†Ž›ǡ™‡„‡Ž‹‡˜‡–Šƒ––Š‡•—•–ƒ‹‡†‹’”‘˜‡‡–•‹‡–ƒŽ‹œ‹‰ƒ†•‘ ‹ƒŽ ˆ— –‹‘‹‰›‹‡Ž†‡†„›’ƒ”‡‘ˆ Ž‹‹ ƒŽ‹’‘”–ƒ ‡ǤŽ–Š‘—‰Š‘‡ ‘—Ž†”‡ƒ•‘ƒ„Ž›ƒ”‰—‡ –Šƒ–’†‘‡•‘–ƒ††— Š–‘†‹”‡ –Ž›’‘•––”‡ƒ–‡–ǡ‘Ž›‹–Š‡’ ‘†‹–‹‘†‹† ‹’”‘˜‡‡–•‹•‘ ‹ƒŽˆ— –‹‘‹‰’”‘˜‡–‘„‡”‘„—•–Ǥ”‡˜‹‘—••–—†‹‡•Šƒ˜‡•Š‘™–Šƒ– •—•–ƒ‹ƒ„Ž›‹’”‘˜‹‰•‘ ‹ƒŽ†›•ˆ— –‹‘‹•‘–‘”‹‘—•Ž›†‹ˆˆ‹ —Ž–™‹–Š’•› Š‘–Š‡”’‡—–‹  ‹–‡”˜‡–‹‘•ȋƒ–Š‡”‡–ƒŽǤǡʹͲͲͷǢ†‡ ‘‰‡–ƒŽǤʹͲͳͺǢ‘•‡–ƒŽǤǡʹͲͳͻǢ ”‡‡Ƭ ‘”ƒǡʹͲͳͻȌǡ ƒ†’Šƒ”ƒ ‘Ž‘‰‹ ƒŽ–”‡ƒ–‡–ȋƒ”„‘Ƭ‘””‡ŽŽǡʹͲͳͶȌǡ‘ˆ–‡ ”‡ƒ–‹‰ƒ‰ƒ’„‡–™‡‡

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146807_JonasWeijers_BNW_def.indd 171 28-10-2020 15:09 Chapter Eight

•›’–‘ƒ–‹ ƒ†ˆ— –‹‘ƒŽ”‡ ‘˜‡”›ȋ‹” Š™‘‘†‡–ƒŽǤǡʹͲͳ͵ȌǤ‹ ‡•‘ ‹ƒŽ†›•ˆ— –‹‘‹• ’”‡†‹ –‹˜‡‘ˆ”‡Žƒ’•‡‹–‘’•› Š‘•‹•ȋ‘—–—”‡ǡ‡Ƭ‘„‡”–•ǡʹͲͲ͸Ȍǡ–Š‡ƒ††‹–‹‘‘ˆ’–‘ ǡ™Š‹Ž‡‘”‡Žƒ„‘”‹–‡•‹˜‡ǡƒ›’”‘˜‡–‘„‡‘”‡ ‘•–‡ˆˆ‡ –‹˜‡Ǥ †‡‡†ǡ–Š‡Ž‹‹–‡† —„‡”‘ˆŠ‘•’‹–ƒŽ‹œƒ–‹‘•‘ˆ’ƒ–‹‡–•’ƒ”–‹ ‹’ƒ–‹‰‹’•‡‡•‹†‹ ƒ–‹˜‡‘ˆ–Š‹•ȋ•‡‡ Šƒ’–‡”͹ȌǡƒŽ–Š‘—‰Š‘”‡”‡•‡ƒ” Š‹•‡‡†‡†–‘ ‘‡–‘†‡ˆ‹‹–‹˜‡ ‘ Ž—•‹‘•Ǥ ‘—”–ŠŽ›ǡ–Š‡‘„•‡”˜‡†‡ˆˆ‡ –•‹–Š‡•—„‰”‘—’‘ˆ”‡Žƒ–‹˜‡Ž›”‡ ‡–‘•‡–’ƒ–‹‡–••‡‡ ‡•’‡ ‹ƒŽŽ›”‡Ž‡˜ƒ–Ǥ‡ ‡–‘•‡–’ƒ–‹‡–•‹–Š‡’‰”‘—’•Š‘™‡†‰”‡ƒ–‹’”‘˜‡‡–•ǡM ƒ––ƒ‹‹‰Ž‡˜‡Ž•‘ˆˆ— –‹‘‹‰‘–Š‡‘ ‹ƒŽ — –‹‘‹‰ ƒŽ‡ȋM αͳͳ͸ǤͷͺǢ•‡‡Šƒ’–‡”͹Ȍ‹M „‡–™‡‡–Š‘•‡‘ˆˆ‹”•–‡’‹•‘†‡’•› Š‘•‹•’ƒ–‹‡–•ȋ αͳͲͺǤͲ͹Ȍƒ†Š‡ƒŽ–Š› ‘–”‘Ž•ȋ α ͳ ͳʹ͵Ǥ͵͸Ȍǡƒ•‡•–ƒ„Ž‹•Š‡†„›††‹‰–‘ƒ†††‹‰–‘ȋʹͲͲͺȌ ǤŠ‡‰”‡ƒ–‡”–”‡ƒ–‡–”‡•’‘•‡• ‘ˆ”‡Žƒ–‹˜‡Ž›”‡ ‡–‘•‡–’ƒ–‹‡–•ƒ›‡ƒ–Šƒ–’•Š‘—Ž†„‡‹’Ž‡‡–‡†•‘‘‡””ƒ–Š‡” –ŠƒŽƒ–‡”ǤŠ‹•‹•‡•’‡ ‹ƒŽŽ›’‡”–‹‡–ǡƒ••‘ ‹ƒŽ†›•ˆ— –‹‘‘ˆ–‡‹ ”‡ƒ•‡•†—”‹‰–Š‡ ‘—”•‡‘ˆ ‹ŽŽ‡••ȋƒ”„‘Ƭ‘””‡ŽŽǡʹͲͳͶȌǡƒ† ‘–”‹„—–‡•–‘ƒƒ†˜‡”•‡ ‘—”•‡‘ˆ–Š‡†‹•‘”†‡”ȋ —•ƒ”Ǧ ‘Ž‹‡–ƒŽǤǡʹͲͳͲȌǤ  Suggestions for future research

Future research should investigate whether the loneliness contributing to psychosis is ‘in the eye quantityof the beholder’ or ‘–Ǥ ‘–Š‡”™‘”†•ǡ‹–•Š‘—Ž†‹˜‡•–‹‰ƒ–‡™Š‡–Š‡”’•› Š‘•‹•‹•”‡Žƒ–‡†–‘quali –Š‡ ‘ˆ•‘ ‹ƒŽ”‡Žƒ–‹‘•‘”–Š‡Ž‘™‡š’‡”‹‡ ‡† –›‘ˆ‡š‹•–‹‰”‡Žƒ–‹‘•Š‹’•Ǥ‡”Šƒ’• Ž‘‡Ž‹‡••‹•‘”‡ƒ‹–‘–Š‡ˆ‡‡Ž‹‰‘ˆ„‡‹‰‹•—†‡”•–‘‘†‘”•‘ ‹ƒŽ‹ˆ‡”‹‘”‹–›ȋ‡Ž–‡Ƭ ƒ–‘”ǦGraae, 2005) than actual ‘aloneness’. Furthermore, investigating loneliness in the ‘–‡š–‘ˆ†‘’ƒ‹‡•‡•‹–‹œƒ–‹‘ƒ›„‡ƒˆ”—‹–ˆ—Ž˜‡—‡ˆ‘”ˆ—–—”‡”‡•‡ƒ” Šǡƒ•–Š‡ ‘–”‹„—–‹‘‘ˆŽ‘‡Ž‹‡••–‘’•› Š‘•‹•ƒ›„‡„‹‘Ž‘‰‹ ƒŽŽ›‡š’Žƒ‹‡†„›–Š‡•‡•‹–‹œƒ–‹‘‘ˆ–Š‡ ‡•‘Ž‹„‹ †‘’ƒ‹‡•›•–‡ȋ ‘™‡•Ƭ—””ƒ›ǡʹͲͳͶȌǤ‹‡™‹•‡ǡ‹–ƒ›„‡ˆ”—‹–ˆ—Ž–‘‡šƒ‹‡ ™Š‡–Š‡”Ž‘‡Ž‹‡••‹•”‡Žƒ–‡†–‘‹’ƒ‹”‡†‡–ƒŽ‹œ‹‰ˆ— –‹‘ƒŽ‹–›ǡƒ•ƒ”‡ ‡–•–—†›•Š‘™‡† –Šƒ–•‘ ‹ƒŽ‹•‘Žƒ–‹‘’”‡†‹ –•–Š‡‘”›‘ˆ‹†‹’ƒ‹”‡–ȋ‡‘—•ƒǡ‡ŽŽ™‘‘†ǡŽ†”‹†‰‡ǡƬ ‡–ƒŽŽǡʹͲͳͺȌǤ ††‹–‹‘ƒŽŽ›ǡ”‡•‡ƒ” Š•Š‘—Ž†‹˜‡•–‹‰ƒ–‡ǡ™Š‡–Š‡”’‹•‘”‡‡ˆˆ‡ –‹˜‡™Š‡‹–Šƒ•ƒ Ž‘‰‡”†—”ƒ–‹‘ǡ™Š‡‹–‹••’‡ ‹ˆ‹ ƒŽŽ›–ƒ‹Ž‘”‡†–‘’•› Š‘–‹ ’ƒ–‹‡–•ȋƒœǡʹͲͳͺȌǡ™Š‡‹–‹• ‹’Ž‡‡–‡†‹–Š‡’”‘†”‘ƒŽ’Šƒ•‡‘ˆ’•› Š‘•‹•ȋ‡„„ƒ±‡–ƒŽǤǡʹͲͳ͸Ȍǡƒ†™Š‡–Š‡”–Š‡ ‡ˆˆ‡ –•‘ˆ’”‡ƒ‹„‡›‘†•‹š‘–Š•Ǥ ˆƒ –ǡ‰‹˜‡–Š‡™‹†‡Ǧ”ƒ‰‹‰‹’Ž‹ ƒ–‹‘•‘ˆ Š‹Ž†Š‘‘†ƒ„—•‡‘•‡˜‡”‹–›‘ˆ•›’–‘•‹ƒ†—Ž–Š‘‘†ǡ‘‡ ‘—Ž†“—‡•–‹‘™Š‡–Š‡” ‹–‡”˜‡–‹‘••Š‘—Ž†‘–„‡‹’Ž‡‡–‡†ƒ•‡ƒ”Ž›ƒ• Š‹Ž†Š‘‘†Ǥ ƒ‹Ž›Ǧƒ†• Š‘‘ŽǦ–ƒ”‰‡–‡† ‡–ƒŽ‹œƒ–‹‘„ƒ•‡†‹–‡”˜‡–‹‘•ƒ”‡ —””‡–Ž›„‡‹‰‹’Ž‡‡–‡†‹–Š‡‹–‡†‹‰†‘

ͳ Š‡• ‘”‡•”‡’‘”–‡†„›††‹‰–‘‡–ƒŽǤ™‡”‡”‡ ƒŽ —Žƒ–‡†ǡƒ•–Š‡‹”ƒ”–‹ Ž‡‹ ‘””‡ –Ž›‡–‹‘•–Š‡•— ‘ˆ”ƒ™ •—„Ǧ• ‘”‡•ǡƒ•‘’’‘•‡†–‘–Š‡ƒ˜‡”ƒ‰‡‘ˆ• ƒŽ‡†•—„Ǧ• ‘”‡•Ǥ

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146807_JonasWeijers_BNW_def.indd 172 28-10-2020 15:09 Summary and general discussion

ȋ‹†‰Ž‡›Ƭ”‘—˜ƒǡʹͲͳ͵ȌǤ— Š‹–‡”˜‡–‹‘•ƒ›Š‡Ž’’ƒ”‡–•–‘„‡––‡”‹†–Š‡‹” Š‹Ž†”‡ǡ ƒ† Š‹Ž†”‡–‘„‡––‡”‹†–Š‡‹”’‡‡”•ƒ†–Š‡•‡Ž˜‡•Ǥ –™‹ŽŽ„‡‹–‡”‡•–‹‰–‘•‡‡™Š‡–Š‡” •— Š‹–‡”˜‡–‹‘• ƒ•–›‹‡ƒ„—•‡ƒ†‹–•’ƒ–Š‘‰‡‹  ‘•‡“—‡ ‡•Ǥ  ††‹–‹‘ƒŽŽ›ǡ™‡„‡Ž‹‡˜‡–Šƒ–‹ˆ—–—”‡–”‹ƒŽ•ǡ’•Š‘—Ž†„‡ ‘’ƒ”‡†–‘‘–Š‡” –”‡ƒ–‡–•ˆ‘”’•› Š‘–‹ †‹•‘”†‡”••— Šƒ•’ǡȋ‡‰ƒŽ‡–ƒŽǤǡʹͲͲͶȌǡ‘” ȋ†‡ ‘‰ ‡–ƒŽǤǡʹͲͳͺȌǤ•‡–‹‘‡†‡ƒ”Ž‹‡”ǡƒ›‹–‡”˜‡–‹‘•ƒ”‡–Š‘—‰Š––‘„‡ƒ„Ž‡–‘‹ ”‡ƒ•‡ ‡–ƒŽ‹œ‹‰ƒ„‹Ž‹–›Ǥ ‘™‡˜‡”ǡˆ”‘–Š‡’‡”•’‡ –‹˜‡‘ˆ‡–ƒŽ‹œƒ–‹‘–Š‡‘”›ǡ‡–ƒŽ‹œƒ–‹‘ enhancing techniques will be of little value “…if the patient is not helped to mentalize at the time when intense emotional states are evoked in attachment relationships” (Allen, et al., 2008). In ‘—”˜‹‡™ǡ–Š‡ƒ„‹Ž‹–›–‘‡–ƒŽ‹œ‡ ƒ‘–ƒ†—•–‘–„‡‹•‘Žƒ–‡†ˆ”‘–Š‡ƒ–—”ƒŽ•‡––‹‰‹ ™Š‹ Š‹–‹•‘•–Ž‹‡Ž›–‘„‡‹’ƒ‹”‡†ǡƒ‡Ž›‹–Š‡•‡––‹‰‘ˆ”‡Žƒ–‹‘•Š‹’•ǤŠ‹•ƒ›„‡ ‡•’‡ ‹ƒŽŽ›’‡”–‹‡–ˆ‘”’ƒ–‹‡–•™‹–Š™Š‘ǡŽ‹‡’ƒ–‹‡–•™‹–Šȋ ‘ƒ‰›Ƭ—›–‡ǡ ʹͲͲͻȌǡ•‡‡–‘Šƒ˜‡ƒ‘˜‡”ƒ –‹˜‡‹””‘”‡—”‘•›•–‡ȋ ‘”‹ ‡–ƒŽǤǡʹͲͳʹȌƒ† ‡š’‡”‹‡ ‡†‹ˆˆ‹ —Ž–›†‹ˆˆ‡”‡–‹ƒ–‹‰„‡–™‡‡•‡Žˆƒ†‘–Š‡”•‹•‘ ‹ƒŽ ‘–‡š–•ȋƒ••Ƭƒ”ƒ•ǡ ʹͲͲ͵ȌǤ”‡ƒ–‡–•Ž‹‡ƒ› ‘–”‹„—–‡–‘‹’”‘˜‡†ǡ•‡ŽˆǦ‘”‹‡–‡†‡–ƒŽ‹œ‹‰™‹–Š‹ƒ ‹•‘Žƒ–‡†•‡––‹‰ǡ„—–ƒ›‘–‡ ‡••ƒ”‹Ž›‹’”‘˜‡‡–ƒŽ‹œ‹‰‹‹ ‘–‡š–‘ˆ”‡Žƒ–‹‘•Š‹’•Ǥ  ‹•— Š‘”‡ƒ‹–‘‹–Š‹•”‡‰ƒ”†ǡ„—–†‘‡•‘–’”‘˜‹†‡‰”‘—’Ǧ–Š‡”ƒ’›ǡ™Š‹ Š ƒ”‰—ƒ„Ž›‹•–Š‡‘•–‡‘–‹‘ƒŽŽ› ‘’Ž‡š ‘–‡š–ˆ‘”’ ƒ–‹‡–•™‹–ŠǤ General strengths and limitations

’‡ ‹ˆ‹ •–”‡‰–Š•ƒ†Ž‹‹–ƒ–‹‘•‘ˆ‡ƒ Š•–—†›ƒ”‡†‡• ”‹„‡†‹–Š‡”‡•’‡ –‹˜‡ Šƒ’–‡”Ǥ ‘™‡˜‡”ǡ•‘‡‰‡‡”ƒŽ•–”‡‰–Š•ƒ†Ž‹‹–ƒ–‹‘••Š‘—Ž†„‡†‹• —••‡†Ǥ ‹”•–ǡ‹–Š‡•–—†‹‡•

†‡• ”‹„‡†‹–Š‹•†‹••‡”–ƒ–‹‘™‡•‘—‰Š––‘ƒ––ƒ‹ƒŠ‹‰Š•–ƒ†ƒ”†‘ˆ‡ƒ•—”‡‡–“—ƒŽ‹–›„› 8 —•‹‰‹•–”—‡–•–Šƒ–‡ƒ•—”‡•›’–‘•ƒ•–Š‡›‘ —”‹†ƒ‹Ž›Ž‹ˆ‡ǡ ‹” —˜‡–‹‰”‡ ƒŽŽ„‹ƒ•ǡ ‘”„›—•‹‰ ‘ ”‡–‡ǡ„‡Šƒ˜‹‘”ƒŽŽ›ƒ Š‘”‡†‹–‡”˜‹‡™•‘”’‡”ˆ‘”ƒ ‡„ƒ•‡†‹•–”—‡–•ǡ ‹” —˜‡–‹‰’‘‘”‹•‹‰Š–ƒ†‹’ƒ‹”‡†”‡ˆŽ‡ –‹˜‡ ƒ’ƒ ‹–›Ǥš–‡•‹˜‡–”ƒ‹‹‰™ƒ•’”‘˜‹†‡†–‘ ƒš‹‹œ‡‹–‡””ƒ–‡””‡Ž‹ƒ„‹Ž‹–›Ǥ‡ ‘†ǡ™‡ƒ†‡—•‡‘ˆ„Ž‹†‡†”ƒ–‡”•–‘‡Ž‹‹ƒ–‡‘„•‡”˜‡” „‹ƒ•ǤŠ‹”†ǡ™‡‹ Ž—†‡†’ƒ–‹‡–•™‹–Šƒ™‹†‡”ƒ‰‡‘ˆ‹ŽŽ‡••†—”ƒ–‹‘ǡƒ†ƒ—Ž–‹–—†‡‘ˆ ’•› Š‘–‹ †‹ƒ‰‘•‡•ƒ† ‘‘”„‹††‹ƒ‰‘•‡•Ǥ••— Šǡ™‡ˆ‡‡Ž‘—””‡•—Ž–•ƒ†‡“—ƒ–‡Ž›”‡ˆŽ‡ – ‰‡‡”ƒŽ’”ƒ –‹ ‡Ǥƒ›•–—†‹‡•ƒ‡—•‡‘ˆ•–”‹‰‡–‹ Ž—•‹‘ ”‹–‡”‹ƒǡƒ —•–‘–Šƒ–Šƒ•„‡‡ ”‹–‹ ‹œ‡†ˆ‘”‹’ƒ –‹‰–Š‡‰‡‡”ƒŽ‹œƒ„‹Ž‹–›‘ˆ–Š‡‹””‡•—Ž–•ȋ ‘‡”–‡Ž‡–ƒŽǤǡʹͲͳͷȌǤ Š‡ˆ‹”•–ƒ†ˆ‘”‡‘•–Ž‹‹–ƒ–‹‘‘ˆ‘—”•–—†‹‡•‹•–Šƒ––Š‡›ƒŽŽ‹˜‘Ž˜‡†–Š‡•ƒ‡ ”‡•‡ƒ” Š•ƒ’Ž‡ǤŠ‹•‡ƒ•–Šƒ–“—‡•–‹‘•”‡ƒ‹ƒ„‘—––Š‡‰‡‡”ƒŽ‹œƒ„‹Ž‹–›‘ˆ‘—”ˆ‹†‹‰•ƒ• –Š‡”‡•—Ž–•ƒ›•‹’Ž›”‡ˆŽ‡ – Šƒ”ƒ –‡”‹•–‹ ••’‡ ‹ˆ‹ –‘–Š‹••ƒ’Ž‡Ǥ ‹˜‡–Šƒ–‘—”•ƒ’Ž‡Šƒ† ”‡Žƒ–‹˜‡Ž›‹Ž†’‘•‹–‹˜‡ƒ†‡‰ƒ–‹˜‡•›’–‘•ƒ–„ƒ•‡Ž‹‡ȋ•‡‡ Šƒ’–‡”•‡˜‡Ȍǡ‘—”†ƒ–ƒ‡‡†–‘ „‡‹–‡”’”‡–‡†™‹–Š ƒ—–‹‘Ǥ‡ ‘†ǡ–Š‡•–—†‹‡•‘ˆ Šƒ’–‡”•–Š”‡‡ǡˆ‘—”ƒ†ˆ‹˜‡†‹†‘–‹ Ž—†‡

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146807_JonasWeijers_BNW_def.indd 173 28-10-2020 15:09 Chapter Eight

Š‡ƒŽ–Š› ‘–”‘Ž‰”‘—’•ǡƒ‹‰‹–‹’‘••‹„Ž‡–‘‡šƒ‹‡™Š‡–Š‡”–Š‡‘„•‡”˜‡† ‘””‡Žƒ–‹‘•ƒ”‡ •’‡ ‹ˆ‹ –‘’ƒ–‹‡–•™‹–Š ǡ‘”ƒ”‡ƒŽ•‘‡š–ƒ–‹–Š‡‰‡‡”ƒŽ’‘’—Žƒ–‹‘Ǥ

Concluding remarks

The inherent “unǦunderstandability” of psychotic expe”‹‡ ‡•–‘–Š‡Žƒ›ƒ—•–ƒ‡ ’•› Š‘•‹•ƒ’”‘ˆ‘—†Ž›Ž‘‡Ž›‡š’‡”‹‡ ‡Ǥ”ƒ‰‹ ƒŽŽ›ǡƒ•–Š‡”‡•—Ž–•‘ˆ–Š‹•–Š‡•‹••—‰‰‡•–ǡ Ž‘‡Ž‹‡••‹–—”•‡‡•–‘ ‘–”‹„—–‡•‹‰‹ˆ‹ ƒ–Ž›–‘–Š‡•‡˜‡”‹–›‘ˆ–Š‡†‹•‘”†‡”ǡ‰‡‡”ƒ–‹‰ƒ ˜‹ ‹‘—• › Ž‡‘ˆ’ƒ–Š‘‰‡‡•‹•Ǥ owever, we also argued that having one’s personal experiences —†‡”•–‘‘†ƒ•‡ƒ‹‰ˆ—Ž„›ƒ‘–Š‡”ǡ‹•ƒ’‘™‡”ˆ—Ž–‘‘Ž–‘‘˜‡” ‘‡•— Šƒ•‡•‡‘ˆ•‘ ‹ƒŽ ‹•‘Žƒ–‹‘Ǥ‡–ƒŽ‹œ‹‰„ƒ•‡†–”‡ƒ–‡–‹•–Š‘—‰Š––‘Š‡Ž’’‡‘’Ž‡„‡––‡”—†‡”•–ƒ†–Š‡•‡Ž˜‡• ƒ†‘–Š‡”s, and thus improve people’s capacity to communicate with and learn from others. A ‡–ƒŽ‹œ‹‰•–ƒ ‡ƒ›–Š—•Š‡Ž’„”‹†‰‡–Š‡‰ƒ’‘ˆŽ‘‡Ž‹‡••Ǥ ‘™‡˜‡”‹’”‘˜‡†‡–ƒŽ‹œ‹‰ ƒŽ‘‡ƒ›‘–„‡‡‘—‰Šǡƒ•–”—‡’ƒ–‹‡–”‡ ‘˜‡”›ƒŽ•‘”‡“—‹”‡•ƒ•‘ ‹ƒŽ‡˜‹”‘‡––Šƒ–‹• ‰‡—‹‡Ž›™‡ŽŽǦ‡ƒ‹‰ƒ†‡‘–‹‘ƒŽŽ›”‡•’‘•‹˜‡Ǥ‡–Š‡”‡ˆ‘”‡Š‘Ž†–Šƒ–‹–‹•‘–‘Ž› ‹’‘”–ƒ––‘†‡˜‡Ž‘’ƒ‘”‡–Š‘”‘—‰Š—†‡”•–ƒ†‹‰‘ˆ’•› Š‘•‹•ˆ‘”ƒ ƒ†‡‹ ’—”’‘•‡•ǡ„—– –Šƒ––Š‡ƒ –‘ˆ–”›‹‰–‘—†‡”•–ƒ†–Š‡’•› Š‘–‹ ‡š’‡”‹‡ ‡–‘‰‡–Š‡”™‹–Š–Š‡’ƒ–‹‡–ǡ‹ƒ†‘ˆ ‹–•‡Žˆǡƒ›ƒ‹†”‡ ‘˜‡”›Ǥ ‘—”˜‹‡™ǡ–Š‹••Š‘—Ž†‘–‘Ž›„‡–ƒ‡–‘Š‡ƒ”–„› Ž‹‹ ‹ƒ•ǡ„—–„› •‘ ‹‡–›‹‰‡‡”ƒŽǤ References

††‹‰–‘ǡ ǤǡƬ††‹‰–‘ǡǤȋʹͲͲͺȌǤ‘ ‹ƒŽƒ† ‘‰‹–‹˜‡ˆ— –‹‘‹‰‹Schizophrenia research 99 ’•› Š‘•‹•Ǥ ǡ ȋͳǦMentalizing͵Ȍǡͳ͹͸ǦͳͺͳǤ in clinical practice ŽŽ‡ǡ Ǥ Ǥǡ ‘ƒ‰›ǡǤǡƬƒ–‡ƒǡǤǤȋʹͲͲͺȌǤ Ǥ‡”‹ ƒ •› Š‹ƒ–”‹ ••‘ ‹ƒ–‹‘—„Ž‹•Š‹‰ǡƒ•Š‹‰–‘ǡǤ Bartels‐Velthuis, A. A., Blijd‐HoogewysǡǤǤǡƬƒ•ǡ ǤȋʹͲͳͳȌǤBetter theory‐of‐mindActa skills in Š‹Ž†”‡Š‡ƒ”‹‰˜‘‹ ‡•‹–‹‰ƒ–‡–Š‡”‹•‘ˆ•‡ ‘†ƒ”›†‡Ž—•‹‘ˆ‘”ƒ–‹‘ǤPsychiatrica Scandinavica, 124 ȋ͵Ȍǡͳͻ͵Ǧͳͻ͹Ǥ ƒ–‡ƒǡǤǡƬ ‘ƒ‰›ǡǤȋͳͻͻͻȌǤˆˆ‡ –‹˜‡‡••‘ˆ’ƒ”–‹ƒŽŠ‘•’‹–ƒŽ‹œƒ–‹‘‹–Š‡–”‡ƒ–‡–‘ˆAmerican journal of „‘”†‡”Ž‹‡’‡”•‘ƒŽ‹–›†‹•‘”†‡”ǣƒ”ƒ†‘‹œ‡† ‘–”‘ŽŽ‡†–”‹ƒŽǤPsychiatry, 156 ȋͳͲȌǡͳͷ͸͵Ǧͳͷ͸ͻǤ ƒ–‡ƒǡǤǡƬ ‘ƒ‰›ǡǤȋʹͲͲͳȌǤ”‡ƒ–‡–‘ˆ„‘”†‡”Ž‹‡’‡”•‘ƒŽ‹–›†‹•‘”†‡”™‹–ŠAmerican Journal’•› Š‘ƒƒŽ›–‹ ƒŽŽ›‘”‹‡–‡†’ƒ” of psychiatry, 158 –‹ƒŽŠ‘•’‹–ƒŽ‹œƒ–‹‘ǣƒͳͺǦ‘–Šˆ‘ŽŽ‘™Ǧ—’Ǥ ȋͳȌǡ͵͸ǦͶʹǤ

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ƒ–‡ƒǡǤǡƬ ‘ƒ‰›ǡǤȋʹͲͲ͸ȌǤ‡–ƒŽ‹œ‹‰ƒ†„‘”†‡”Ž‹‡’‡”•‘ƒŽ‹–›†‹•‘”†‡”Ǥ  Ǥ ǤŽŽ‡The handbook of mentalization-based treatment ƬǤ ‘ƒ‰›ȋ†•ǤȌǡ ȋ’Ǥͳͺͷ–ʹͲͲȌǤ ‘„‘‡ǡ ǣ ‘Š‹Ž‡›Ƭ‘•  Ǥ ƒ–‡ƒǡǤǡƬ ‘ƒ‰›ǡǤȋʹͲͲͺȌǤͺǦ›‡ƒ”ˆ‘ŽŽ‘™Ǧ—’‘ˆ’ƒ–‹‡–•–”‡ƒ–‡†ˆ‘”„‘”†‡”Ž‹‡’‡”•‘ƒŽ‹–›American Journal of †‹•‘”†‡”ǣ‡–ƒŽ‹œƒ–‹‘Psychiatry, 16 Ǧ„ƒ•‡†–”‡ƒ–‡–˜‡”•—•–”‡ƒ–‡–ƒ•—•—ƒŽǤ ͷȋͷȌǡ͸͵ͳǦ͸͵ͺǤ ‡ Š‹ǡǤǡ‘•‹ƒǡǤǡ—‘‘ ‘”‡ǡǤǡ‰‘•–‘‹ǡ Ǥǡ‘•‹‡ŽŽ‹ǡ Ǥǡ‹Ž˜‡•–”‹ǡǤǤǡǤǤǤƬƒ˜ƒŽŽƒ”‘ǡǤ ȋʹͲͳͻȌǤ–ƒ„‹Ž‹–›ƒ†‰‡‡”ƒŽ‹œƒ–‹‘‘ˆ ‘„‹‡†–Š‡‘”›‘ˆ‹†ƒ† ‘‰‹–‹˜‡Psychiatric rehabilitation journal.”‡‡†‹ƒ–‹‘‹–‡”˜‡–‹‘•‹• Š‹œ‘’Š”‡‹ƒǣ ‘ŽŽ‘™ Ǧ—’”‡•—Ž–•Ǥ

‡”–Š‡Ž‘–ǡǤǡ‡‹‡—šǡǤǡ ƒ”‘Ǧ‹••‘‡––‡ǡ Ǥǡƒ Šƒ”‹–±ǡǤǡƬ—œ‹ǡǤȋʹͲͳͻȌǤŠ‡’”‘–‡ –‹˜‡ ”‘Ž‡‘ˆ‡–ƒŽ‹œ‹‰ǣ‡ˆŽ‡ –‹˜‡ˆ— –‹‘‹‰ƒ•ƒ‡†‹ƒ–‘”„‡–™‡‡ Š‹Ž†ƒŽ–”‡ƒ–‡–ǡChild Abuse & Neglect 95 ’•› Š‘’ƒ–Š‘Ž‘‰›ƒ†’ƒ”‡–ƒŽƒ––‹–—†‡‹‡š’‡ –‹‰’ƒ”‡–•Ǥ Australian andǡ NewǤ ‹” Š™‘‘†ǡǤǡZealandƬ Journalƒ ‹ŽŽƒǡ Ǥȋͳͻͻ͵ȌǤƒ”Ž›‹–‡”˜‡–‹‘‹• Š‹œ‘’Š”‡‹ƒǤ of Psychiatry  ǡʹ͹ȋ͵Ȍǡ͵͹ͶǦ͵͹ͺǤ ‹” Š™‘‘†ǡǤǡ‘‘”ǡǤǡ‡•–‡”ǡ Ǥǡƒ––‡”•‘ǡǤǡ ”‡‡ƒ–Ž‡ǡǤǡƒ”•ŠƒŽŽǡǤǡǤǤǤƬ˜‡”ƒ”†ǡǤ ȋʹͲͳ͵ȌǤ‡†— ‹‰†—”ƒ–‹‘‘ˆ—–”‡ƒ–‡†’•› Š‘•‹•ǣ ƒ”‡’ƒ–Š™ƒ›•–‘‡ƒ”Ž›‹–‡”˜‡–‹‘The British Journal of Psychiatry 203 ‹’•› Š‘•‹••‡”˜‹ ‡•Ǥ ǡ ȋͳȌǡͷͺǦ͸ͶǤ Žƒ‰›•ǡǤǤǡƬ ‹Ž•‡”‘–ŠǡǤ ǤȋʹͲͲͲȌǤ‹•–‹ –‹˜‡ˆ‡ƒ–—”‡•‘ˆ•Š‘”–‐–‡”’•› Š‘†›ƒ‹ ‐ ‹–‡”’‡”•‘ƒŽ’•› Š‘–Š‡”ƒ’›ǣ”‡˜‹‡™‘ˆ–Š‡ ‘’ƒ”ƒ–‹˜‡’•› Š‘–Š‡”ƒ’›’”‘ ‡••Clinical psychology: Science and practice 7 Ž‹–‡”ƒ–—”‡ǤAttachment and loss, vol. II: Separation ǡ ȋʹȌǡͳ͸͹ǦͳͺͺǤ ‘™Ž„›ǡ Ǥȋͳͻ͹͵ȌǤ Ǥƒ•‹ ‘‘•ǡ‡™‘”ǡǤ

”ƒ†ǡǤǤǡ ‡”›ǡǤǡ‘••‡ŽŽǡǤǡ‡†ƒŽŽǡǤǡƬŠ‘ƒ•ǡǤȋʹͲͳͺȌǤ‘–”ƒ—ƒǦˆ‘ —•‡† 8 ’•› Š‘Ž‘‰‹ ƒŽ‹–‡”˜‡–‹‘•Šƒ˜‡ƒ‡ˆˆ‡ –‘’•› Š‘–‹ •›’–‘•ǫ•›•–‡ƒ–‹ ”‡˜‹‡™Schizophrenia research 195 ƒ†‡–ƒǦƒƒŽ›•‹•Ǥ ǡ ǡͳ͵ǦʹʹǤ ”‡–ǡǤǤǡƬ ‘ƒ‰›ǡǤȋʹͲͳͶȌǤ‡–ƒŽ‹œƒ–‹‘Ǧ„ƒ•‡†–”‡ƒ–‡–ƒ’’”‘ƒ Š–‘†‹•–—”„ƒ ‡•‘ˆ •‘ ‹ƒŽ—†‡”•–ƒ†‹‰‹• Š‹œ‘’Š”‡‹ƒǤ Ǥ Ǥ›•ƒ‡”ǡ Ǥ‹ƒ‰‰‹‘ǡƒ†Ǥ”ò‡ Social cognition and metacognition in schizophrenia: Psychopathology and treatmentȋ†•ǤȌǡ approaches, ʹͶͷǦʹͷͻǤŽ•‡˜‹‡” ƒ†‡‹ ”‡••ǡƒ‹‡‰‘ǡǤ ”‘‘™‡ŽŽǡǤǤǡ‡–ƒŽŽǡǤǤǡƬƒ”‡•‡ǡ ǤȋʹͲͳ͵ȌǤš–‡”ƒŽ‹œ‹‰„‹ƒ•‡•ƒ†ŠƒŽŽ— ‹ƒ–‹‘•‹ •‘—” ‡Ǧ‘‹–‘”‹‰ǡ•‡ŽˆPsychological medicineǦ‘‹–‘”‹‰ƒ†•‹‰ƒŽ†‡–‡ –‹‘•–—†‹‡•ǣƒ‡43 –ƒǦƒƒŽ›–‹  ”‡˜‹‡™Ǥ ǡ ȋͳʹȌǡʹͶ͸ͷǦʹͶ͹ͷǤ ƒ”„‘ǡǤǡƬ‘””‡ŽŽǡǤǤȋʹͲͳͶȌǤŽ‹‹ ƒŽ’”‡†‹ –‘”•‘ˆ–Š‡”ƒ’‡—–‹ ”‡•’‘•‡–‘ƒ–‹’•› Š‘–‹ •Dialogues in clinical neuroscience 16 ‹• Š‹œ‘’Š”‡‹ƒǤ ǡ ȋͶȌǡͷͲͷǤ

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ƒ–Š‡”ǡǤǡ‡ǡǤǡ––‘ǡǤǤǡ‘˜‡Žǡ Ǥǡ—‡•‡”ǡǤǤǡƬ ‘ˆˆǡǤǤȋʹͲͲͷȌǤ’‹Ž‘–•–—†›‘ˆSchizophrenia ˆ— –‹‘ƒŽ‘‰‹–‹˜‡‡Šƒ˜‹‘”ƒŽŠ‡”ƒ’›ȋˆȌˆ‘”• Š‹œ‘’Š”‡‹ƒǤResearch, 74 ȋʹǦ͵ȌǡʹͲͳǦʹͲͻǤ Šƒ†™‹ ǡǤǡƒ›Ž‘”ǡǤǤǡƬ„„ƒǡǤȋʹͲͲͷȌǤBehavioural and Cognitive Psychotherapy‹†ˆ—Ž‡••‰”‘—’•ˆ‘”’‡‘’Ž‡™‹–Š33 ’•› Š‘•‹•Ǥ ǡ ȋ͵Ȍǡ͵ͷͳǦ͵ͷͻǤ Šƒ†™‹ ǡǤǡ–”ƒ—••ǡǤǡ ‘‡•ǡǤǤǡ‹‰†‘ǡǤǡŽŽ‡––ǡǤǡƒƒŠ›ǡǤǡƬ ƒ›™ƒ”†ǡǤȋʹͲͳ͸ȌǤ ”‘—’‹†ˆ—Ž‡••SchizophreniaǦ„ƒ•‡†‹–‡”˜‡–‹‘ˆ‘”†‹•–”‡••‹ Research, 175 ‰˜‘‹ ‡•ǣƒ’”ƒ‰ƒ–‹ ”ƒ†‘‹•‡† ‘–”‘ŽŽ‡†–”‹ƒŽǤ ȋͳǦ͵Ȍǡͳ͸ͺǦͳ͹͵Ǥ Š‹‡•ƒǡǤǡƬ ‘ƒ‰›ǡǤȋʹͲͳͶȌǤ‡ˆŽ‡ –‹˜‡ˆ— –‹‘ƒ•ƒ‡†‹ƒ–‘”„‡–™‡‡ Š‹Ž†Š‘‘†ƒ†˜‡”•‹–›ǡPersonality and mental health, 8 ’‡”•‘ƒŽ‹–›†‹•‘”†‡”ƒ†•›’–‘†‹•–”‡••Ǥ ȋͳȌǡͷʹǦ͸͸Ǥ Ž‡‡•‡ǡǤǡ˜ƒ•ǡ Ǥǡ”—‡”ǡǤǡ—Š‘ŽǡǤǡ‹˜ƒŽŽǡǤǡ§˜‡”ǡǤǡƒ•ǡǤǤǡƒ”–‡Ž•Ǧ ‡Ž–Š—‹•ǡǤǡ‘˜‰ƒƒ”†ǡǤǡƬ ‡’’‡•‡ǡǤȋʹͲͳ͸ȌǤ•› Š‘–‹ ‡š’‡”‹‡ ‡•ƒ†Š›’‡”Psychological medicine, 46Ǧ –Š‡‘”›Ǧ‘ˆǦ‹†‹’”‡ƒ†‘Ž‡• ‡ ‡–ƒ„‹”–Š ‘Š‘”–•–—†›Ǥ ȋͳȌǡ ͺ͹ǦͳͲͳǤ ‘—–—”‡ǡǤǤǡ‡ǡǤǤǡƬ‘„‡”–•ǡǤǤȋʹͲͲ͸ȌǤŠ‡ˆ— –‹‘ƒŽ•‹‰‹ˆ‹ ƒ ‡‘ˆ•‘ ‹ƒŽ ‘‰‹–‹‘Schizophrenia bulletin 32 ‹• Š‹œ‘’Š”‡‹ƒǣƒ”‡˜‹‡™Ǥ ǡ ȋͳȌǡͶͶǦ͸͵Ǥ ‘” ‘”ƒǡǤǡ‡” ‡”ǡ Ǥǡ ”‹–ŠǡǤǤǡͳͻͻͷǤ Š‹œ‘’Š”‡‹ƒǡ•›’–‘ƒ–‘Ž‘‰›ƒ†•‘ ‹ƒŽ‹ˆ‡”‡ ‡ǣSchizophrenia research, investigating17 “theory of mind” in people with schizophrenia. ȋͳȌǡͷǦͳ͵Ǥ ”‹•–ׄƒŽǦƒ”˜ž‡œǡǤǡŠ‡‹„ƒ—ǡǤǡƒŽŽ‡•’ÀǡǤǡ‹–Œƒ˜‹ŽƒǡǤǡ›‹Ǧ ‡”‡›•ǡ Ǥǡ™ƒ’‹ŽǡǤǤǡ ƒ””ƒ–‡•Ǧ‹†ƒŽǡǤȋʹͲͳ͸ȌǤ ’ƒ –‘ˆƒ†˜‡”•‡ Š‹Ž†Š‘‘†‡š’‡”‹‡ ‡•‘’•› Š‘–‹ Focus, 14 ǦŽ‹‡ •›’–‘•ƒ†•–”‡••”‡ƒ –‹˜‹–›‹†ƒ‹Ž›Ž‹ˆ‡‹‘ Ž‹‹ ƒŽ›‘—‰ƒ†—Ž–•Ǥ  ȋ͵Ȍǡ ͵ͺ͹Ǧ͵ͻͷǤ ‡„„ƒ±ǡǤǡ‡‹Ž‘—†ǡ ǤǡƒŽƒ‹‹‘•ǡ Ǥǡ‘Ž‹†ƒǦ‘œœ‹ǡǤǡ”ƒ†‘ǡǤǡ ‘ƒ‰›ǡǤǡƬƒ–‡ƒǡ ǤȋʹͲͳ͸ȌǤ‡–ƒŽ‹œƒ–‹‘JournalǦ„ƒ•‡†–”‡ƒ–‡–‹ Ž‹‹ ƒŽŠ‹‰Š of Contemporary PsychotherapyǦ”‹•ˆ‘”’•› Š‘•‹•ǣƒ”ƒ–‹‘ƒŽ‡46 ƒ† Ž‹‹ ƒŽ‹ŽŽ—•–”ƒ–‹‘Ǥ ǡ ȋͶȌǡʹͳ͹ǦʹʹͷǤ ‡„„ƒ±ǡǤǡƒŽƒ‹‹‘•ǡ Ǥǡ—›–‡ǡǤǡƒ†‘—†ǡǤǡ”ƒ†‘ǡǤǡ‘Ž‹†ƒ‘œœ‹ǡǤǡǤǤǤƬ”‡–ǡǤǤ ȋʹͲͳ͸ȌǤ––ƒ Š‡–ǡ‡—”‘„‹‘Ž‘‰›ǡƒ†‡–ƒŽ‹œ‹‰ƒŽ‘‰–Š‡’•› Š‘•‹• ‘–‹——ǤFrontiers in human neuroscience, 10 ǡͶͲ͸Ǥ ‡„„ƒ±ǡǤǡƬ‘ˆˆ‡ŽǡǤȋʹͲͳͻȌǤ‡–ƒŽ‹œ‹‰–Š”‘—The Neurobiology-Psychotherapy‰Š–Š‡‡ƒ”Ž›•–ƒ‰‡•‘ˆ–Š‡•› Š‘•‹•-Pharmacology Intervention Triangle: The ‘–‹——Ǥneed for common sense in 21st century mental health ǡͳͶͳǤ †‡ ‘‰ǡǤǡ˜ƒ‘‡”•‰‘‡†ǡǤ ǤǤǡ‹‡”ƒǡǤǤǡƒ ‡–‘–ǡǤǡ—†‡”‹ǡǤǡ”‡†•ǡ ǤǡǤǤǤƬ‹Œ‡„‘”‰ǡ Ǥ ǤǤȋʹͲͳͻȌǤ‡–ƒ ‘‰‹–‹˜‡”‡ˆŽ‡ –‹‘ƒ†‹•‹‰Š––Š‡”ƒ’›ȋ ȌPsychological Medicine 49 ˆ‘”’ƒ–‹‡–•™‹–Š• Š‹œ‘’Š”‡‹ƒǤ ǡ ȋʹȌǡ͵Ͳ͵Ǧ͵ͳ͵Ǥ

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†‡ƒƒ–ǡǤǤǡ‡‡”ǡ Ǥǡ Š‘‡˜‡”•ǡǤǤƬ†‡ ‘‰Š‡ǡ ǤȋʹͲͲ͹ȌǤ‡Žƒ–‹˜‡‡ˆˆ‹ ƒ ›‘ˆ ’•› Š‘–Š‡”ƒ’›ƒ† ‘„‹‡†–Š‡”ƒ’›‹–Š‡–”‡ƒ–‡–‘ˆ†‡’”‡••‹‘ǣ‡–ƒEuropean Psychiatry, 22 ǦƒƒŽ›•‹•Ǥ ȋͳȌǡͳ–ͺǤ †‡ƒƒ–ǡǤǤǡ†‡ ‘‰Š‡ǡ Ǥǡ Š‘‡˜‡”•ǡǤƬ‡‡”ǡ ǤȋʹͲͲͻȌŠ‡‡ˆˆ‡ –‹˜‡‡••‘ˆŽ‘‰Harvard ReviewǦ–‡” of ’•› Š‘ƒƒŽ›–‹ –Š‡”ƒ’›ǣPsychiatry 17 •›•–‡ƒ–‹ ”‡˜‹‡™‘ˆ‡’‹”‹ ƒŽ•–—†‹‡•Ǥ ǡ ȋͳȌǣͳ–ʹ͵Ǥ †‡‡—Ž‡‡‡•–‡”ǡǤǡƒ•–‡‡Žƒ†–ǡǤǡ—›–‡ǡǤǡƬ‘™› ǡǤȋʹͲͳͺȌǤ‡–ƒŽ‹œ‹‰ƒ•ƒ ‡ Šƒ‹•‘ˆ Šƒ‰‡‹–Š‡–”‡ƒ–‡–‘ˆ’ƒ–‹‡–•™‹–Š„‘”†‡”Ž‹‡’‡”•‘ƒŽ‹–›†‹•‘”Personality Disorders: Theory, Research,†‡”ǣ ’ƒ”ƒŽŽ‡Ž’”‘ ‡••‰”‘™–Š‘†‡Ž‹‰ƒ’’”‘ƒ ŠǤand Treatment 9  ǡ ȋͳȌǡʹʹǤ ‡‘—•ƒǡǤǡ‡ŽŽ™‘‘†ǡǤǡŽ†”‹†‰‡ǡǤǡƬ‡–ƒŽŽǡǤǤȋʹͲͳͺȌǤŠ‡”‘Ž‡‘ˆ•‘ ‹ƒŽ‹•‘Žƒ–‹‘ƒ†Psychiatry Research, 269 •‘ ‹ƒŽ ‘‰‹–‹‘‹–Š‘—‰Š–†‹•‘”†‡”Ǥ ǡͷ͸Ǧ͸͵Ǥ ”‹‡••‡ǡǤǡ—‹Œ’‡”•ǡǤǡ†‡ƒƒ–ǡǤǤǤǡ„„ƒ••ǡǤǤǡ†‡ ‘‰Š‡ǡ Ǥǡ‡‡”ǡ Ǥ ǤǤȋʹͲͳͲȌǤŠ‡ ‡ˆˆ‹ ƒ ›‘ˆ•Š‘”–Clinical PsychologicalǦ–‡”’•› Š‘†›ƒ‹ ’•› Š‘–Š‡”ƒ’›ˆ‘”†‡’”‡••‹‘ǣƒ‡–ƒ Review, 30 ǦƒƒŽ›•‹•Ǥ ǡʹͷ–͵͸Ǥ ”—‡”ǡǤǡ‹••‡”ǡǤǡ›–‡ƒǡǤǡƬƒ•ǡ ǤȋʹͲͳ͵ȌǤ Ž‡š‹„Ž‡ƒ••‡”–‹˜‡ ‘—‹–›–”‡ƒ–‡–ǣ Clinical‡˜‡”‹–›‘ˆ•›’–‘•ƒ†’•› Š‹ƒ–”‹ Š‡ƒŽ–Š•‡”˜‹ ‡—•‡Ǣƒ Practice & Epidemiology in Mental Health, 9 ”‡ƒŽŽ‹ˆ‡‘„•‡”˜ƒ–‹‘ƒŽ•–—†›Ǥ ǡʹͲʹ–ʹͲͻǤ —”ŠƒǡǤǤǡŠƒ„‡”•ǡ ǤǤǡ‘™‡”ǡǤ ǤȋʹͲͲͷȌǤ‘‰Ǧ–‡”‘—– ‘‡‘ˆ ‘‰‹–‹˜‡„‡Šƒ˜‹‘—”Health Technology Assessment, 9 –Š‡”ƒ’›ȋȌ Ž‹‹ ƒŽ–”‹ƒŽ•‹ ‡–”ƒŽ ‘–Žƒ†Ǥ ǡͳ–ͳ͹ͶǤ •‹ǡǤǡ‘”ƒ†‹ǡǤǡƒ”‰‡–ǡǤǡ ‘ƒ‰›ǡǤǡƒ„‘—”‹ǡǤǡƬ‡”–Š‡Ž‘–ǡǤȋʹͲͳͷȌǤ ‡–ƒŽ‹œƒ–‹‘‹ Š‹Ž†”‡ƒ†‘–Š‡”•‹–Š‡ ‘–‡š–‘ˆ–”ƒ—ƒǣ‹‹–‹ƒŽ•–—†›‘ˆ–Š‡British Journal of Developmental

˜ƒŽ‹†‹–›‘ˆ–Š‡Š‹Ž†‡ˆŽ‡ –‹˜‡ — –‹‘‹‰ ƒŽ‡ǤPsychology 33  8 ǡ ȋʹȌǡʹͲ͵Ǧʹͳ͹Ǥ ‘ƒ‰›ǡǤǡƬƒ–‡ƒǡǤǤȋʹͲͲ͸ȌǤ‡ ŠJournal of clinical psychology ƒ‹••‘ˆ Šƒ‰‡‹‡–ƒŽ‹œƒ–‹‘62 ‐„ƒ•‡†–”‡ƒ–‡–‘ˆ Ǥ ǡ ȋͶȌǡͶͳͳǦͶ͵ͲǤ ‘ƒ‰›ǡǤǡƬ—›–‡ǡǤȋʹͲͲͻȌǤ†‡˜‡Ž‘’‡–ƒŽǡ‡–ƒŽ‹œƒ–‹‘Ǧ„ƒ•‡†ƒ’’”‘ƒ Š–‘–Š‡Development and —†‡”•–ƒ†‹‰ƒ†–”‡ƒ–‡–‘ˆ„‘”†‡”Ž‹‡’‡”•‘ƒŽ‹–›psychopathology 21 †‹•‘”†‡”Ǥ ǡ ȋͶȌǡͳ͵ͷͷǦͳ͵ͺͳǤ ‘ƒ‰›ǡǤǡƬŽŽ‹•‘ǡǤȋʹͲͳͶȌǤŠ‡”‘Ž‡‘ˆ‡–ƒŽ‹œ‹‰ƒ†‡’‹•–‡‹ –”—•–‹–Š‡–Š‡”ƒ’‡—–‹ Psychotherapy 51 ”‡Žƒ–‹‘•Š‹’Ǥ ǡ ȋ͵Ȍǡ͵͹ʹǤ ‘ƒ‰›ǡǤǡ—›–‡ǡǤǡŽŽ‹•‘ǡǤǡƬƒ’„‡ŽŽǡǤȋʹͲͳ͹ȌǤŠƒ–™‡Šƒ˜‡ Šƒ‰‡†‘—”‹†• ƒ„‘—–ǣƒ”–ʹǤ‘”†‡”Ž‹‡’‡”•‘ƒŽ‹–›†‹•‘”†‡”ǡ‡’‹•–‡‹ –”—•–ƒ†–Š‡†‡˜‡Ž‘’‡–ƒŽBorderline personality disorder and emotion •‹‰‹ˆ‹ ƒ ‡‘ˆ•‘ ‹ƒŽ ‘—‹ ƒ–‹‘Ǥdysregulation 4  ǡ ȋͳȌǡͻǤ

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”‡‡ƒǡǤǡƒ‹–‡ǡ Ǥǡ–ƒ”–—’ǡ Ǥǡ›‡”•ǡǤǡ‹•–‡”ǡǤǡ ‡”‡›ǡ ǤǡǤǤǤƬ ‘•–‡”ǡǤȋʹͲͳͷȌǤ ˆˆ‹ ƒ ›‘ˆ ‘‰‹–‹˜‡„‡Šƒ˜‹‘—”ƒŽ–Š‡”ƒ’›ˆ‘”•Ž‡‡’‹’”‘˜‡‡–‹’ƒ–‹‡–•™‹–Š ’‡”•‹•–‡–†‡Ž—•‹‘•ƒ†ŠƒŽŽ— ‹ƒ–‹‘•ȋȌǣƒ’”‘•’‡ –‹˜‡ǡƒ••‡••‘”The Lancet Psychiatry 2 Ǧ„Ž‹†ǡ ”ƒ†‘‹•‡† ‘–”‘ŽŽ‡†’‹ŽThe cognitive neuropsychology‘––”‹ƒŽǤ of schizophreniaǡ ȋͳͳȌǡͻ͹ͷǦͻͺ͵Ǥ ”‹–ŠǡǤǤȋͳͻͻʹȌǤ Ǥ‘†‘ǡǣ•› Š‘Ž‘‰› ”‡••Ǥ —•ƒ”Ǧ‘Ž‹ǡǤǡ›”‡ǡǤǡƒŽƒ‰‰‹ƒǡǤǡƒ›ǡ Ǥǡƒ„”ƒŠƒǡǤǡ ‘Š•ǡǤǡǤǤǤƬ ‡ƒǤȋʹͲͳͲȌǤ ‘ ‹ƒŽ†›•ˆ— –‹‘’”‡†‹ –•–™‘›‡ƒ”• Ž‹‹ ƒŽ‘—– ‘‡‹’‡‘’Ž‡ƒ–Journal of psychiatric research 44 —Ž–”ƒǦŠ‹‰Š”‹•ˆ‘” ’•› Š‘•‹•Ǥ ǡ ȋͷȌǡʹͻͶǦ͵ͲͳǤ ƒ”‡–›ǡǤǤǡƬ ”‡‡ƒǡǤȋͳͻͻͻȌǤ‘‰‹–‹˜‡ƒ’’”‘ƒ Š‡•–‘†‡Ž—•‹‘•ǣƒ ”‹–‹ ƒŽ”‡˜‹‡™‘ˆBritish journal of clinical psychology 38 –Š‡‘”‹‡•ƒ†‡˜‹†‡ ‡Ǥ ǡ ȋʹȌǡͳͳ͵ǦͳͷͶǤ ”‡‡ǡǤ Ǥǡ ‘”ƒǡǤǤǡƬ‡‡ǡ ǤȋʹͲͳͻȌǤ‘•‘ ‹ƒŽƒ†•‘ ‹ƒŽ ‘‰‹–‹‘‹• Š‹œ‘’Š”‡‹ƒǣWorld Psychiatry 18 —””‡–‡˜‹†‡ ‡ƒ†ˆ—–—”‡†‹”‡ –‹‘•Ǥ ǡ ȋʹȌǡͳͶ͸Ǧͳ͸ͳǤ ‡ƒ˜‡•ǡǤǡ†‰‡”•ǡǤǡƬ ‘†‰‡‹•ǡ ǤȋʹͲͳͻȌǤ‘‰‹–‹˜‡„‡Šƒ˜‹‘—”ƒŽ–Š‡”ƒ’›ˆ‘”ƒš‹‡–›‹Psychosis 11 ’•› Š‘•‹•ǣƒ•›•–‡ƒ–‹ ”‡˜‹‡™ƒ†‡–ƒǦƒƒŽ›•‹•Ǥ ǡ ȋ͵Ȍǡʹʹ͵Ǧʹ͵͹Ǥ ‘‡”–‡ŽǡǤǡג‡œǡǤǡƒ‰ǡǤǡ ‘œžŽ‡œǦ‹–‘ǡǤǡ‹‘•‹ǡ ǤǡƬŽƒ ‘ǡǤȋʹͲͳͷȌǤ ‡‡”ƒŽ‹œƒ„‹Ž‹–›‘ˆ’Šƒ”ƒ ‘Ž‘‰‹ ƒŽƒ†’•› Š‘–Š‡”ƒ’› Ž‹‹ ƒŽ–”‹ƒŽ”‡•—Ž–•ˆ‘”Personality Disorders: Theory, „‘”†‡”Ž‹‡’‡”•‘ƒŽ‹–›†‹•‘”†‡”–‘ ‘—‹–›•ƒ’Ž‡•ǤResearch, and Treatment 6  ǡ ȋͳȌǡͺͳǤ ‘ˆˆƒǡ Ǥǡ ¡ ‡ŽǡǤǡ Žƒ—•‡”ǡǤǡƬ—’’‡”ǡǤActa PsychiatricaȋʹͲͳʹȌǤ”ƒ†‘‹•‡† ‘–”‘ŽŽ‡†–”‹ƒŽ‘ˆ–Š‡ Scandinavica 125 ‡ˆˆ‹ ƒ ›‘ˆ•—’’‘”–‡†‡’Ž‘›‡–Ǥ ǡ ȋʹȌǡͳͷ͹Ǧͳ͸͹Ǥ ‘™‡•ǡǤǤǡƬ—””ƒ›ǡǤǤȋʹͲͳͶȌǤ Š‹œ‘’Š”‡‹ƒǣƒ‹–‡‰”ƒ–‡†•‘ ‹‘†‡˜‡Ž‘’‡–ƒŽThe Lancet 383 Ǧ ‘‰‹–‹˜‡‘†‡ŽǤ ǡ ȋͻͻʹͻȌǡͳ͸͹͹Ǧͳ͸ͺ͹Ǥ ƒ—Šƒ”ǡǤǡ ‡ƒǡǤ Ǥǡƒ†—ƒǡ Ǥǡ —‰ǡǤǡƒŽ˜ƒ†‘”ǡǤǡƬƒ™•ǡǤǤȋʹͲͳͶȌǤ‘‰‹–‹˜‡– „‡Šƒ˜‹‘—”ƒŽ–Š‡”ƒ’›ˆ‘”–Š‡•›’–‘•‘ˆ• Š‹œ‘’Š”‡‹ƒǣ•›•–‡ƒ–‹ ”‡˜‹‡™ƒ†‡–ƒThe British Journal of Psychiatry 204 Ǧ ƒƒŽ›•‹•™‹–Š‡šƒ‹ƒ–‹‘‘ˆ’‘–‡–‹ƒŽ„‹ƒ•Ǥ ǡ ȋͳȌǡʹͲǦ ʹͻǤ ƒ—Šƒ”ǡǤǡƒ™•ǡǤǤǡƬ ‡ƒǡǤ ǤȋʹͲͳͻȌǤˆ‘”• Š‹œ‘’Š”‡‹ƒǣƒ ”‹–‹ ƒŽPsychological medicine 49 ˜‹‡™’‘‹–Ǥ ǡ ȋͺȌǡͳʹ͵͵Ǧͳʹ͵͸Ǥ ޔ‰‡•‡ǡǤǤǡ ”‡—†ǡǤǡޛ‡ǡǤǡ ‘”†‡–ǡ Ǥǡ†‡”•‡ǡǤǡƬŒÞŽ„›‡ǡǤȋʹͲͳ͵ȌǤ—– ‘‡‘ˆ ‡–ƒŽ‹œƒ–‹‘‐„ƒ•‡†ƒ†•—’’‘”–‹˜‡’•› Š‘–Š‡”ƒ’›‹’ƒ–‹‡–•™‹–Š„‘”†‡”Ž‹‡Acta Psychiatrica Scandinavica 127 ’‡”•‘ƒŽ‹–›†‹•‘”†‡”ǣƒ”ƒ†‘‹œ‡†–”‹ƒŽǤ ǡ ȋͶȌǡ͵ͲͷǦ ͵ͳ͹Ǥ ‡ŽŽ‡Š‡”ǡ Ǥǡ‡‡Ž‡›ǡ Ǥǡ‘” ‘”ƒǡǤǡƒ•ƒ›ǡ Ǥǡƒ••‡”ƒǡǤǡƒ”Ž‹ǡǤǡǤǤǤƬƒ‘ǡǤȋʹͲͳ͵ȌǤ Š‹Ž†Š‘‘†–”ƒ—ƒƒ†’•› Š‘•‹•‹ƒ’”‘•’‡ –‹˜‡ ‘Š‘”–•–—†›ǣ ƒ—•‡ǡ‡ˆˆ‡ –ǡƒ†American Journal of Psychiatry, 170 †‹”‡ –‹‘ƒŽ‹–›Ǥ ȋ͹Ȍǡ͹͵ͶǦ͹ͶͳǤ

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Š‘—”›ǡǤǡ‡ ‘–‡ǡǤǡ ƒ—†‹ƒ‘ǡǤǤǡƬƒ“—‹ǡǤȋʹͲͳ͵ȌǤ‹†ˆ—ŽSchizophrenia research 150 ‡••‹–‡”˜‡–‹‘•ˆ‘” ’•› Š‘•‹•ǣƒ‡–ƒǦƒƒŽ›•‹•Ǥ ǡ ȋͳȌǡͳ͹͸ǦͳͺͶǤ ‹ŽŽƒ•’›ǡ Ǥǡ‡„„‹‰–‘ǡǤǡŽ‹œƒ”†ǡǤǡ ‘Š•‘ǡǤǡ‘Žƒǡ Ǥǡ‹ŽŽ‹‰ǡǤǡƬ‹‰ǡǤȋʹͲͲ͸ȌǤŠ‡ •–—†›ǣƒ†‘‹•‡†‡˜ƒŽ—ƒ–‹‘‘ˆƒ••‡”–‹˜‡ ‘—‹–›–”‡ƒBritish Medical Journal, 332 –‡–‹‘”–Š ‘†‘Ǥ ǡͺͳͷ–ͺʹͲǤ ‡–ǡǤǡ‹†ˆ‘”•ǡǤǡ ¡”¡‡ǡǤǡ¡Ž‹‘•‹ǡǤǡ‹”–ƒŽƒǡǤǡƒƒ•‘‡ǡǤǤǡǤǤǤƬ ‡Ž•‹‹ •› Š‘–Š‡”ƒ’›–—†› ”‘—’ǤȋʹͲͲͺȌǤƒ†‘‹œ‡†–”‹ƒŽ‘–Š‡‡ˆˆ‡ –‹˜‡‡••‘ˆŽ‘‰Ǧƒ† •Š‘”–Ǧ–‡”’•› Š‘†›ƒ‹ ’•› Š‘–Š‡”ƒ’›ƒ†•‘Ž—–‹‘Psychological medicineǦˆ‘ —•‡†–Š‡”ƒ’›‘’•› Š‹ƒ–”‹ 38 •›’–‘•†—”‹‰ƒ͵Ǧ›‡ƒ”ˆ‘ŽŽ‘™Ǧ—’Ǥ ǡ ȋͷȌǡ͸ͺͻǦ͹Ͳ͵Ǥ ƒ‰‡”ǡ Ǥ Ǥǡƒ‰ƒ•ǡǤ ǤǡƒŽ ‡†‘ǡǤǡƬ —‡–‡•ǡǤȋʹͲͳʹȌǤ’’Ž›‹‰‹†ˆ—Ž‡••–Š‡”ƒ’›‹ƒBehavioural and Cognitive ‰”‘—’‘Psychotherapyˆ’•› Š‘–‹ ‹†‹˜‹†—ƒŽ•ǣƒ ‘–”‘ŽŽ‡†•–—†›Ǥ40  ǡ ȋͳȌǡͳͲͷǦͳͲͻǤ Lardinois, M., Lataster, T., Mengelers, R., Van Os, J., & Myin‐Germeys,Acta Psychiatrica I. (2011).Scandinavica, Childhood 123 trauma ƒ†‹ ”‡ƒ•‡†•–”‡•••‡•‹–‹˜‹–›‹’•› Š‘•‹•Ǥ ȋͳȌǡʹͺǦ ͵ͷǤ ƒ™•ǡǤǤǡƒ”Ž‹‰–‘ǡǤǡ‘†‡ŽǡǤǤǡ ‡ƒǡǤ ǤǡƬ ƒ—Šƒ”ǡǤȋʹͲͳͺȌǤ‘‰‹–‹˜‡ ‡Šƒ˜‹‘—”ƒŽŠ‡”ƒ’›ˆ‘”• Š‹œ‘’Š”‡‹ƒBMC psychology 6Ǧ‘—– ‘‡•ˆ‘”ˆ— –‹‘‹‰ǡ†‹•–”‡••ƒ†“—ƒŽ‹–›‘ˆ Ž‹ˆ‡ǣƒ‡–ƒǦƒƒŽ›•‹•Ǥ ǡ ȋͳȌǡ͵ʹǤ ‡‹ Š•‡”‹‰ǡ Ǥǡ—›–‡ǡǤǡ ‹Ž•‡”‘–ŠǡǤ Ǥǡ„„ƒ••ǡǤǡƒ”„‡”ǡ ǤǤǡ‡‡ˆ‡ǡ ǤǤǡǤǤǤƬ–‡‹‡”–ǡǤ ȋʹͲͳͷȌǤ•› Š‘†›ƒ‹ –Š‡”ƒ’›‡‡–•‡˜‹†‡ ‡The Lancet Psychiatry 2 Ǧ„ƒ•‡†‡†‹ ‹‡ǣƒ•›•–‡ƒ–‹ ”‡˜‹‡™ —•‹‰—’†ƒ–‡† ”‹–‡”‹ƒǤ ǡ ȋ͹Ȍǡ͸ͶͺǦ͸͸ͲǤ ‡ŠƒǡǤǡƒŠ­‡•—Žƒ”ǡǤǡ”‘ ƒǡǤǤǡ‹‡†‡”„‹ ǡǤǤǡœ‹‘„‡ǡ Ǥǡ ƒŽŽ‹ƒ–ǡ ǤǡƬ‘–ƒ‰ǡ

ǤȋʹͲͳͶȌǤ—„Œ‡ –‹˜‡‡š’‡”‹‡ ‡‘ˆ‡‘–‹‘•ƒ†‡‘–‹‘ƒŽ‡’ƒ–Š›‹’ƒ”ƒ‘‹†Psychiatry research 220 8 • Š‹œ‘’Š”‡‹ƒǤ ǡ ȋ͵ȌǡͺʹͷǦͺ͵͵Ǥ ‹‡„‡”ƒǡ ǤǤǡ‹š‘ǡǤǤǡƬ ‘Ž†ƒǡ Ǥ ǤȋʹͲͳ͵ȌǤƒ”Ž›†‡–‡ –‹‘ƒ†‹–‡”˜‡–‹‘‹JAMA 310 • Š‹œ‘’Š”‡‹ƒǣƒ‡™–Š‡”ƒ’‡—–‹ ‘†‡ŽǤ ǡ ȋ͹Ȍǡ͸ͺͻǦ͸ͻͲǤ ‹ ‘ŽǡǤǤǡ‹‡ˆǡǤǡ‡•–‡”ƒǡǤǡ‹‡‰Ž‡”ǡǤǡ‡•–‹‰ǡǤǤǡ ‡‹„ƒ ŠǡǤǡ‡ŠŽǡǤȋʹͲͳͶȌǤ Š‘•–ƒ›•ǡ™Š‘„‡‡ˆ‹–•ǫ”‡†‹ –‹‰†”‘’‘—–ƒ† Šƒ‰‡‹ ‘‰‹–‹˜‡„‡Šƒ˜‹‘—”–Š‡”ƒ’›Psychiatry Research 216 ˆ‘”’•› Š‘•‹•Ǥ ǡ ȋʹȌǡͳͻͺǦʹͲͷǤ ƒ –‘•Šǡ ǤǤȋʹͲͳ͵ȌǤ‡–ƒŽ‹œ‹‰ƒ†‹–•”‘Ž‡ƒ•ƒ‡†‹ƒ–‘”‹–Š‡”‡Žƒ–‹‘•Š‹’„‡–™‡‡ Š‹Ž†Š‘‘†‡š’‡”‹‡ ‡•ƒ†ƒ†—Ž–ˆ— Psihologija 46 –‹‘‹‰ǣš’Ž‘”‹‰–Š‡‡’‹”‹ ƒŽ ‡˜‹†‡ ‡Ǥ ǡ ȋʹȌǡͳͻ͵ǦʹͳʹǤ  ‘”‹ ǡǤǤǡ”—ǡǤǤǡ‡ƒ†Ž‡ǡ ǤǤǡƒ”ƒ†‹•‘ǡǤǡƒƒ†ƒǡǤǡƬ†”‡ƒ•‡ǡǤȋʹͲͳʹȌǤPsychiatry Research: ‹””‘”‡—”‘ˆ— –‹‘ǡ’•› Š‘•‹•ǡƒ†‡’ƒ–Š›‹• Š‹œ‘’Š”‡‹ƒǤNeuroimaging 201  ǡ ȋ͵Ȍǡʹ͵͵Ǧʹ͵ͻǤ

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 ‘””›ǡǤǤȋʹͲͳͲȌǤ‹••›†”‘‡•ǡ Ž‹‹ ƒŽ•–ƒ‰‹‰ƒ†ǣ‡™†‹ƒ‰‘•–‹ Schizophrenia Research 120 ‹ˆ”ƒ•–”— –—”‡ˆ‘”‡ƒ”Ž›‹–‡”˜‡–‹‘‹’•› Š‹ƒ–”›Ǥ ǡ ȋͳǦ͵ȌǡͶͻǦ ͷ͵Ǥ Minding the child: Mentalization-based interventions with ‹†‰Ž‡›ǡǤǡƬ”‘—˜ƒǡ Ǥȋ†•ǤȌǤȋʹͲͳ͵children, young people and theirȌǤ families Ǥ‘—–Ž‡†‰‡ǡ‘†‘ǡ‹–‡†‹‰†‘Ǥ ‘”‹–œǡǤǡƬ‘‘†™ƒ”†ǡǤǤȋʹͲͲ͹ȌǤ‡–ƒ ‘‰‹–‹˜‡–”ƒ‹‹‰‹• Š‹œ‘’Š”‡‹ƒǣˆ”‘„ƒ•‹ Current opinion in psychiatry 20 ”‡•‡ƒ” Š–‘‘™Ž‡†‰‡–”ƒ•Žƒ–‹‘ƒ†‹–‡”˜‡–‹‘Ǥ ǡ ȋ͸Ȍǡ ͸ͳͻǦ͸ʹͷǤ ›‹Ǧ ‡”‡›• ǡƬ˜ƒ• ǤȋʹͲͲ͹ȌǤ–”‡••Clinical psychologyǦ”‡ƒ –‹˜‹–›‹’•› Š‘•‹•ǣ‡˜‹†‡ ‡ˆ‘”ƒƒˆˆ‡ –‹˜‡ review, ’ƒ–Š™ƒ›–‘’•› Š‘•‹•Ǥ ʹ͹ȋͶȌǡͶͲͻǦͶʹͶǤ

‘”†±ǡǤǡƒŽǡǤǡƬ‘”Žƒ†‡”ǡǤȋʹͲͳʹȌǤ‡•‘—” ‡ ”‘—’••‡”–‹˜‡‘—‹–›”‡ƒ–‡– ȋClinicalȌƒ•ƒ–‘‘Ž‘ˆ‡’‘™‡”‡–ˆ‘” Ž‹‡–•™‹–Š•‡˜‡”‡‡–ƒŽ‹ŽŽ‡••ǣƒ‡–ƒ practice and epidemiology in mental health: CP & EMH, 8 ǦƒƒŽ›•‹•Ǥ ǡͳͶͶǤ

—‰–‡”ǡǤǤǡ‰‡Ž•„‡Žǡ Ǥǡ¡ŠŽ‡”ǡǤǡ‡‡–ǡǤǡƬ˜ƒ‡Ž†Š—‹œ‡ǡǤȋʹͲͳ͸ȌǤ—– ‘‡•‘ˆ  ƒ••‡”–‹˜‡ ‘—‹–›–”‡ƒ–‡–ȋ Ȍ‹’Ž‡‡–ƒ–‹‘ǣƒ’”‘•’‡ –‹˜‡”‡ƒŽCommunity mental health journal, 52 Ž‹ˆ‡•–—†›Ǥ ȋͺȌǡͺͻͺǦͻͲ͹Ǥ

‡”‡‹”ƒǡ Ǥ ǤǡƬ‡„„ƒ±ǡǤȋʹͲͳͺȌǤ –‡‰”ƒ–‹˜‡Ǧ‡Žƒ–‹‘ƒŽ’’”‘ƒ Š‹ Š‹œ‘’Š”‡‹ƒǣ ”‘ Š‹Ž‘•‘’Š‹ ƒŽ”‹ ‹’Ž‡•–‘‡–ƒŽ‹œƒ–‹‘Schizophrenia and CommonǦƒ•‡†”ƒ –‹ ‡Ǥ  ‹’׎‹–‘ǡ Ǥǡ ‘­ƒŽ˜‡•ǡ Ǥǡ Sense ‡”‡‹”ƒǡ Ǥ Ǥȋ†•ǤȌǡ ǡͳͻ͵ǦʹͲ͹ǤŠƒǡ™‹–œ‡”Žƒ†ǣ ’”‹‰‡”Ǥ ‘•ǡǤǡ ”ƒ‡ǡǤǡ‹–ǡ Ǥǡ‹Œ‡ǡǤ Ǥǡ–ƒ”‹‰ǡǤǤǡƒ†‡” ƒƒ‰ǡǤǡǤǤǤƬ Š‹”„‡ ǡ Ǥ ȋʹͲͳͻȌǤ‘‰‹–‹˜‡„‡Šƒ˜‹‘”ƒŽ–Š‡”ƒ’›ˆ‘”•‘ ‹ƒŽƒ –‹˜ƒ–‹‘‹”‡ ‡–Journal of consulting and clinical psychologyǦ‘•‡–’•› Š‘•‹•ǣ87 ƒ†‘‹œ‡† ‘–”‘ŽŽ‡†–”‹ƒŽǤ ǡ ȋʹȌǡͳͷͳǤ —‹†±ǡǤǡ‰ǡǤ Ǥǡ‘Š‡ǡǤǡ Š‡ŽŽǡǤǡƒŽ–‡”ǡ Ǥǡƒ””ǡǤ ǤǡƬ ”‡‡ǡǤ ǤȋʹͲͳ͹ȌǤŠ‹Ž†Š‘‘† –”ƒ—ƒǦ”‡Žƒ–‡†ƒŽ–‡”ƒ–‹‘•‹„”ƒ‹ˆ— –‹‘†—”‹‰ƒŠ‡‘”›Schizophrenia research 189 Ǧ‘ˆǦ‹†–ƒ•‹ • Š‹œ‘’Š”‡‹ƒǤ ǡ ǡͳ͸ʹǦͳ͸ͺǤ ‡ƒ†ǡ Ǥǡ˜ƒ•ǡ Ǥǡ‘””‹•‘ǡǤǤǡƬ‘••ǡǤǤȋʹͲͲͷȌǤŠ‹Ž†Š‘‘†–”ƒ—ƒǡ’•› Š‘•‹•ƒ†Acta • Š‹œ‘’Š”‡‹ƒǣƒŽ‹–‡”ƒ–—”‡”‡˜‹‡™™‹–Š–Š‡‘”‡–‹ ƒŽƒ† Ž‹‹ ƒŽ‹’Ž‹ ƒ–‹‘•ǤPsychiatrica Scandinavica 112 ǡ ȋͷȌǡ͵͵ͲǦ͵ͷͲǤ ‘••‘—™ǡǤ ǤǡƬ ‘ƒ‰›ǡǤȋʹͲͳʹȌǤ‡–ƒŽ‹œƒ–‹‘Journal of theǦ„ƒ•‡†–”‡ƒ–‡–ˆ‘”•‡Žˆ American Academy of CǦŠƒ”‹ƒ†‘Ž‡• ‡–•ǣhild & Adolescent ƒ”ƒ†‘‹œ‡†Psychiatry 51 ‘–”‘ŽŽ‡†–”‹ƒŽǤ Technicalǡ ȋͳʹȌǡͳ͵ͲͶ adaptationsǦͳ͵ͳ͵Ǥ from MBT to Schizophrenic Psychosis. Working on the Self ƒœǡǤȋʹͲͳͺȌǤBoundaries ǡ’”‡•‡–‡†ƒ– –‡”ƒ–‹‘ƒŽ‘ˆ‡”‡ ‡‘ˆ‡–ƒŽ‹œƒ–‹‘ƒ•‡†”‡ƒ–‡–ˆ‘” •› Š‘•‹•ǡƒ†”‹†ǡ’ƒ‹Ǥ

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Schizophrenia Bulletin,

ƒ••ǡǤǤǡƬƒ”ƒ•ǡ ǤȋʹͲͲ͵ȌǤ Š‹œ‘’Š”‡‹ƒǡ ‘• ‹‘—•‡••ǡƒ†–Š‡•‡ŽˆǤ29 ǡͶʹ͹–ͶͶͶǤ  Š‹‡–‹ǡǤȋʹͲͳ͹ȌǤŠ‡†‡˜‡Ž‘’‡–ƒŽ”‘‘–•‘ˆ†‹••‘ ‹ƒ–‹‘ǣ—Ž–‹’Ž‡‡†‹ƒ–‹‘Psychoanalytic Psychology 34 ƒƒŽ›•‹•Ǥ ǡ ȋͳȌǡͻ͸Ǥ ‡‰ƒŽǡǤǤǡ‡ƒ•†ƒŽ‡ǡ ǤǤǡƬ‹ŽŽ‹ƒ•ǡ ǤǤ ǤȋʹͲͲͶȌǤ‹†ˆ—Ž‡••Ǧƒ•‡†‘‰‹–‹˜‡Š‡”ƒ’›ǣ Š‡‘”‡–‹ ƒŽƒ–‹‘ƒŽ‡ƒ†’‹”‹ ƒŽ–ƒ–—•Ǥ  ƒ›‡•ǡǤǤǡ ‘ŽŽ‡––‡ǡǤǤǡƬ‹‡ŠƒǡǤMindfulness and acceptance: Expanding the cognitive-behavioral tradition Ǥȋ†•ǤȌǡ ǡͶͷ– ͸ͷǤ‡™‘”ǡǣ —‹Žˆ‘”†”‡••Ǥ The British ‡Ž–‡ǡ ǤǤǡƬƒ–‘”Journal of PsychiatryǦ ”ƒƒ‡ǡǤ187ȋʹͲͲͷȌǤ‘ ‹ƒŽ†‡ˆ‡ƒ–ǣ”‹•ˆƒ –‘”ˆ‘”• Š‹œ‘’Š”‡‹ƒǫ ǡ ȋʹȌǡͳͲͳǦͳͲʹǤ American psychologist 65 Š‡†Ž‡”ǡ ǤȋʹͲͳͲȌǤŠ‡‡ˆˆ‹ ƒ ›‘ˆ’•› Š‘†›ƒ‹ ’•› Š‘–Š‡”ƒ’›Ǥ ǡ ȋʹȌǡ ͻͺǤ ‹ǡ ǤǡƬ’ƒ‹ǡǤȋʹͲͳ͹ȌǤ•› Š‘Ž‘‰‹ ƒŽ‹–‡”˜‡–‹‘•ˆ‘”–”ƒ—ƒ‹‹†‹˜‹†—ƒŽ•™Š‘Šƒ˜‡Psychosis 9 ’•› Š‘•‹•ǣƒ•›•–‡ƒ–‹ ”‡˜‹‡™ƒ†‡–ƒǦƒƒŽ›•‹•Ǥ ǡ ȋͳȌǡ͸͹ǦͺͳǤ ‘Ž•ǡǤǤȋʹͲͳͺȌǤŠ‡‡—”‘„‹‘Ž‘‰‹ ƒŽ—†‡”’‹‹‰•‘ˆ’•› Š‘ƒƒŽ›–‹ –Š‡‘”›ƒ†Frontiers in behavioral neuroscience 12 –Š‡”ƒ’›Ǥ ǡ ǡʹͻͶǤ ’”‘‰ǡǤǡ Š‘–Š‘”•–ǡǤǡ‘•ǡǤǡ ‘šǡ ǤǡƬƒ‰‡Žƒ†ǡ ǤȋʹͲͲ͹ȌǤŠ‡‘”›‘ˆ‹†‹The British Journal of Psychiatry 191 • Š‹œ‘’Š”‡‹ƒǣ‡–ƒǦƒƒŽ›•‹•Ǥ ǡ ȋͳȌǡͷǦͳ͵Ǥ –‡‹‡”–ǡǤǡ—†‡”ǡǤǡƒ„—‰ǡǤǡ ‘›‡”ǡ ǤǡƬ‡‹ Š•‡”‹‰ǡ ǤȋʹͲͳ͹ȌǤ•› Š‘†›ƒ‹ –Š‡”ƒ’›ǣ ƒ•‡ˆˆ‹ ƒ ‹‘—•ƒ•‘–Š‡”‡’‹”‹ ƒŽŽ›•—’’‘”–‡†–”‡ƒ–‡–•ǫ‡–ƒAmerican Journal of Psychiatry 174 ǦƒƒŽ›•‹•–‡•–‹‰ ‡“—‹˜ƒŽ‡ ‡‘ˆ‘—– ‘‡•Ǥ ǡ ȋͳͲȌǡͻͶ͵Ǧͻͷ͵Ǥ ›•–‡ƒǡǤǡ—†‡”‹ǡǤǡŽ‘‡‡”•ǡǤǡ‘‘”†ƒǡǤǡƬ‹‡”•ƒǡǤȋʹͲͲ͹ȌǤ••‡”–‹˜‡Acta

‘—‹–›–”‡ƒ–‡–‹–Š‡‡–Š‡”Žƒ†•ǣ”ƒ†‘‹œ‡† ‘–”‘ŽŽ‡†–”‹ƒŽǤPsychiatrica Scandinavica, 116 8 ǡͳͲͷ–ͳͳʹǤ ƒ—„‡”ǡǤǡ‹‡”ƒǡǤǡƒ„‡”‰ǡǤǡƬ Š”Ú†‡”ǡǤȋʹͲͳ͸ȌǤ‡–ƒŽ‹œƒ–‹‘‡†‹ƒ–‡•–Š‡ ”‡Žƒ–‹‘•Š‹’„‡–™‡‡‡ƒ”Ž›ƒŽ–”‡ƒ–‡–ƒ†’‘–‡–‹ƒŽˆ‘”˜‹‘Ž‡ ‡‹Psychopathology 49 ƒ†‘Ž‡• ‡ ‡Ǥ ǡ ȋͶȌǡʹ͵͸ǦʹͶ͸Ǥ ‘™ǡ ǤǤǡ‹‡‡”ǡǤ Ǥǡ„„ƒ••ǡǤǡ‡‹ Š•‡”‹‰ǡ Ǥǡ”‹‡••‡ǡǤǡƬƒ„—‰ǡǤȋʹͲͳʹȌǤ‡–ƒǦ ƒƒŽ›•‹•‘ˆ’•› Š‘†›ƒ‹ ’•› Š‘–Š‡”ƒ’›‘—– ‘‡•ǣPsychotherapy 49 ˜ƒŽ—ƒ–‹‰–Š‡‡ˆˆ‡ –•‘ˆ”‡•‡ƒ” ŠǦ •’‡ ‹ˆ‹ ’”‘ ‡†—”‡•Ǥ ǡ ȋ͵Ȍǡʹ͹͸Ǥ ”ƒ—‡Ž•‡ǡǤǤǡ —Ž‡›ǡǤǡ ƒ•‡ǡ ǤǤǡ‡†‡”•‡ǡǤǤǡ‹‡Ž•‡ǡ Ǥ ǤǤǡ”‹‡”ǡǤ ǤǡǤǤǤƬ ‹‘•‡ǡǤȋʹͲͳ͸ȌǤ‡–ƒ ‘‰‹–‹‘‹ˆ‹”•–PsychiatryǦ‡’‹•‘†‡’•› Š‘•‹•ƒ†‹–•ƒ research 238 ••‘ ‹ƒ–‹‘™‹–Š ’‘•‹–‹˜‡ƒ†‡‰ƒ–‹˜‡•›’–‘’”‘ˆ‹Ž‡•Ǥ ǡ ǡͳͶǦʹ͵Ǥ ˜ƒ†‡‡”‰ǡǤǤǡ†‡‘–ǡǤǤǡ˜ƒ†‡”Ž‡—‰‡ŽǡǤǤǡ†‡‘‘•ǡǤǡ†‡ ‘‰ŠǡǤǡƒ‹‡ǡǤǡ Ƭ˜ƒ†‡” ƒƒ‰ǡǤȋʹͲͳͷȌǤ”‘Ž‘‰‡†‡š’‘•—”‡˜•‡›‡‘˜‡‡–†‡•‡•‹–‹œƒ–‹‘ƒ†

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”‡’”‘ ‡••‹‰˜•™ƒ‹–‹‰Ž‹•–ˆ‘”’‘•––”ƒ—ƒ–‹ •–”‡••†‹•‘”†‡”‹’ƒ–‹‡–•™‹–ŠƒJAMA psychiatry 72 ’•› Š‘–‹ †‹•‘”†‡”ǣƒ”ƒ†‘‹œ‡† Ž‹‹ ƒŽ–”‹ƒŽǤ ǡ ȋ͵ȌǡʹͷͻǦʹ͸͹Ǥ ˜ƒ†‡” ƒƒ‰ǡǤǡ‹‡ƒǡǤ Ǥǡ‹‡–†‹Œǡ Ǥǡ”ƒ‰–ǡǤǡ •‹‰ǡ ǤǤǡŽƒƒ••‡ǡǤǤǡǤǤǤƬ‹•œ‡ǡǤ ǤȋʹͲͳʹȌǤ‘‰‹–‹˜‡„‡Šƒ˜‹‘”ƒŽ–Š‡”ƒ’›ˆ‘”•—„Œ‡ –•ƒ–—Ž–”ƒŠ‹‰Š”‹•ˆ‘”†‡˜‡Ž‘’‹‰Schizophrenia bulletin 38 ’•› Š‘•‹•ǣƒ”ƒ†‘‹œ‡† ‘–”‘ŽŽ‡† Ž‹‹ ƒŽ–”‹ƒŽǤ ǡ ȋ͸ȌǡͳͳͺͲǦ ͳͳͺͺǤ ˜ƒ†‡” ƒƒ‰ǡǤǡ˜ƒ†‡‡”‰ǡǤǡƬ •‹‰ǡ ǤȋʹͲͳ͹ȌǤ‹–Š‡’”‡˜‡–‹‘‘ˆ’•› Š‘•‹•ƒ† ‘–Š‡”•‡˜‡”‡‡–ƒŽ†‹•‘”†‡”•‹’ƒ–‹‡–•™‹–Šƒƒ–”‹•‡–ƒŽ•–ƒ–‡ǣƒ”‡˜‹‡™ƒ†Schizophrenia research, ’”‘’‘•‡†‡š–•–‡’•Ǥ ͺͺǦͻ͵Ǥ ƒ‘•–‡”Š‘—–ǡǤǡ‹–ǡ Ǥǡ”ƒ„„‡†ƒǡǤǡƒ•–‡Ž‡‹ǡǤǡ–ƒ”‹‰ǡǤǤǤǡƬ˜ƒ‡” ƒƒ‰ǡǤ ȋʹͲͳ͸ȌǤ‡–ƒ ‘‰‹–‹˜‡–”ƒ‹‹‰ˆ‘”• Š‹œ‘’Š”‡‹ƒ•’‡ –”—’ƒ–‹‡–•ǣƒ‡–ƒPsychological medicine 46 ǦƒƒŽ›•‹•‘ ‘—– ‘‡•–—†‹‡•Ǥ ǡ ȋͳȌǡͶ͹Ǧͷ͹Ǥ ˜ƒ‡Ž—™ǡǤ ǤǡƬŠƒ ‡ǡǤǤȋʹͲͳͶȌǤ‹ˆˆ‡”‡–‹ƒ–‹‰„‡–™‡‡•‡Žˆƒ†‘–Š‡”•ǣƒ‡–ƒBrain imaging and Ǧ ƒƒŽ›•‹•‘ˆˆ •–—†‹‡•‘ˆ•‡Žˆbehavior, 8 Ǧ”‡ ‘‰‹–‹‘ƒ†–Š‡‘”›‘ˆ‹†Ǥ ȋͳȌǡʹͶǦ͵ͺǤ ƒ”‡•‡ǡ Ǥǡ‡‡–•ǡ Ǥǡ”—‡”ǡǤǡ‹‡˜‡”•‡ǡǤǡƒ–ƒ•–‡”ǡǤǡ‹‡ Š–„ƒ—‡”ǡǤǡǤǤǤƬ‡–ƒŽŽǡǤǤ ȋʹͲͳʹȌǤŠ‹Ž†Š‘‘†ƒ†˜‡”•‹–‹‡•‹ ”‡ƒ•‡–Š‡”‹•‘ˆ’•› Š‘•‹•ǣƒ‡–ƒSchizophreniaǦƒƒŽ›•‹•‘ˆ’ƒ–‹‡– bulletin 38 Ǧ ‘–”‘Žǡ’”‘•’‡ –‹˜‡Ǧƒ† ”‘••Ǧ•‡ –‹‘ƒŽ ‘Š‘”–•–—†‹‡•Ǥ ǡ ȋͶȌǡ ͸͸ͳǦ͸͹ͳǤ ‡‹Œ‡”•ǡ Ǥ Ǥǡ–‡ƒ–‡ǡǤǡ‹‡ Š–„ƒ—‡”ǡǤǤǡƒ’ƒƒ”–ǡǤ ǤǤǡ—”‡Ž‹‰•Ǧ‘–‡‘‡ǡǤ ǤǤǡƬ ‡Ž–‡ǡ ǤǤȋʹͲʹͲȌǤ‡–ƒŽ‹œƒ–‹‘Ǧ„ƒ•‡†–”‡ƒ–‡–ˆ‘”’•› Š‘–‹ †‹•‘”†‡”ǣƒ”ƒ–‡”Psychological Medicine. Ǧ „Ž‹†‡†ǡ—Ž–‹Ǧ ‡–‡”ǡ”ƒ†‘‹œ‡† ‘–”‘ŽŽ‡†–”‹ƒŽǤ  ›‡•ǡǤǡ–‡‡ŽǡǤǡ˜‡”‹––ǡǤǡƬƒ””‹‡”ǡǤȋʹͲͲͺȌǤ‘‰‹–‹˜‡„‡Šƒ˜‹‘”–Š‡”ƒ’›ˆ‘”Schizophrenia • Š‹œ‘’Š”‡‹ƒǣ‡ˆˆ‡ –•‹œ‡•ǡ Ž‹‹ ƒŽ‘†‡Ž•ǡƒ†‡–Š‘†‘Ž‘‰‹ ƒŽ”‹‰‘”Ǥbulletin 34  ǡ ȋ͵Ȍǡͷʹ͵Ǧͷ͵͹Ǥ

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Addendum

SUMMARY IN DUTCH

VALORIZATION

LIST OF PUBLICATIONS AND INVITED LECTURES

ACKNOWLEDGEMENTS

CURRICULUM VITAE

Appendices

146807_JonasWeijers_BNW_def.indd 185 28-10-2020 15:09 Summary in Dutch

Nederlandse samenvatting

Inleiding

‹–’”‘‡ˆ• Š”‹ˆ–‹•Š‡–”‡•—Ž–ƒƒ–˜ƒ‡‡œ‡•Œƒƒ”Žƒ‰‡‡’‹”‹• Š‡”‡‹•™ƒƒ”‹‹‘†‡”œ‘‡Š‡„ ‰‡†ƒƒƒƒ”‡–ƒŽ‹•‡”‡†˜‡”‘‰‡‡‹†‡”‹•Šƒ†‡Ž‹‰‘†‡”’ƒ–‹´–‡‡–‡‡ ’•› Š‘–‹• Š‡•–‘‘”‹•Ǥ  •› Š‘•‡‹•‡‡•›†”‘‘†ƒ–™‘”†–‰‡‡‡”–†‘‘”‡‡˜‡”Ž‹‡•˜ƒ ‘–ƒ –‡–†‡ ”‡ƒŽ‹–‡‹–Ǥ‡‡”‡˜ƒ’•› Š‘•‡œ‹Œ†‡ƒƒ™‡œ‹‰Š‡‹†˜ƒ‹†‹‘•› ”ƒ–‹• Š‡ǡ•‘• ƒƒ–‘‘„ƒƒ”onjuiste interpretaties van de werkelijkheid, ook wel ‘wanen’ genoemd, en de perceptie van dingen die niet echt aanwezig zijn, ‘hallucinaties’ genoemd. Ongeveer 6% van de ƒŽ‰‡‡‡„‡˜‘Ž‹‰Š‡‡ˆ–‘’‡‹‰‘‡–‹Š‡–Ž‡˜‡±±‘ˆ‡‡”†‡”‡’•› Š‘–‹• Š‡ ‡”˜ƒ”‹‰‡ǡƒƒ”œ—Ž‡‡”˜ƒ”‹‰‡Š‘‡˜‡‹‡–‘‘†œƒ‡Ž‹Œ‡”™‹Œ•Š‡–†ƒ‰‡Ž‹Œ•ˆ— –‹‘‡”‡ ‡”•–‹‰–‡˜‡”•–‘”‡Ǥ ‡’•› Š‘–‹• Š‡•–‘‘”‹•‹•’‡”†‡ˆ‹‹–‹‡’ƒ–Š‘Ž‘‰‹• Š‡‹˜ƒŽ‹†‡‡”–’ƒ–‹´–‡†‹™‹ŒŽ• ‡”•–‹‰Ǥ‹‡Š‡–•’‡ –”—˜ƒ’•› Š‘–‹• Š‡•–‘‘”‹••‡™‘”†–•‘•‘†‡”• Š‡‹†‰‡ƒƒ– –—••‡ƒˆˆ‡ –‹‡˜‡’•› Š‘•‡•ǡ†‹‡—‹–•Ž—‹–‡†˜‘‘”‘‡‹†‡ ‘–‡š–˜ƒƒ‹• Š‡‘ˆ †‡’”‡••‹‡˜‡‡’‹•‘†‡ǡ‡†‡œ‘‰‡ƒƒ†‡̵‹‡–Ǧƒˆˆ‡ –‹‡˜‡’•› Š‘–‹• Š‡•–‘‘”‹•̵ȋȌǡ†‹‡ ǦͷǦ ƒ–‡‰‘”‹‡´„‡˜ƒ–ƒŽ•• Š‹œ‘ˆ”‡‹‡ǡ• Š‹œ‘Ǧƒˆˆ‡ –‹‡˜‡•–‘‘”‹•ǡ‘”–†—”‡†‡’•› Š‘–‹• Š‡ •–‘‘”‹•‡™ƒƒ•–‘‘”‹•Ǥ ‡‡‡•–‡’ƒ–‹´–‡‡–˜‡”–‘‡™ƒ‡‘ˆŠƒŽŽ— ‹ƒ–‹‡•ȋ‡”‹ ƒ•› Š‹ƒ–”‹  ••‘ ‹ƒ–‹‘ǡʹͲͳ͵Ȍǡ‘‘™‡Ž’•› Š‘–‹• Š‡‘ˆ̵’‘•‹–‹‡˜‡•›’–‘‡̵‰‡‘‡†Ǥ”ƒ†‹–‹‘‡‡Ž ‰‡œ‹‡Ž‹‰–†‡ƒ†”—˜ƒ†‡„‡Šƒ†‡Ž‹‰‘’†‡œ‡’‘•‹–‹‡˜‡•›’–‘‡Ǥƒ–‹•‹•• Š‹‡‘‘ ‹‡–œ‘‰‡‘†ƒ–†‡œ‡•›’–‘‡†‹™‹ŒŽ•Š‡–‡‡•–‹Š‡–‘‘‰•’”‹‰‡‡†ƒƒ”ƒƒ•–˜ƒƒ ƒ†‡“—ƒƒ–„‡Šƒ†‡Ž†—‡™‘”†‡‡–ƒ–‹’•› Š‘–‹• Š‡‡†‹ ƒ–‹‡Ǥ Š–‡”ǡƒƒ•–†‡’‘•‹–‹‡˜‡ •›’–‘‡ǡŽƒ–‡˜‡‡Ž’ƒ–‹´–‡‡–‘‘‡‡ƒˆƒ‡œ‹‡‹Š‡–•‘ ‹ƒƒŽˆ— –‹‘‡”‡ǡ œ‘ƒŽ•Š‡–˜‡”‘‰‡‘™‡”‘ˆ”‡Žƒ–‹‡•‹•–ƒ†–‡Š‘—†‡Ǥ‡„‡Šƒ†‡Ž‹‰˜ƒ†‹–•‘ ‹ƒƒŽ †‹•ˆ— –‹‘‡”‡ƒǡ‘†ƒ•”‡ ‡–‡Ž‹Œ–‘‡‰‡‘‡ƒƒ†ƒ Š–ȋ„‹Œ˜Ǥ —– Š‡‘ǡ‡‹• ƒ”“—‡•ǡƬ ‘™‡•ǡʹͲͳͻȌǡƒŽ•‘†‡”‰‡• Š‘˜‡‹†Œ‡™‘”†‡„‡• Š‘—™†Ǥ–‹•’› Š‘–‹• Š‡ ‡†‹ ƒ–‹‡‹•‰‡‡‡ˆˆ‡ –‹‡˜‡„‡Šƒ†‡Ž‹‰˜‘‘”Š‡–•‘ ‹ƒƒŽ†‹•ˆ— –‹‘‡”‡ȋ‹Šƒ‡–ƒŽǤǡʹͲͲ͵Ȍǡ ™ƒƒ”†‘‘”†‹™‹ŒŽ•‡‡‰”‘–‡Ž‘‘ˆ‘–•–ƒƒ––—••‡†‡‡”•–˜ƒ†‡’‘•‹–‹‡˜‡•›’–‘‡‡†‡ ƒ–‡˜ƒ†‹•ˆ— –‹‘‡”‡„‹Œ’ƒ–‹´–‡‡– Š”‘‹• Š‡ȋ„‹Œ˜Ǥ‹” Š™‘‘†‡–ƒŽǤǡʹͲͳ͵ȌǤ –‡”‡”‘‰ǡ‹†‡ƒˆ‰‡Ž‘’‡ͳͲͲŒƒƒ”™‡‹‹‰˜‘‘”—‹–‰ƒ‰‰‡„‘‡–‹†‡„‡Šƒ†‡Ž‹‰˜ƒŠ‡– •‘ ‹ƒƒŽ†‹•ˆ— –‹‘‡”‡„‹Œ’ƒ–‹´–‡‡–ȋ ”‡‡ǡ ‘”ƒƬ‡‡ǡʹͲͳͷȌǤƒ–‹•™”ƒ‰ǡ‘†ƒ– †‡ƒ–‡˜ƒ•‘ ‹ƒƒŽ†‹•ˆ— –‹‘‡”‡˜‘‘”•’‡ŽŽ‡†‹•˜‘‘”‡‡–‡”—‰‡‡”˜ƒ‡‡’•› Š‘–‹• Š‡

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‡’‹•‘†‡ȋ‘—–—”‡ǡ‡Ƭ‘„‡”–•ǡʹͲͲ͸Ȍ‡‡‡•Ž‡ Š–‡”„‡Ž‘‘’˜ƒ†‡•–‘‘”‹•ȋ —•ƒ”Ǧ‘Ž‹‡– ƒŽǤǡʹͲͳͲȌǡ mogelijk  Š–‡”ǡœ‘„Ž‹Œ–—‹–‡‡”‡ ‡–‘˜‡”œ‹ Š–•ƒ”–‹‡Žǡ‹•ˆ— –‹‘‡‡ŽŠ‡”•–‡Ž™‡Ž ȋ‡‘Šƒ”†–‡–ƒŽǤǡʹͲͳ͹ȌǤ ’Žƒƒ–•˜ƒˆƒ”ƒ ‘Ž‘‰‹• Š‡ˆƒ –‘”‡ǡŽ‹Œ‡‡ Š–‡”˜‘‘”ƒŽ•‘ ‹ƒŽ‡ ˆƒ –‘”‡–œ‘ƒŽ•‡‡‰‡˜‘‡Ž˜ƒ˜‡”„‘†‡Š‡‹†ȋ‹•‡•–ƒ†–ǡ‘–‡‹”‘ǡ‹‹œǡƬŠƒ˜‡•ǤʹͲͳʹȌ‡ †‡ƒ–‡˜ƒ‡”˜ƒ”‡•‘ ‹ƒŽ‡•–‡—ȋ‘”ƒǡ‹†‡ŽŽǡ› ŠƬƒ Šƒ†ƒǡʹͲͳ͵ǢŠ‘ƒ•ǡ —”ƒŽ‹†Šƒ”ƒǡ‡†‘ˆˆǡƬ”ƒ’ƒŽ•‹ǡʹͲͳ͸Ȍ–˜ƒ„‡Žƒ‰˜‘‘”Š‡–ˆ— –‹‘‡Ž‡Š‡”•–‡ŽǤƒƒ”‘‹• ‡”†‡Žƒƒ–•–‡†‡ ‡‹ƒ‡‡”ƒƒ†ƒ Š–˜‘‘”†‡‘–™‹‡Ž‹‰˜ƒ‹‡–Ǧˆƒ”ƒ ‘Ž‘‰‹• Š‡ǡ ’•› Š‘•‘ ‹ƒŽ‡‹–‡”˜‡–‹‡•†‹‡Š‡–•‘ ‹ƒƒŽˆ— –‹‘‡”‡˜‡”„‡–‡”‡ȋ„‹Œ˜Ǥ ‘Ž–Šƒ—•‡‡–ƒŽǤǡ ʹͲͲ͹ȌǤ”œ‹Œ–‘–—–‘‡‘‰™‡‹‹‰•–—†‹‡•‰‡™‡‡•–†‹‡Žƒ–‡œ‹‡†ƒ–‹††‡Ž• ’•› Š‘–Š‡”ƒ’‡—–‹• Š‡‹–‡”˜‡–‹‡•Š‡–•‘ ‹ƒƒŽˆ— –‹‘‡”‡†——”œƒƒ˜‡”„‡–‡”†ƒ™‘”†‡ ȋœ‹‡ ‘”ƒƬ ”‡‡ǡʹͲͳͻ˜‘‘”‡‡‘˜‡”œ‹ Š–Ȍǡƒƒ”±±‡‡Ž‡ǡ”‡ ‡–‡•–—†‹‡‰ƒˆ™‡Ž ƒƒ™‹Œœ‹‰‡†ƒ–†‹–‘‰‡Ž‹Œ‹•ȋ‡ Š‹‡–ƒŽǤǡʹͲͳͻȌǤ Mentaliseren en sociaal functioneren

‹–‘†‡”œ‘‡„Ž‹Œ–†ƒ–‡‡„‡’‡”–•ociaal cognitief of ‘mentaliserend’ vermogen een „‡Žƒ‰”‹Œ‡„‹Œ†”ƒ‰‡Ž‡˜‡”–ƒƒŠ‡–•‘ ‹ƒƒŽ†‹•ˆ— –‹‘‡”‡˜ƒ’ƒ–‹´–‡‡–ȋ„‹Œ˜Ǥ ‡––ǡ ‹‡ Š–„ƒ—‡”ǡ‡ǡ˜ƒ•Ƭ”ƒ„„‡†ƒǡʹͲͳͳȌǤ‡–ƒŽ‹•‡”‡‹•Š‡–˜‡”‘‰‡‘‰‡†”ƒ‰˜ƒ Œ‡œ‡Žˆ‡ƒ†‡”‡–‡„‡‰”‹Œ’‡‹–‡”‡˜ƒ‡–ƒŽ‡–‘‡•–ƒ†‡œ‘ƒŽ•˜‡”Žƒ‰‡•ǡ„‡Š‘‡ˆ–‡•ǡ ‰‡˜‘‡Ž‡•‡‘˜‡”–—‹‰‹‰‡Ǥ‘‘”–‡‡–ƒŽ‹•‡”‡—‡‡•‡œ‹ Š‡‡˜‘‘”•–‡ŽŽ‹‰ƒ‡ van iemands binnenwereld. Vervolgens kan zo’n voorstelling gebruikt worden om het gedrag ˜ƒƒ†‡”‡ȋ‡Œ‡œ‡ŽˆȌ–‡„‡‰”‹Œ’‡ǡ‘Š‡––‡—‡˜‘‘”•’‡ŽŽ‡‡‘‡”‘’‡‡ƒ†‡“—ƒ–‡ ƒ‹‡”‘’–‡—‡”‡ƒ‰‡”‡Ǥ”‹•‡ Š–‡”™‡Ž‡‡„‡’ƒƒŽ†‡ƒ–‡˜ƒ˜‘‘”•–‡ŽŽ‹‰•˜‡”‘‰‡ ‘†‹‰‘–‡—‡‡–ƒŽ‹•‡”‡ǡ‘†ƒ–Š‡–‰‡†”ƒ‰†ƒ–™‡„‹Œ‡‡ƒ†‡”œ‹‡‹‡–’‡”•‡†‹‡•

‹–‡–‹‡•”‡ˆŽ‡ –‡‡”–Ǥ A  ƒ–‹´–‡‡–Š‡„„‡‘’‡‡”†‡”‡˜Žƒ‡’”‘„Ž‡‡‡–‡–ƒŽ‹•‡”‡ǡœ‘ƒŽ• Š‡–—‡‹–‡”’”‡–‡”‡˜ƒƒ†‡”ƒ•‡–ƒŽ‡–‘‡•–ƒ†‡ȋ’”‘‰ǡǡ Š‘–Š‘”•–ǡ‘•ǡ ‘šǡƬ ˜ƒ‰‡Žƒ†ǡʹͲͲ͹ȌǡŠ‡–Š‡”‡‡˜ƒƒ†‡”ƒ•‡‘–‹‡•ȋ̵‹• ‘ŽŽǡƒ‹‰Ƭƒ•‘ǡʹͲͳͶȌǡ Š‡–Š‡”‡‡˜ƒ†‡‡‹‰‡‡‘–‹‡•ȋ”—‡Ž‹‡–ƒŽǤǡʹͲͲ͹Ȍ‡Š‡–˜‡”™‘‘”†‡˜ƒŠ—‡‹‰‡ ‡‘–‹‡•ȋ”±‡ƒ—ǡʹͲͲ͸ȌǤ ‡–‡‡ƒ‡˜ƒ‹•Šƒ†‡Ž‹‰‹†‡‹†‡”–‹Œ†œ‘—±±˜ƒ†‡ ‘‘”œƒ‡˜‘‘”†‹–„‡’‡”–‡‡–ƒŽ‹•‡”‡†˜‡”‘‰‡—‡œ‹ŒǤƒ–‹´–‡‡–œ‹Œ ‘‰‡˜‡‡”†”‹‡ƒƒŽ˜ƒ‡”Š‡–•Žƒ Š–‘ˆˆ‡”‰‡™‡‡•–˜ƒ‹•„”—‹‘ˆ‹•Šƒ†‡Ž‹‰‹Š— ‹†‡”–‹Œ††ƒ‡•‡†‹‡‰‡‡’•› Š‘•‡Š‡„„‡‰‡”‡‰‡ȋƒ”‡•‡‡–ƒŽǤǡʹͲͳʹȌǤ‡‰”‘‘– ƒƒ–ƒŽƒ”–‹‡Ž‡•—‰‰‡”‡‡”–œ‡Žˆ•†ƒ–‹†‡”‹•Šƒ†‡Ž‹‰‡‡ ƒ—•ƒŽ‡”‘Ž•’‡‡Ž–‹†‡ ‘–™‹‡Ž‹‰˜ƒȋƒ–Š‡•‘ǡŠ‡’Š‡”†ǡ‹ Š„‡ ǡƒ—”‡•ǡƬƒ””ǡʹͲͳ͵Ǣƒ”‡•‡‡–ƒŽǤǡ ʹͲͳʹǢ‘”‰ƒƬ ‹•Š‡”ǡʹͲͲ͹Ǣ˜ƒƒ‡–ƒŽǤǡʹͲͳͷȌǤ‘‡–ƒŽ‹•ƒ–‹‡–Š‡‘”‹‡’•–‡Ž–†ƒ–†‡ƒ–‡˜ƒ

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˜‡‹Ž‹‰Š‡‹†‹†‡‘’˜‘‡†‹‰•‘‰‡˜‹‰˜ƒ‡‡‹†„‡’ƒƒŽ–Š‘‡‰‘‡†Š‡–˜‡”‘‰‡‘–‡ ‡–ƒŽ‹•‡”‡œ‹ Š‘–™‹‡Ž–Ǥ‹•Šƒ†‡Ž‹‰‹†‡‹†‡”–‹Œ†™‘”†–‰‡œ‹‡ƒŽ•†‹ƒ‡–”ƒƒŽ –‡‰‡‰‡•–‡Ž†ƒƒ‡‡˜‡‹Ž‹‰‡‘’˜‘‡†‹‰•‘‰‡˜‹‰Ǥ ‡–œ‘—Š‡–‘–™‹‡Ž‡˜ƒŠ‡– ‡–ƒŽ‹•‡”‡†˜‡”‘‰‡–‡‰‡‰ƒƒ‘†ƒ–Š‡–”‡’”‡•‡–‡”‡˜ƒ†‡˜‹Œƒ†‹‰‡‘ˆ‘˜‡”• Š‹ŽŽ‹‰‡ ‰‡‘‡†•–‘‡•–ƒ†˜ƒ†‡˜‡”œ‘”‰‡”ǡ‡‡•‘‘”–ˆ‘„‹• Š‡ƒ‰•–œ‘—‘’™‡‡ǡ‘†ƒ–†‹– ‘˜‡”™‡Ž†‹‰‡†’‹ŒŽ‹Œ‹•˜‘‘”Š‡–‹†Ǥ  ‘‹‰‡‘†‡”œ‘‡‡”•Š‡„„‡‘‘‰‡‘’’‡”††ƒ–‡‡„‡’‡”–‡–ƒŽ‹•‡”‡†˜‡”‘‰‡ ‘’Šƒƒ”„‡—”–ƒ„‹Œ†”ƒ‰‡ƒƒ†‡Ž‹‹• Š‡•›’–‘‡˜ƒȋ‡„„ƒ±Ƭ‘ˆˆ‡ŽǡʹͲͳͻȌǤ ”ƒ„‹Œ˜‘‘”„‡‡Ž†™‘”†‡„‡–‘‘‰††ƒ–ƒ Š–‡”˜‘Ž‰‹‰•Ǧ‡„‡–”‡‹‰•™ƒ‡’‡”†‡ˆ‹‹–‹‡ ‘Œ—‹•–‡‘’˜ƒ––‹‰‡œ‹Œ‘˜‡”†‡‡–ƒŽ‡–‘‡•–ƒ†‡˜ƒƒ†‡”‡ȋ ”‹–ŠǡͳͻͻʹȌǤƒƒ”ƒƒ•– ™‡‡”•’‹‡‰‡Ž‡‡‰ƒ–‹‡˜‡•›’–‘‡ǡœ‘ƒŽ•ƒˆ‰‡˜Žƒ–‡ƒˆˆ‡ –‹‡˜‡‡š’”‡••‹‡ǡ‘‰‡Ž‹Œ‡‡ ‘—‹ ƒ–‹‡•–‘‘”‹•†‹‡™‘”†–˜‡”‘‘”œƒƒ–†‘‘”‡‡‘˜‡”‘‰‡‘–‡„‡‰”‹Œ’‡†ƒ– ‰‡„ƒ”‡ǡ‹–‘ƒ–‹‡‡‰‡œ‹ Š–•—‹–†”—‹‰‡–ƒŽ‡–‘‡•–ƒ†‡‘˜‡”„”‡‰‡ȋ ”‹–ŠǡͳͻͻʹȌǤ Doelen van dit proefschrift  ’„ƒ•‹•˜ƒƒŽ†‡œ‡˜‘‘”‡‹•™ƒ•‡‡˜‘Ž‰‡†‡Ž‘‰‹• Š‡•–ƒ’‘‘†‡”œ‘‡–‡†‘‡ ƒƒ”†‡˜‡”™‡˜‡Š‡‹†˜ƒ‹†‡”‹•Šƒ†‡Ž‹‰ǡ‡–ƒŽ‹•‡”‡†˜‡”‘‰‡‡’•› Š‘•‡Ǥ ƒƒ”ƒƒ•–Š‡„„‡™‡‘†‡”œ‘ Š–‘ˆ‡–ƒŽ‹•‡”‡‡˜‘”†‡”‡†‡Š‡”ƒ’‹‡˜‘‘”•› Š‘–‹• Š‡ •–‘‘”‹••‡ȋ’Ȍ‡‡‡ˆˆ‡ –‹‡˜‡„‡Šƒ†‡Ž‹‰‹•‘Š‡–•‘ ‹ƒƒŽˆ— –‹‘‡”‡‡Š‡– ‡–ƒŽ‹•‡”‡†˜‡”‘‰‡˜ƒ’ƒ–‹´–‡–‡˜‡”„‡–‡”‡Ǥ†ƒ––‡†‘‡Š‡„‹†‡˜‘Ž‰‡†‡†‘‡Ž‡ ‘’‰‡•–‡Ž†ǤDoel I: Schetsen hoe mentalisatietheorie kan bijdragen aan het begrijpen en behandelen van NAPS. ‡‡Ž ˜ƒ†‹–’”‘‡ˆ• Š”‹ˆ–˜‘”– Š‡––Š‡‘”‡–‹•• Š‡”ƒƒ™‡”˜ƒŠ‡–’”‘‡ˆ• Š”‹ˆ–Ǥ  Š‘‘ˆ†•–—ͳ‰‡˜‡™‡‡‡ƒŽ‰‡‡‡‹Ž‡‹†‹‰‘’Š‡–’”‘‡ˆ• Š”‹ˆ–Ǥ Š‘‘ˆ†•–—–™‡‡„‡• Š”‹Œ˜‡ ™‡‡‡–Š‡‘”‡–‹• Š‘†‡Ž˜ƒ‰‡„ƒ•‡‡”†‘’†‡‡–ƒŽ‹•ƒ–‹‡–Š‡‘”‹‡Ǥƒƒ”‹Ž‡‰‰‡™‡—‹– Š‘‡‹†‡”‹•Šƒ†‡Ž‹‰ǡ‘˜‡‹Ž‹‰‡Š‡ Š–‹‰ǡ•‘ ‹ƒƒŽ†‹•ˆ— –‹‘‡”‡ǡ•Ž‡ Š–‡‡‘–‹‡”‡‰—Žƒ–‹‡ǡ een gebrek aan ‘epistemisch vertrouwen’ en verminderd mentaliseren met elkaar samenhangen ‡Š‘‡†‡œ‡ˆƒ –‘”‡—‡„‹Œ†”ƒ‰‡ƒƒ’•› Š‘•‡Ǥƒƒ”ƒƒ•–™‘”†–„‡•’”‘‡Š‘‡’ ƒ™‘”†‡‹‰‡œ‡–‘’ƒ–‹´–‡‡––‡„‡Šƒ†‡Ž‡Ǥ Doel II: Het toetsen van verschillende hypothesen die de relatie tussen kindermishandeling en de ernst van symptomen bij volwassen patiënten met NAPS kunnen verklaren.

‡•–—†‹‡•†‹‡‹ †‡‡Ž ˜ƒ†‹–’”‘‡ˆ• Š”‹ˆ–„‡• Š”‡˜‡œ‹ŒǡŠƒ††‡–‘–†‘‡Ž‘˜‡”• Š‹ŽŽ‡†‡Š›’‘–Š‡•‡–‡ –‘‡–•‡†‹‡—‡Š‡Ž’‡„‹ŒŠ‡–˜‡”Žƒ”‡˜ƒŠ‡–˜‡”„ƒ†–—••‡‹•Šƒ†‡Ž‹‰‹†‡ ‹†‡”–‹Œ†‡†‡‡”•–˜ƒ†‡•›’–‘‡‹†‡˜‘Ž™ƒ••‡Š‡‹†Ǥ  In hoofdstuk drie onderzochten we of een verhoogde ‘stressreactiviteit’ het verband –—••‡‹†‡”‹•Šƒ†‡Ž‹‰‡’•› Š‘–‹• Š‡•›’–‘‡‹†‡˜‘Ž™ƒ••‡Š‡‹†ƒ˜‡”Žƒ”‡ǡ

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œ‘ƒŽ•‡‡”†‡”‹•‰‡•—‰‰‡”‡‡”†ȋ›‹Ǧ ‡”‡›•Ƭ˜ƒ•ǡʹͲͲ͹Ǣ‡Ž‹‰ǡ‘—‘––‡ǡ‘–Ǧ‘Ž†‡”ǡ˜ƒ •Ƭ˜ƒ†‡” ƒƒ‰ǡʹͲͳ͸ȌǤ‘Ž‰‡•†‡œ‡‘’˜ƒ––‹‰”‡•—Ž–‡‡”– ——Žƒ–‹‡˜‡„Ž‘‘–•–‡ŽŽ‹‰ƒƒ –”ƒ—ƒ–‹• Š‡‡”˜ƒ”‹‰‡–‹Œ†‡•†‡‹†‡”–‹Œ†‹‡‡˜‡”Š‘‘‰†‡‡‘–‹‘‡Ž‡”‡•’‘•‘’•–”‡••Ǥ  ƒ†‡”‡™‘‘”†‡ǡ†‡˜”‘‡‰‡„Ž‘‘–•–‡ŽŽ‹‰ƒƒ‹†‡”‹•Šƒ†‡Ž‹‰œ‘—’‡”•‘‡‘’Žƒ–‡”‡ Ž‡‡ˆ–‹Œ†‰‡˜‘‡Ž‹‰‡”ƒ‡˜‘‘”•–”‡••ȋ Žƒ•‡”ǡ˜ƒ•ǡ‘”–‡‰‹Œ•Ƭ›‹Ǧ ‡”‡›•ǡʹͲͲ͸Ǣ ”‹•–ׄƒŽǦƒ”˜ž‡œ‡–ƒŽǤǡʹͲͳ͸Ǣ˜ƒ‹‡”‘’‡–ƒŽǤǡʹͲͳͺǢƒ”†‹‘‹•ǡƒ–ƒ•–‡”ǡ‡‰‡Ž‡”•ǡ˜ƒ•ǡƬ ›‹Ǧ ‡”‡›•ǡʹͲͳ͵Ǣ‡‹‹‰Šƒ—•‡–ƒŽǤǡʹͲͳ͸ȌǤ‹†‡”‹•Šƒ†‡Ž‹‰„Ž‡‡‹‡‡”†‡”‘†‡”œ‘‡ ‹†‡”†ƒƒ†•ƒ‡–‡Šƒ‰‡‡–‰”‘–‡”‡‡‰ƒ–‹‡˜‡‡‘–‹‘‡Ž‡‡’•› Š‘–‹• Š‡”‡ƒ –‹‡•‘’ •–”‡••ȋ Žƒ•‡”‡–ƒŽǤǡʹͲͲ͸Ǣ”‹•–ׄƒŽǦƒ”˜ž‡œǡʹͲͳ͸Ǣ˜ƒ‹‡”‘’‡–ƒŽǤǡʹͲͳͺǡƒ”†‹‘‹•‡–ƒŽǤ ʹͲͳͳȌǡƒƒ”†‡•–ƒ–‹•–‹• Š‡ƒƒŽ›•‡†‹‡‰‡Šƒ–‡‡”†™‡”†‹†‹‡•–—†‹‡•™ƒ•‘‰‡Ž‹Œ‹‡– ‘’–‹ƒƒŽ˜‘‘”Š‡–ƒƒŽ›•‡”‡˜ƒ‹‡–Ǧ‘”ƒƒŽ˜‡”†‡‡Ž†‡†ƒ–ƒǤ ‡–†‘‡Ž˜ƒŠ‘‘ˆ•–—†”‹‡™ƒ• †ƒƒ”‘‘–‡–‡•–‡‘ˆǣͳȌ•–”‡••‰‡”‡Žƒ–‡‡”†‹•ƒƒ†‡‹–‡•‹–‡‹–˜ƒ‡‰ƒ–‹‡˜‡‡‘–‹‡‡ ’•› Š‘–‹• Š‡‡”˜ƒ”‹‰‡‹’ƒ–‹´–‡‡–ǢʹȌ†‡‡”•–˜ƒ‹•Šƒ†‡Ž‹‰‹†‡‹†‡”–‹Œ† †‡œ‡•–”‡••”‡ƒ –‹˜‹–‡‹–˜‡”‰”‘‘–‡͵Ȍ‡‡•–ƒ–‹•–‹• Š‡ƒƒŽ›•‡†‹‡‰‡• Š‹–‹•˜‘‘”‹‡–Ǧ‘”ƒƒŽ ˜‡”†‡‡Ž†‡†ƒ–ƒǡ†‡œ‡Žˆ†‡”‡•—Ž–ƒ–‡œ‘—‘’Ž‡˜‡”‡Ǥ Š‘‘ˆ†•–—˜‹‡”‘†‡”œ‘ Š–‡™‡‘ˆ‹•Šƒ†‡Ž‹‰‹†‡‹†‡”–‹Œ†‰‡”‡Žƒ–‡‡”†‹•ƒƒ ‡‡”‡‡œƒƒŠ‡‹†‹†‡˜‘Ž™ƒ••‡Š‡‹†‡‘ˆ‡‡œƒƒŠ‡‹†‘’Šƒƒ”„‡—”–™‡‡”‡‡” •›’–‘‡‹Š‡–†ƒ‰‡Ž‹Œ•Ž‡˜‡œ‘—˜‘‘”•’‡ŽŽ‡Ǥ‡”˜‘Ž‰‡•‘†‡”œ‘ Š–‡™‡‘ˆ†‡”‡Žƒ–‹‡ –—••‡‹•Šƒ†‡Ž‹‰‹†‡‹†‡”–‹Œ†‡’•› Š‘–‹• Š‡•›’–‘‡‹Š‡–†ƒ‰‡Ž‹Œ•Ž‡˜‡ ˜‡”Žƒƒ”†œ‘——‡™‘”†‡†‘‘”‡‡œƒƒŠ‡‹†‡‘ˆ†‡”‡Žƒ–‹‡–—••‡’•› Š‘–‹• Š‡ •›’–‘‡‡‡‡œƒƒŠ‡‹†˜‡”Žƒƒ”†ƒ™‘”†‡†‘‘”ƒ‰•–‹‰‡‡†‡’”‡••‹‡˜‡‰‡˜‘‡Ž‡•Ǥ Š‘‘ˆ†•–—˜‹Œˆ‘†‡”œ‘ Š–‡™‡‘ˆ‡‡˜‡”‹†‡”†‡–ƒŽ‹•‡”‡†˜‡”‘‰‡†‡ ”‡Žƒ–‹‡ƒ˜‡”Žƒ”‡–—••‡‹†‡”‹•Šƒ†‡Ž‹‰‡†‡ƒ–‡˜ƒ•‘ ‹ƒƒŽ†‹•ˆ— –‹‘‡”‡‡†‡ ‡”•–˜ƒŽ‹‹• Š‡•›’–‘‡„‹Œ˜‘Ž™ƒ••‡’ƒ–‹´–‡‡–ǤDoel III: Testen of Mentaliseren Bevorderende Therapie voor psychotische stoornis (MBTp)

een effectieve aanvulling is op de gebruikelijke behandeling met betrekking tot sociaal A disfunctioneren en beperkt mentaliserend vermogen.

Treatment as Usual ‡‡Ž Š‡„„‡™‡‰‡–‡•–‘ˆ†‡ –‘‡˜‘‡‰‹‰˜ƒ’ƒƒ ȋȌœ‘—Ž‡‹†‡–‘–‡‡‰”‘–‡”‡˜‡”„‡–‡”‹‰‘’ ‰‡„‹‡†˜ƒ•‘ ‹ƒƒŽˆ— –‹‘‡”‡‡‡–ƒŽ‹•‡”‡†˜‡”‘‰‡ȋƒƒ•–ƒ†‡”‡—‹–‘•–˜ƒ”‹ƒ„‡Ž‡ȌǤ Belangrijkste meetinstrumenten van het proefschrift Sociaal functioneren. Social Functioning Scale

‡ƒ–‡˜ƒ•‘ ‹ƒƒŽˆ— –‹‘‡”‡™‡”†‰‡‡–‡ƒƒ†‡Šƒ†˜ƒ†‡  ȋ Ȍǡ‡‡œ‡Žˆ”ƒ’’‘”–ƒ‰‡Ǧ˜”ƒ‰‡Ž‹Œ•–ȋ‹” Š™‘‘†ǡ‹–Šǡ‘ Š”ƒ‡ǡ‡––‘Ƭ‘’‡•–ƒ‡ǡͳͻͻͲȌ †‹‡œ‡˜‡†‹‡•‹‡•˜ƒ•‘ ‹ƒƒŽˆ— –‹‘‡”‡‡‡–ǡ–‡™‡–‡ǣ–‡”—‰–”‡‹‰—‹–•‘ ‹ƒŽ‡•‹–—ƒ–‹‡•ǡ ‹–‡”’‡”•‘‘Ž‹Œ‡ ‘—‹ ƒ–‹‡ǡ˜‡”‘‰‡–‘–ƒ—–‘‘‘ˆ— –‹‘‡”‡ǡ†ƒƒ†™‡”‡Ž‹Œ

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146807_JonasWeijers_BNW_def.indd 189 28-10-2020 15:09 Summary in Dutch

ƒ—–‘‘‘ˆ— –‹‘‡”‡ǡ”‡ ”‡ƒ–‹‡˜‡ƒ –‹˜‹–‡‹–‡ǡ•‘ ‹ƒŽ‡ƒ –‹˜‹–‡‹–‡‡™‡”Ǥ‡ ƒƒ– ‰‡„”—‹˜ƒ ‘ ”‡–‡˜‘‘”„‡‡Ž†‡‘Š‡–•‘ ‹ƒƒŽˆ— –‹‘‡”‡–‡„‡‘‘”†‡Ž‡ȋ„‹Œ˜‘‘”„‡‡Ž††‡ Š‘‡˜‡‡ŽŠ‡‹†˜”‹‡†‡‘ˆ†‡–‹Œ††‹‡’‡”†ƒ‰ƒŽŽ‡‡†‘‘”‰‡„”ƒ Š–™‘”†–Ȍœ‘†ƒ–•—„Œ‡ –‹‡˜‡ ‘‘”†‡Ž‡œ‘˜‡‡Ž‘‰‡Ž‹Œ˜‡”‡†‡—‡™‘”†‡Ǥ†‡”œ‘‡Š‡‡ˆ–ƒƒ‰‡–‘‘††ƒ–†‡  „‡–”‘—™„ƒƒ”‡˜ƒŽ‹†‡‹•‡†ƒƒ”ƒƒ•–‰‡˜‘‡Ž‹‰‰‡‘‡‰‘˜‡”ƒ†‡”‹‰‡†‘‘”†‡–‹Œ†Š‡‡‘’ –‡’‹‡ȋ‹” Š™‘‘†‡–ƒŽǤǡͳͻͻͲȌǤ‡ƒŽ‰‡‡‡• ‘”‡˜‘‘”•‘ ‹ƒƒŽˆ— –‹‘‡”‡™‘”†–„‡’ƒƒŽ† †‘‘”Š‡–‰‡‹††‡Ž†‡–‡‡‡˜ƒƒŽŽ‡†‹‡•‹‡•Ǥ Meting van mentaliserend vermogen

‡–‡–‡˜ƒ‡–ƒŽ‹•‡”‡†˜‡”‘‰‡•–ƒƒ–‘‰‹†‡‹†‡”• Š‘‡‡Ǥ”‹•–‘–—–‘‡™‡‹‹‰ ‘•‡•—•‘˜‡”Š‘‡‡–ƒŽ‹•‡”‡†˜‡”‘‰‡Š‡–„‡•–ƒ™‘”†‡‰‡‡–‡Ǥ ‡–‡–‡˜ƒŠ‡– ˜‡”‘‰‡‘–‡‡–ƒŽ‹•‡”‡‘’„ƒ•‹•˜ƒœ‡Žˆ”ƒ’’‘”–ƒ‰‡‹•–”—‡–‡‹•‘‡‹Ž‹Œǡ‘†ƒ–Š‡– ‡‹‰‡–ƒŽ‹•‡”‡†˜‡”‘‰‡˜‡”‡‹•–‘–‡„‡‰”‹Œ’‡™ƒƒ”Š‡–‡‹‰‡‡–ƒŽ‹•‡”‡†˜‡”‘‰‡ –‡‘”–• Š‹‡–Ǥƒ†‡ƒ†‡”‡ƒ–œ‹Œ˜‡‡Ž‰‡„”—‹–‡‹‡–Ǧœ‡Žˆ”ƒ’’‘”–ƒ‰‡‹•–”—‡–‡‡”‰ ˜‡”• Š‹ŽŽ‡†‡Š‡„„‡†‹™‹ŒŽ••Ž‡ Š–‡’•› Š‘‡–”‹• Š‡‡‹‰‡• Šƒ’’‡Ǥ‡œ‹Œ„‹Œ˜‘‘”„‡‡Ž† ‹‡–„‡–”‘—™„ƒƒ”‘ˆ‡–‡‹‡–™ƒ–œ‡„‡‘‰‡–‡‡–‡ȋ ”‡‡‡–ƒŽǡʹͲͲͺǢ ‘”ƒƬ ”‡‡ǡ ʹͲͳͻȌǤ‡‹•–”—‡–‡˜‘‘”Š‡–‡–‡˜ƒ‡–ƒŽ‹•‡”‡†˜‡”‘‰‡†‹‡‹†‹–’”‘‡ˆ• Š”‹ˆ– ™‘”†‡‰‡„”—‹–ǡ˜‡”†‹‡‡†—•‡‹‰‡ƒƒ†ƒ Š–Ǥ  ‡‡”‡ ‡–‰”‘‘–• ŠƒŽ‹‰‘†‡”œ‘‡ƒƒ”†‡’•› Š‘‡–”‹• Š‡‡‹‰‡• Šƒ’’‡˜ƒHinting Task ˜‡‡Ž‰‡„”—‹–‡‹•–”—‡–‡‘Š‡–‡–ƒŽ‹•‡”‡†˜‡”‘‰‡–‡‡–‡ǡ™‡”††‡  ȋ Ǣ‘” ‘”ƒǡ‡” ‡”ǡƬ ”‹–Šǡ1995) als een van de weinige instrumenten ‘goed genoeg’ „‡˜‘†‡˜‘‘”‰‡„”—‹‹Ž‹‹• Š‘†‡”œ‘‡ȋ‹Šƒ‡–ƒŽǤǡʹͲͳ͵ȌǤ‡ „‡˜ƒ––‹‡‘”–‡ ’ƒ••ƒ‰‡•ǡ™ƒƒ”„‹Œ‡Ž‡’ƒ••ƒ‰‡‡‡‹–‡”ƒ –‹‡–—••‡–™‡‡’‡”•‘ƒ‰‡•™‡‡”‰‡‡ˆ–†‹‡†‘‘”†‡ ”‡•’‘†‡–‘‡–™‘”†‡‰‡Ã–‡”’”‡–‡‡”†Ǥ‡’‡”•‘ƒ‰‡•„‡†‘‡Ž‡‹†‡œ‡’ƒ••ƒ‰‡•‹‡–•ƒ†‡”• †ƒ†ƒ–œ‹ŒŽ‡––‡”Ž‹Œœ‡‰‰‡Ǥ–‡—‡„‡‰”‹Œ’‡™ƒ–†‡’‡”•‘ƒ‰‡•‹†‡’ƒ••ƒ‰‡• „‡†‘‡Ž‡ǡ‘‡–‡”‡•’‘†‡–‡œ‹ Š‹†‡’‡”•‘ƒ‰‡—‡˜‡”’Žƒƒ–•‡Ǥ‡˜‘‘”„‡‡Ž†ǣ  ‡–‡”‘–Š‡–ƒ–‘‘”˜ƒ‡–„‹‡ƒ‡‡Žƒ‰‡œ™ƒ”‡”‡‹•Ǥ‡–„‡‰‹–†‹”‡ ––‡ ˜ertellen over een aantal zakelijke ontwikkelingen. Peter onderbreekt Annet met een: “Tjonge, jonge, dat was me een lange zware reis”. Wat bedoelde Peter werkelijk toen hij dit zei? ȋ‘” ‘”ƒǡ ‡” ‡”ǡƬ ”‹–ŠǡͳͻͻͷȌǤ

 ‡ ‡‡–†—•Š‡–˜‡”‘‰‡‘‡‡‹†‡‡Theory of Mind –‡˜‘”‡‘˜‡”™ƒ–‡”‘‰ƒƒ–‹ƒ†‡”ƒ•‰‡‡•–ǡ ook wel ‘ ’ genoemd. In feite gaat het hier om een cognitief, op anderen ‰‡‘”‹´–‡‡”†ƒ•’‡ –˜ƒ‡–ƒŽ‹•‡”‡Ǥ‡ –‘‘†‡˜‘Ž†‘‡†‡–‡•–ǦŠ‡”–‡•–„‡–”‘—™„ƒƒ”Š‡‹†ǡ •Ž‡ Š–•Ž‡‹‡Ž‡‡”‡ˆˆ‡ –‡ǡ‡‡•–‡”‡”‡Žƒ–‹‡‡–•‘ ‹ƒƒŽˆ— –‹‘‡”‡‡‘‘˜‘Ž†‘‡†‡

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146807_JonasWeijers_BNW_def.indd 190 28-10-2020 15:09 Summary in Dutch

‰‡˜‘‡Ž‹‰Š‡‹†‘’ƒ–‹´–‡–‡—‡‘†‡”• Š‡‹†‡˜ƒ‡•‡œ‘†‡”ȋ‹Šƒ ‡–ƒŽǤǡʹͲͳ͵ȌǤ‡ ™‘”†–‡ Š–‡”‘‘„‡”‹–‹•‡‡”†‘†ƒ–Š‹Œ–‡ƒ‡Ž‹Œœ‘—œ‹Œǡ™ƒ–ƒ leiden tot ‘plafondeffecten’ (bijv. Roberts & Penn,Theory 2009). of MindDe HT wordt gescoord op een 20Ǧ ’—–•• ŠƒƒŽǡ™ƒƒ”„‹ŒŠ‘‰‡”‡• ‘”‡•‡‡„‡–‡”‡ ˜‡”–‡‰‡™‘‘”†‹‰‡Ǥ ‡––™‡‡†‡‹•–”—‡–†ƒ–™‡Š‡„„‡‰‡„”—‹–˜‘‘”Š‡–‡–‡˜ƒ‡–ƒŽ‹•‡”‡†Social Cognition and Object-Relations Scale ˜‡”‘‰‡‹•†‡ ȋȌǡ†‹‡‰‡„”—‹–ƒ™‘”†‡ ‘ƒ””ƒ–‹‡˜‡˜ƒ’ƒ–‹´–‡–‡ƒƒŽ›•‡”‡‡–‡„‡‘‘”†‡Ž‡Ǥƒ””ƒ–‹‡˜‡–‡‰‡‡”‡”‡‹• ‰‡„”—‹‰‡ƒƒ–˜ƒ†‡Š‡ƒ–‹• Š‡’’‡” ‡’–‹‡Ǧ‡•–ȋǢ—””ƒ›ǡͳͻͶ͵ȌǤ‡‹•‡‡ œ‘‰‡ƒƒ†‡‘projectieve’ taak die bestaat uit zwartǦ™‹–ˆ‘–‘̵•˜ƒƒ„‹‰—‡ǡ˜‡‡ŽƒŽ•‘ ‹ƒŽ‡ •‹–—ƒ–‹‡•œ‘ƒŽ•‡•‡‹‡‡Žƒ†• Šƒ’Ǥ –‘–ƒƒŽœ‹Œ‡”œ‡•’Žƒ–‡‰‡„”—‹–Ǥ‡•’‘†‡–‡ ™‘”†‡†ƒƒ”„‹Œ‘†‡”ƒ†‡”‡‰‡˜”ƒƒ‰†‘–‡„‡• Š”‹Œ˜‡™ƒ–‡”‰‡„‡—”–‘’†‡’Žƒƒ–ǡ™ƒ–‡” ‘‰ƒƒ–‹†‡’‡”•‘‡‘’†‡’Žƒƒ–ǡ™ƒ–‡”˜‘‘”ƒˆ‹•‰‡‰ƒƒƒƒ†‡’Žƒƒ–‡Š‘‡†‡•‹–—ƒ–‹‡‘’†‡ ’Žƒƒ–ƒˆŽ‘‘’–Ǥ ‡–‹•˜ƒƒ‹‡–Š‡Ž‡ƒƒŽ†—‹†‡Ž‹Œ™ƒ–†‡•‹–—ƒ–‹‡•’”‡ ‹‡•˜‘‘”•–‡ŽŽ‡‡†‡ ’Žƒ–‡—‡†—•‘’‡‡”†‡”‡ƒ‹‡”‡‰‡Ã–‡”’”‡–‡‡”†™‘”†‡Ǥ‡’ƒ–‹´–‘‡–†—•œ‡Žˆ ‹˜—ŽŽ‹‰‰‡˜‡ƒƒŠ‡–‰‡‡†ƒ–ƒˆ‰‡„‡‡Ž†™‘”†–Ǥ‡–„‡Š—Ž’˜ƒ†‡ƒ˜‡”˜‘Ž‰‡• ontleed worden in welke mate patiënten een ‘psychoǦlogisch’ verhaal kunnen vertellen over de ’Žƒ–‡Ǥ Š‡–•›•–‡‡˜ƒ™‘”†‡˜‹‡”†‹‡•‹‡•˜ƒ•‘ ‹ƒƒŽ ‘‰‹–‹‡ˆ˜‡”‘‰‡ ‘†‡”• Š‡‹††‡ǣŠ‡–˜‡”‘‰‡‘‡‡„‡‡Ž†–‡˜‘”‡˜ƒ†‡’•› Š‘Ž‘‰‹• Š‡†”‹Œˆ˜‡”‡˜ƒ ƒ†‡”‡‡Š‡–˜‡”‘‰‡‘‘’„ƒ•‹•†ƒƒ”˜ƒ‡‡Ž‘‰‹• Š‡‡‰‡Ž‘‘ˆ™ƒƒ”†‹‰‡˜‡”Žƒ”‹‰˜‘‘” gedrag te kunnen geven (ook wel ‘begrip van sociale causaliteit genoemd’); het vermogen ‘†‡”• Š‡‹†–‡—‡ƒ‡–—••‡Š‡–‡‹‰‡’‡”•’‡ –‹‡ˆ‡†ƒ–˜ƒ†‡ƒ†‡”ȋ†‡ ‘complexiteit van representaties’); de mate waarin sociale interactie als goedaardig gezien wordt (de ‘affectǦ–‘‘˜ƒ”elaties’) en in hoeverre er sprake is van morele standaarden waarbij

de ander gezien wordt als een doel op zich en niet als een middel (het ‘vermogen tot emotioneel A investeren’). Deze vier dimensies van mentaliserend vermogen werden gescoord op een ˜‹ŒˆǦ ’—–•• ŠƒƒŽǡ™ƒƒ”„‹ŒŠ‘‰‡”‡• ‘”‡•‘‘Š‘‰‡”‡•‘ ‹ƒŽ‡ ‘‰‹–‹‡˜‡ ƒ’ƒ ‹–‡‹–‡ ˜‡”–‡‰‡™‘‘”†‹‰‡Ǥ ‡™‘”†–‹†‡”˜ƒƒ‰‡„”—‹–˜ƒ™‡‰‡œ‹Œ–‹Œ†”‘˜‡†‡‡’”‘Œ‡ –‹‡˜‡ƒƒ”†‡ ™‘”†–†ƒƒ”‘˜ƒƒ‘˜‡”‰‡•Žƒ‰‡„‹Œ„‡‘‘”†‡Ž‹‰‡˜ƒ‡‡–‹•–”—‡–‡ȋœ‹‡„‹Œ˜Ǥ‹Šƒ‡– ƒŽǤǡʹͲͳ͵Ǣ ‘”ƒǡƬ ”‡‡ʹͲͳͻȌǤ‹–‹•Œƒ‡”‘†ƒ–Š‡–‰‘‡†„‡•–—†‡‡”†‡‡˜‘Ž†‘‡†‡ ƒ†‡“—ƒ–‡’•› Š‘‡–”‹• Š‡‡‹‰‡• Šƒ’’‡„‡œ‹–Ǥ†‡”œ‘‡™‹Œ•–—‹–†ƒ–Š‡–‡‡˜ƒŽ‹†‡‡ „‡–”‘—™„ƒƒ”‹•–”—‡–‹•‘•‘ ‹ƒŽ‡ ‘‰‹–‹‡–‡‡–‡ȋ‡›‡”ǡʹͲͲͶȌ‡–‡‡‰‘‡†‡‹–‡”‡ ‘•‹•–‡–‹‡–—••‡’Žƒ–‡ȋ ‹„„ƒ”†ǡ‹– Š‡ŽŽƬ‘” ‡”‡ŽŽ‹ǡʹͲͲͳȌ‡‡‡‰‘‡†‡ȋ ‹„„ƒ”†‡–ƒŽǤǡ ʹͲͲͳȌ–‘–—‹–•–‡‡†‡ȋ‡›‡”ǡʹͲͲͶȌ„‡–”‘—™„ƒƒ”Š‡‹†–—••‡„‡‘‘”†‡Žƒƒ”•˜ƒƒ””ƒ–‹‡˜‡Ǥ ‡Žƒ‰”‹Œ‹•‘‘‘–‡˜‡”‡Ž†‡†ƒ–˜‘Ž‰‡•—›–‡ǡ ‘ƒ‰›ǡ‘™› ‡‡”‘–‡ȋʹͲͳʹȌ†‡

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‡‡˜ƒ†‡™‡‹‹‰‡–‡•–‡‹•†‹‡˜”‹Œ™‡ŽƒŽŽ‡ƒ•’‡ –‡˜ƒŠ‡–‡–ƒŽ‹•‡”‡†˜‡”‘‰‡ ‡‡–ǡœ‘™‡Ž†‡ ‘‰‹–‹‡˜‡ƒ•’‡ –‡ȋ‰‡‡–‡†‘‘” ‘’Ž‡š‹–‡‹–˜ƒ”‡’”‡•‡–ƒ–‹‡•‡„‡‰”‹’ ˜ƒ•‘ ‹ƒŽ‡ ƒ—•ƒŽ‹–‡‹–ȌƒŽ•†‡ƒˆˆ‡ –‹‡˜‡ƒ•’‡ –‡ȋ‰‡‡–‡†‘‘”ƒˆˆ‡ –Ǧ–‘‘˜ƒ”‡Žƒ–‹‡•‡ ˜‡”‘‰‡–‘–‡‘–‹‘‡‡Ž‹˜‡•–‡”‡ȌǤ Mishandeling in de kindertijd Childhood Experience of Care and Abuse

‡ ȋǢ‹Žˆ—Ž ‘ǡ”‘™Ƭ ƒ””‹•ǡͳͻͻͶȌ‹•‡‡ ”‡–”‘•’‡ –‹‡ˆǡ•‡‹Ǧ‰‡•–”— –—”‡‡”†‹–‡”˜‹‡™™ƒƒ”‡‡‘†‡”œ‘‡‡”•†‡‡”•–˜ƒ‘‰‡Ž‹Œ ‹•„”—‹‡‹•Šƒ†‡Ž‹‰‘’†‡Ž‡‡ˆ–‹Œ†˜ƒͲǦͳ͸Œƒƒ”—‡„‡‘‘”†‡Ž‡Ǥ‡„”‡‰–†‡ ƒ–‡˜ƒ‘—†‡”Ž‹Œ ‘ˆŽ‹ –ǡˆ›•‹‡‡‹•Šƒ†‡Ž‹‰ǡ•‡•—‡‡Ž‹•„”—‹‡’•› Š‘Ž‘‰‹• Š‡ ‹•Šƒ†‡Ž‹‰‹ƒƒ”–Ǥ ›•‹‡‡‹•Šƒ†‡Ž‹‰™‡”††ƒƒ”„‹Œ‰‡†‡ˆ‹‹‡‡”†ƒŽ•ˆ›•‹‡‰‡™‡Ž†‡– Ž‹ Šƒ‡Ž‹ŒŽ‡–•‡Ž–‘–‰‡˜‘Ž‰Ǥ‡•—‡‡Ž‹•„”—‹™‡”†‰‡†‡ˆ‹‹‡‡”†ƒŽ•‡‡•‡•—‡‡Ž‹ ‹†‡–†ƒ– †‘‘”†‡’ƒ”–‹ ‹’ƒ–ƒŽ•‘‰‡™‡•–™‡”†‡”˜ƒ”‡Ǥ—†‡”Ž‹Œ ‘ˆŽ‹ –™‡”†‰‡†‡ˆ‹‹‡‡”†ƒŽ•†‡ Š‘‡˜‡‡ŽŠ‡‹†”—œ‹‡•–—••‡†‡œ‘”‰˜‡”Ž‡‡”•ȋ‘‰‡Ž‹Œ‹ Ž—•‹‡ˆŠ‡–‹†ȌǤ•› Š‘Ž‘‰‹• Š‡ ‹•Šƒ†‡Ž‹‰™‡”†‰‡†‡ˆ‹‹‡‡”†ƒŽ•‡š–”‡‡”‹–‹‡ǡƒˆ™‹Œœ‹‰ǡ‘ˆ˜‡”‡†‡”‹‰Ǥ  ƒ‡Ž–›’‡‹•Šƒ†‡Ž‹‰™‡”†œ‘™‡Ž‹–‡•‹–‡‹–ƒŽ•ˆ”‡“—‡–‹‡‹ƒƒ”–‰‡„”ƒ Š–Ǥ‡ ˆ”‡“—‡–‹‡˜ƒ‹•Šƒ†‡Ž‹‰™‡”†„‡‘‘”†‡‡Ž†‘’‡‡˜‹Œˆ’—–•• ŠƒƒŽǣͲȋ‘‘‹–Ȍǡͳȋœ‡Ž†‡ǣ±± ‘ˆ–™‡‡‡‡”Ȍǡʹȋ‹ ‹†‡–‡‡Žǣ‡‡”†ƒ–™‡‡‡‡”ǡƒƒ”‹‡–ƒƒ†‡Ž‹Œ•Ȍǡ͵ȋ”‡‰‡Žƒ–‹‰ǣ ƒƒ†‡Ž‹Œ•‘ˆ˜ƒ‡”Ȍ‘ˆͶȋ˜ƒƒǣ™‡‡Ž‹Œ•‘ˆ˜ƒ‡”ȌǤ‡‹–‡•‹–‡‹–˜ƒ‹•„”—‹™‡”† „‡‘‘”†‡‡Ž†‘’‡‡˜‹‡”’—–•• ŠƒƒŽǣͲȋ‰‡‡Ȍǡͳȋ‡‹‰•œ‹•Ȍǡʹȋƒ–‹‰Ȍ‘ˆ͵ȋ‡”•–‹‰Ȍǡ‡– —‹–œ‘†‡”‹‰˜ƒ‘—†‡”Ž‹Œ ‘ˆŽ‹ –ǡ†ƒ–™‡”†‰‡• ‘‘”†‘’‡‡˜‹Œˆ’—–•• ŠƒƒŽ†‹‡‘‘Ͷȋ‰‡™‡Ž†Ȍ „‡˜ƒ––‡Ǥ ‡–’”‘†— –˜ƒ‹–‡•‹–‡‹–‡ˆ”‡“—‡–‹‡•ƒ‡„‡’ƒƒŽ†‡†‡–‘–ƒƒŽ• ‘”‡˜ƒ ‹•Šƒ†‡Ž‹‰‹†‡‹†‡”–‹Œ†ǡ‡˜ƒ”‹‡‡”†‡–—••‡†‡Ͳ‡ͷʹǡ™ƒƒ”„‹ŒŠ‘‰‡”‡• ‘”‡•‡”•–‹‰‡” ˜‘”‡˜ƒ‹•Šƒ†‡Ž‹‰˜‡”–‡‰‡™‘‘”†‹‰†‡Ǥ‡‹•„‡–”‘—™„ƒƒ”‡˜ƒŽ‹†‡„‡˜‘†‡ †‘‘”†‡‘–™‹‡Žƒƒ”•ȋ‹ˆ—Ž ‘ǡ”‘™Ƭ ƒ””‹•ǡͳͻͻͶȌǤ Klinische symptomen en ziekte-inzicht Positive and Negative Syndrome Scale

‡ ȋǢƒ›ǡ ‹•œ„‡‹ǡƬ’ˆ‡”ǡͳͻͺ͹Ȍ‹•‰‡„”—‹–‘ †‡Ž‹‹• Š‡•›’–‘‡‡œ‹‡–‡Ǧ‹œ‹ Š–‹ƒƒ”––‡„”‡‰‡Ǥ ‡–‹•‡‡•‡‹Ǧ‰‡•–”— –—”‡‡”† ‹–‡”˜‹‡™†ƒ–˜‡‡Ž‰‡„”—‹–‹‘†‡”œ‘‡ƒƒ”‘†ƒ–Š‡–‰‘‡†‡’•› Š‘‡–”‹• Š‡ ™ƒŽ‹–‡‹–‡ǡ„‡œ‹–ȋ‡”ƒŽ–ƒƬ—‡•–ƒǡͳͻͻͶȌǤ‡Š‡„„‡†‡•’‡ ‹ˆ‹‡‰‡„”—‹–‘†‡‡”•– ˜ƒ’‘•‹–‹‡˜‡•›’–‘‡ǡ‡‰ƒ–‹‡˜‡•›’–‘‡ǡ†‡’”‡••‹‡ǡƒ‰•–‡‰‡„”‡ƒƒœ‹‡–‡Ǧ‹œ‹ Š– in kaart te brengen. In dit instrument bevatten de dimensies ‘positieve symptomen’ en ‘negatieve symptomen’ elk zeven items (zie Weijers et al. 2016 voor meer informatie). Angst, †‡’”‡••‹‡‡‰‡„”‡‹‰œ‹‡–‡Ǧ‹œ‹ Š–™‡”†‡ƒŽŽ‡‡–±±‹–‡‰‡‡–‡ǤŽ‹–‡™‡”† ‰‡‡–‡‡–œ‡˜‡’—–•• ŠƒŽ‡ǡ™ƒƒ”„‹Œͳ†‡ƒˆ™‡œ‹‰Š‡‹†˜ƒŠ‡–•›’–‘‘

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˜‡”–‡‰‡™‘‘”†‹‰†‡‡͹‡‡œ‡‡”‡”•–‹‰‡ƒ–‡Ǥ‘‘”†‹–’”‘‡ˆ• Š”‹ˆ–‹•‰‡„”—‹‰‡ƒƒ–˜ƒ ‡‡‡†‡”Žƒ†•‡˜‡”•‹‡ȋ‘Ž–Šƒ—•ǡ‹‰‡ƒ•Ƭ Š‡‡ǡʹͲͲͲȌǤ Experience Sampling: psychotische ervaringen, negatief en positief affect, eenzaamheid, middelengebruik, verscheidene types stress en stressreactiviteit.

†‹–’”‘‡ˆ• Š”‹ˆ–Š‡„„‡™‡–‡˜‡•‰‡„”—‹‰‡ƒƒExperience Sampling Method –˜ƒ‡‡‹–‡•‹‡˜‡†ƒ‰„‘‡‡–Š‘†‡ǡ†‡ ‘ ’ (ESM). Gevoelens en psychiatrische symptomen zoals ‡‡œƒƒŠ‡‹†ǡƒ‰•–‘ˆŠ‡–Š‘”‡˜ƒ•–‡‡œ‹Œ’‡”†‡ˆ‹‹–‹‡–‹Œ†‡Ž‹Œ‡–‘‡•–ƒ†‡†‹‡ǡ ƒˆŠƒ‡Ž‹Œ˜ƒ†‡ ‘–‡š–ǡ—‡ˆŽ— –—‡”‡‰‡†—”‡†‡†‡†ƒ‰Ǥ‡Š‡„„‡†ƒƒ”‘‡‡ ‡Ž‡–”‘‹• Š†ƒ‰„‘‡ǡ†‡̵•›ƒ–‡̵‰‡„”—‹–‘‡”˜ƒ”‹‰‡˜ƒ’ƒ”–‹ ‹’ƒ–‡‹Š—†ƒ‰‡Ž‹Œ• Ž‡˜‡˜ƒ•––‡Ž‡‰‰‡Ǥ‹Œ†‡•˜‹‡”‡‡–’‡”‹‘†‡•˜‡”•’”‡‹†‘˜‡”–™‡‡Œƒƒ”ǡ™‡”†ƒƒ’ƒ–‹´–‡ ‰‡˜”ƒƒ‰†‘†‡•›ƒ–‡‰‡†—”‡†‡œ‡•†ƒ‰‡„‹Œœ‹ Š–‡Š‘—†‡Ǥ‹‡‡‡”’‡”†ƒ‰‰‡‡”‡‡”†‡ †‡•›ƒ–‡‡‡‰‡Ž—‹†••‹‰ƒƒŽȋ‡‡’‹‡’Ȍ‘’‘˜‘‘”•’‡Ž„ƒ”‡‘‡–‡Ǥƒƒ”‘’‘‡•–‡ ’ƒ”–‹ ‹’ƒ–‡ƒ–™‘‘”†‡‰‡˜‡‘’˜‡”• Š‡‹†‡‡˜”ƒ‰‡‘˜‡”Š—‰‡‘‡†•–‘‡•–ƒ†Ǥ‡”†‡” ‘†‡”œ‘‡Š‡‡ˆ–ƒƒ‰‡–‘‘††ƒ–‡‡„‡–”‘—™„ƒ”‡‡˜ƒŽ‹†‡‡–Š‘†‡‹•˜‘‘”‡–‹‰‡„‹Œ ’‡”•‘‡‡–’•› Š‘–‹• Š‡•–‘‘”‹••‡ȋ‡Ž‡•’ƒ—Žǡ†‡”‹‡•ǡƬ˜ƒ•ǡʹͲͲʹǢ‹Š›‡–ƒŽǤǡʹͲͲ͸Ǣ Š‡™‹••‡‡–ƒŽǤǡʹͲͳͳȌǤ†ƒ–’”‘‡ˆ’‡”•‘‡Š‡”ŠƒƒŽ†‡Ž‹Œ‰‡˜”ƒƒ‰†™‘”†‡‘˜”ƒ‰‡Ž‹Œ•–‡ ‹–‡˜—ŽŽ‡‹Š—ƒ–——”Ž‹Œ‡‘‰‡˜‹‰ǡ‹•‡‡”‡ ‘Ž‘‰‹• Š˜ƒŽ‹†‡†ƒ†‡‡‡•–‡ ‡‡–‹•–”—‡–‡†‹‡˜ƒƒ‹‡‡‹•–‡ŽŽ‹‰‘ˆ—‹˜‡”•‹–‡‹–™‘”†‡ƒˆ‰‡‘‡Ǥ ‹‡”‘†‡” „‡• Š”‹Œ˜‡™‡‡‡Ž‡˜ƒ”‹ƒ„‡Ž‡†‹‡‰‡‡–‡œ‹Œ‡–„‡Š—Ž’˜ƒ†‡•›ƒ–‡‡†‹‡ƒƒ„‘† komen in dit proefschrift. Alle vragen of stelling, voortaan ‘items’ genoemd, werden gemeten op ‡‡œ‡˜‡’—–•• ŠƒƒŽȋͳαŠ‡Ž‡ƒƒŽ‹‡–ǡ͹αPsychotische ervaringen. Š‡‡Ž‡”‰Ȍǡ–‡œ‹Œƒ†‡”•ƒƒ‰‡‰‡˜‡Ǥ  ƒ’ƒ”–‹ ‹’ƒ–‡™‡”†‰‡˜”ƒƒ‰†‘†‡‡”•–˜ƒŠ— ’•› Š‘–‹• Š‡‡”˜ƒ”‹‰‡‘’†ƒ–‘‡––‡„‡‘‘”†‡Ž‡‡–†‡˜‘Ž‰‡†‡œ‡˜‡‹–‡•ǣ̵ ˜‘‡Ž‡

ƒ Š–‡”†‘ Š–‹‰̵ǡ̵ „‡„ƒ‰‘†‡ ‘–”‘Ž‡–‡˜‡”Ž‹‡œ‡̵ǡ̵ ˜‘‡Ž†ƒ–ƒ†‡”‡‡‹‡–‘‰‡̵ǡ A ̵ ˜‘‡Ž†ƒ–ƒ†‡”‡‡’‹Œ™‹ŽŽ‡†‘‡̵ǡ̵‹Œ‰‡†ƒ Š–‡™‘”†‡„‡Ã˜Ž‘‡††‘‘”ƒ†‡”‡ ‡•‡̵ǡ̵ ˜‘‡Ž‡‘™‡”‡Ž‹Œ̵‡̵ Š‘‘”•–‡‡̵Ǥ‡‰‡‹††‡Ž†‡• ‘”‡˜ƒ†‡œ‡‹–‡• „‡’ƒƒŽ†‡†‡–‘–ƒŽ‡• ‘”‡˜ƒDepressieve en angstige’•› Š‘–‹• Š‡‡”˜ƒ”‹‰‡Ǥ gevoelens.   ‡ƒ–‡˜ƒ˜ƒ†‡’”‡••‹‡˜‡‡ƒ‰•–‹‰‡‰‡˜‘‡Ž‡•Ǥ ™‡”†‡„‡‘‘”†‡‡Ž††‘‘”†‡ƒˆœ‘†‡”Ž‹Œ‡‹–‡•̵ ˜‘‡Ž‡‡‡”•Žƒ Š–‹‰̵‡̵ ˜‘‡Ž‡ƒ‰•–‹‰̵ǤEenzaamheid   Ǥ‡ƒ–‡˜ƒ‡‡œƒƒŠ‡‹†™‡”†‰‡‡–‡‡–Š‡–‹–‡̵ ˜‘‡Ž‡ ‡‡œƒƒ̵ǤMiddelengebruik.  ‹Œ‡Ž‡’‹‡’™‡”†‡–„‡Š—Ž’˜ƒ ƒ–‡‰‘”‹• Š‡‹–‡•—‹–‰‡˜”ƒƒ‰†‘ˆ ’ƒ”–‹ ‹’ƒ–‡•‹†•†‡Žƒƒ–•–‡’‹‡’‹††‡Ž‡Šƒ††‡‰‡„”—‹–ǡ™ƒƒ”‘†‡”ǣȋͳȌ ƒˆ‡Ã‡ǡȋʹȌ ‹ ‘–‹‡ǡȋ͵Ȍ‡†‹ ƒ–‹‡ǡȋͶȌƒŽ ‘Š‘ŽǡȋͷȌ ƒƒ„‹•ǡȋ͸Ȍƒ†‡”‡†”—‰•ǡ‘ˆȋ͹Ȍ‰‡‡Ǥ

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Sociale stress.

 ƒ”–‹ ‹’ƒ–‡™‡”†‰‡˜”ƒƒ‰†‹–‡˜—ŽŽ‡‘ˆœ‡ƒŽŽ‡‡™ƒ”‡‘ˆ‹ ‰‡œ‡Ž• Šƒ’˜ƒƒ†‡”‡Ǥƒ‡‡”œ‹Œ‹Š‡–‰‡œ‡Ž• Šƒ’˜ƒƒ†‡”‡˜‡”‡‡”†‡™‡”†•‘ ‹ƒŽ‡ •–”‡••˜‡”˜‘Ž‰‡•‰‡‡–‡‡–†‡‹–‡•ǣ̵ œ‘—Ž‹‡˜‡”ƒŽŽ‡‡œ‹Œ̵‡̵ Š‡–‰‡œ‡Ž• Šƒ’™ƒƒ”‹ ‹‘‡–‡‡Ž˜‡”‡‡”Activiteit-gerelateerde’”‡––‹‰̵ȋ‘‰‡‡‡”†‰‡ ‘†‡‡”†ȌǤ stress.   ‡ƒ–‡˜ƒƒ –‹˜‹–‡‹–Ǧ‰‡”‡Žƒ–‡‡”†‡•–”‡•• ™‡”†„‡‘‘”†‡‡Ž† ƒƒ†‡Šƒ†˜ƒ†”‹‡‹–‡•‡–„‡–”‡‹‰–‘–†‡ƒ –‹˜‹–‡‹–†‹‡’ƒ”–‹ ‹’ƒ–‡‘’†ƒ–‘‡– ‘†‡”ƒ‡Ǥ Š‡–„‹Œœ‘†‡”„‡‘‘”†‡‡Ž†‡’ƒ”–‹ ‹’ƒ–‡Š‘‡„‡™ƒƒœ‡œ‹ Š˜‘‡Ž†‡‹Š‡– †‘‡˜ƒŠ—Š—‹†‹‰‡ƒ –‹˜‹–‡‹–ȋ̵ „‡‹‡–„‡™ƒƒ‘†‡œ‡ƒ –‹˜‹–‡‹––‡†‘‡̵ȌǡŠ‘‡‘‡‹Ž‹Œ Š—Š—‹†‹‰‡ƒ –‹˜‹–‡‹–™ƒ•ȋ̵‡œ‡ƒ –‹˜‹–‡‹–‹•‘‡‹Ž‹Œ̵Ȍǡ‡‹™‡Ž‡ƒ–‡œ‡Ž‹‡˜‡”„‡œ‹‰œ‘—†‡ œ‹Œ‡–‡‡ƒ†‡”‡ƒ –‹˜‹–‡‹–ȋ̵ œ‘—Ž‹‡˜‡”‹‡–•ƒ†‡”•†‘‡̵ȌǤ ‡–‰‡‹††‡Ž†‡˜ƒ†‡†”‹‡ ‹–‡•™‡”†‰‡„”—‹–ƒŽ•‡‡‹†‹ ƒ–‘”˜‘‘”ƒ –‹˜‹–‡‹– Gebeurtenis-gerelateerde stress. Ǧ ‰‡”‡Žƒ–‡‡”†‡•–”‡••Ǥ ‡ƒ–‡˜ƒ ‰‡„‡—”–‡‹•Ǧ‰‡”‡Žƒ–‡‡”†‡•–”‡••™‡”† „‡‘‘”†‡‡Ž††‘‘”’ƒ”–‹ ‹’ƒ–‡–‡˜”ƒ‰‡‘ƒƒ–‡‰‡˜‡Š‘‡ƒƒ‰‡ƒƒ†‡„‡Žƒ‰”‹Œ•–‡ ˜‘‘”‰ƒƒ†‡‰‡„‡—”–‡‹•™ƒ•‰‡™‡‡•–Ǥ‡œ‡• ‘”‡™‡”†‘‰‡‡‡”†‰‡ ‘†‡‡”†ƒŽ•‹†‹ ƒ–‘”˜‘‘” ‰‡„‡—”–‡ Negatief‹•Ǧ‰‡”‡Žƒ–‡‡”†‡•–”‡••Ǥ affect.  ‡ƒ–‡˜ƒ‡‰ƒ–‹‡ˆƒˆˆ‡ – ™‡”†‰‡†‡ˆ‹‹‡‡”†ƒŽ•†‡‰‡‹††‡Ž†‡• ‘”‡ ˜ƒ†‡˜‘Ž‰‡†‡•–‡‹‰•‹–‡•ǣ̵ ˜‘‡Ž‡ƒ‰•–‹‰̵ǡ̵ ˜‘‡Ž‡‡‡œƒƒ̵ǡ̵ ˜‘‡Ž‡ ‘œ‡‡”̵ǡ̵ ˜‘‡Ž‡‰‡Ã””‹–‡‡”†̵ǡ̵ ˜‘‡Ž‡‡‡”•Žƒ Š–‹‰̵ǡ̵ ˜‘‡Ž‡• Š—Ž†‹‰̵‡̵ ˜‘‡Ž‡ •‘„‡”̵ǤPositief affect.  ‡ƒ–‡˜ƒ’‘•‹–‹‡ˆƒˆˆ‡ –™‡”†‰‡†‡ˆ‹‹‡‡”†ƒŽ•†‡‰‡‹††‡Ž†‡• ‘”‡˜ƒ †‡˜‘Ž‰‡†‡•–‡‹‰•‹–‡•ǣ̵ ˜‘‡Ž‡‰‡Ž—‹‰̵ǡ̵ ˜‘‡Ž‡–‡˜”‡†‡̵ǡ̵ ˜‘‡Ž‡˜”‘Ž‹Œ̵ǡ̵  ˜‘‡Ž‡‘Stressreactiviteit.–•’ƒ‡̵‡̵ ˜‘‡Ž‡‡–Š‘—•‹ƒ•–̵Ǥ  ‡ƒ–‡˜ƒ•–”‡••”‡ƒ –‹˜‹–‡‹–™‡”†„‡”‡‡†ƒŽ•†‡ƒ••‘ ‹ƒ–‹‡–—••‡ •–”‡••ȋ†ƒ–‘œ‘™‡Žƒ –‹˜‹–‡‹–Ǧǡ‰‡„‡—”–‡‹•Ǧ‰‡”‡Žƒ–‡‡”†‡‘ˆ•‘ ‹ƒŽ‡•–”‡••œ‹ŒȌ‡‡‰ƒ–‹‡ˆ ƒˆˆ‡ –‘ˆ’•› Š‘–‹• Š‡‡”˜ƒ”‹ ‰‡Ǥ Bevindingen Deel I, Hoofdstuk 2.

Š‘‘ˆ†•–—ʹ•–‡Ž†‡™‡ǡ‘˜‡”‡‡‘•–‹‰†‡Š—‹†‹‰‡‘’˜ƒ––‹‰‡‘˜‡”Š‡–‘–•–ƒƒ ˜ƒ‘Ǧƒˆˆ‡ –‹‡˜‡’•› Š‘•‡ȋ„‹Œ˜Ǥ ‘™‡•Ƭ—””ƒ›ǡʹͲͳͶȌǡ†ƒ–‡‡•‡•‹–‹•ƒ–‹‡˜ƒŠ‡– ‡•‘Ž‹„‹• Š‡†‘’ƒ‹‡”‰‡•›•–‡‡‹„‡Žƒ‰”‹Œ‡ƒ–‡„‹Œ†”ƒƒ‰–ƒƒŠ‡–‘–•–ƒƒ˜ƒ†‡ ˜”‡‡†‡‡”˜ƒ”‹‰‡†‹‡‡‡”‡†œ‹Œ˜‘‘”’•› Š‘•‡•Ǥ‡”†‡”‰‡„”—‹–‡™‡ ‡–ƒŽ‹•ƒ–‹‡–Š‡‘”‹‡ƒŽ•‡‡ ‘ ‡’–—‡‡Ž”ƒƒ™‡”‘–‡„‡ƒ”‰—‡–‡”‡™ƒƒ”‘œ—Ž‡ ˜”‡‡†‡‡”˜ƒ”‹‰‡˜ƒƒ‘’’•› Š‘–‹• Š‡™‹Œœ‡‰‡Ã–‡”’”‡–‡‡”†™‘”†‡Ǥ‡”•‘‡‡–‡‡ ˜‡”‹†‡”†˜‡”‘‰‡‘–‡‡–ƒŽ‹•‡”‡ǡ˜‡”–‘‡‘‡‹–‡‘œ‹ Š„‡™—•––‡™‘”†‡˜ƒŠ— •—„Œ‡ –‹‡˜‡‰‡‘‡†•–‘‡•–ƒ†‡‡‡”˜ƒ”‹‰‡ǡ™ƒ–Š‡–„‡‘‡‹Ž‹Œ–‘†ƒƒ””‹–‹• Š‘’–‡

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”‡ˆŽ‡ –‡”‡Ǥ’†‡œ‡ƒ‹‡”Š‘—†‡œ‹Œ‹†‡””‡‡‹‰‡–†‡‹˜Ž‘‡††‹‡Š—•—„Œ‡ –‹‡˜‡ ‰‡‘‡†•–‘‡•–ƒ†‡Š‡„„‡‘’Š—ƒƒ†ƒ Š–ǡ‰‡†ƒ Š–‡‡‰‡†”ƒ‰Ǥƒ‡‡”‹‡ƒ†œ‹ Š „‹Œ˜‘‘”„‡‡Ž†‹‡–„‡™—•–‹•˜ƒœ‹Œƒ Š–‡”†‘ Š–ǡœƒŽŠ‹Œ‹‡–‘’‡”‡Š‘‡†‡œ‡‡–ƒŽ‡ –‘‡•–ƒ††‡‡”˜ƒ”‹‰˜ƒ†‡™‡”‡Ž‹ŒŠ‡‹†„‡Ã˜Ž‘‡†–ǡ”‡•—Ž–‡”‡†‹†‡‘˜‡”–—‹‰‹‰†ƒ–zijn, ervaart ƒ†‡”‡„‡†”‹‡‰Ž‹Œ‡•Ž‡ Š– ‹’Žƒƒ–•˜ƒ†ƒ–Š‹Œœ‡œ‘ Ǥ‡ƒ†‡”˜‘‘”„‡‡Ž†‹•†ƒ– •–‡‡†‹‡‹–‡”‰‡‰‡‡”‡‡”†œ‹Œǡ—‡™‘”†‡–‘‡‰‡• Š”‡˜‡ƒƒ‡š–‡”‡„”‘‡Ǥ  ˆ‡‹–‡™‘”†–‘’†‡œ‡ƒ‹‡”†‡•—„Œ‡ –‹‡˜‡‡”˜ƒ”‹‰‰‡Ž‹Œ‰‡•–‡Ž†ƒƒ†‡‡š–‡”‡”‡ƒŽ‹–‡‹–Ǥ ‡˜‘—†‹‰‰‡œ‡‰†Š‡Ž’–‡–ƒŽ‹•‡”‡‘•—„Œ‡ –‹‡˜‡„‡Ž‡˜‹‰–‡‹†‡–‹ˆ‹ ‡”‡‡ˆ‡‹–‡˜ƒ „‡Ž‡˜‹‰–‡• Š‡‹†‡Ǥ ‡„‡–‘‘‰†‡˜‡”†‡”†ƒ–‡‡„‡’‡”–‡–ƒŽ‹•‡”‡†˜‡”‘‰‡‘‰‡Ž‹Œ‘‘˜‡”„ƒ† Š‘—†–‡–Š‡–„‡’‡”–‡•‘ ‹ƒƒŽˆ— –‹‘‡”‡†ƒ–‰‡‘„•‡”˜‡‡”†™‘”†–„‹Œ’ƒ–‹´–‡‡–Ǥ Als ‘hoger cognitief proces’ wordt mentaliseren ondermijnd door‘˜‡”ƒ–‹‰‡‡‘–‹‘‡Ž‡•–”‡••Ǥ ‹Œ†‡•‡‘–‹‘‡Ž‡‘–”‡‰‡Ž‹‰‡‡Ž‹„‹• Š‡†‡Ž‡˜ƒ†‡Š‡”•‡‡†‡ ‘–”‘Ž‡‘˜‡”†‡ Š‡”•‡’”‘ ‡••‡‘’œ‹ ŠǤ ‹‡”†‘‘””‡ƒ‰‡‡”–‡•‡ŽŽ‡”‘’œƒ‡†‹‡ƒ ——–†‡ƒƒ†ƒ Š–˜”ƒ‰‡ǡ œ‘ƒŽ•‰‡˜ƒƒ”ǡƒƒ”†‹–’”‘ ‡•‰ƒƒ––‡‘•–‡˜ƒ ‘‰‹–‹‡˜‡ ‘’Ž‡š‹–‡‹–Ǥƒƒ”†‘‘”œ‹Œ ‹†‹˜‹†—‡‹†‡”‰‘‡†‹•–ƒƒ–‘ƒ†‡“—ƒƒ–‘’Š—‡‹‰‡‡‘–‹‡•‡†‹‡˜ƒƒ†‡”‡–‡ ”‡ˆŽ‡ –‡”‡Ǥ‹–˜‡”‘‘”œƒƒ–’”‘„Ž‡‡‘’‰‡„‹‡†˜ƒˆ— –‹‘‡”‡‹ ‘’Ž‡š‡•‘ ‹ƒŽ‡•‹–—ƒ–‹‡• ‘†ƒ–†‡’‡”•‘‘‹™‡•–‹‡‘‡‹–‡‡”˜ƒƒ”––‡„‡‰”‹Œ’‡™ƒ–ƒ†‡”‡†‡‡‡˜‘‡Ž‡Ǥ ‘‰‡Ž‹Œ‰‡˜‘Ž‰‡†ƒƒ”˜ƒœ‹Œ„—‹–‡‰‡•Ž‘–‡–‡™‘”†‡†‘‘”ƒ†‡”‡‘ˆŠ‡–œ‹ Š–‡”—‰–”‡‡ —‹–•‘ ‹ƒŽ‡•‹–—ƒ–‹‡•Ǥ ‡„‡ƒ”‰—‡–‡‡”†‡˜‡”†‡”†ƒ–‹•Šƒ†‡Ž‹‰‡‡‡‘˜‡‹Ž‹‰‡Š‡ Š–‹‰‹†‡ ‹†‡”–‹Œ†–˜ƒƒ˜‘‘”‘‡†„‹Œ’ƒ–‹´–‡‡––„‹Œ†”ƒ‰‡ƒƒ„‡’‡”‹‰‡‹Š‡– ‡–ƒŽ‹•‡”‡†˜‡”‘‰‡Ǥ‡–ƒŽ‹•ƒ–‹‡–Š‡‘”‹‡•–‡Ž–ƒ‡Ž‹Œ†ƒ–Š‡–˜‡”‘‰‡‘‘’‡‘–‹‡•–‡ ”‡ˆŽ‡ –‡”‡‡œ‡–‡”‡‰—Ž‡”‡™‘”†–‘–™‹‡Ž††‘‘”‡‡˜‡‹Ž‹‰‡‹–‡”ƒ –‹‡‡–‘—†‡”•ȋ‡Žƒ–‡”

‡–Ž‡‡ˆ–‹Œ†•‰‡‘–‡ȌǤ‹†‡”‹•Šƒ†‡Ž‹‰‘ˆ˜‡”™ƒƒ”Ž‘œ‹‰œ‘—‡‡ˆ‘„‹• Š‡ƒ‰•– A „‡™‡”•–‡ŽŽ‹‰‡˜‘‘”Š‡–”‡ˆŽ‡ –‡”‡‘’ƒ†‡”ƒ•‰‡‘‡†•–‘‡•–ƒ†ǡ™ƒ–†‡‘–™‹‡Ž‹‰˜ƒ Š‡–‡–ƒŽ‹•‡”‡†˜‡”‘‰‡„‡‘‡‹Ž‹Œ–ȋ‹ǡʹͲͳͷȌǤ Ten slotte hebben we betoogd dat een gebrek aan ‘epistemisch vertrouwen’ –†ƒ–™‹Ž œ‡‰‰‡ǡŠ‡–˜‡”‘‰‡‘‹‡—™‡‹ˆ‘”ƒ–‹‡˜ƒƒ†‡”‡–‡„‡Šƒ†‡Ž‡ƒŽ•’‘–‡–‹‡‡Ž ‰‘‡†„‡†‘‡Ž†‡”‡Ž‡˜ƒ–ȋ ‘ƒ‰›ǡ—›–‡ǡŽŽ‹•‘Ƭƒ’„‡ŽŽǡʹͲͳ͹Ȍ–‡‡’‡”•‘‘ƒˆ•‹Œ†–˜ƒ sociaal leervermogen en interpersoonlijke betekenisgeving. Fonagy en collega’s (2017) ˜‡”‘†‡”•–‡ŽŽ‡†ƒ–Š‡–˜‘‘”‡•‡‰‡ƒ‡Ž‹Œ‡”‹•‘‹‡–•˜‘‘”™ƒƒ”ƒƒ–‡‡‡ǡ ™ƒ‡‡”œ‹Œ†‡„”‘˜ƒ†‹‡‹ˆ‘”ƒ–‹‡˜‡”–”‘—™‡Ǥ Š–‡”ǡ’ƒ–‹´–‡‡––‘‡†‹™‹ŒŽ• ‡‡ƒŽ‰‡‡‡Š‘—†‹‰˜ƒ™ƒ–”‘—™‡–‡‘’œ‹ Š–‡˜ƒƒ†‡”‡ǡ‡™ƒ–œ‹Œ–‡œ‡‰‰‡Š‡„„‡ǡ soms aangeduid als ‘epistemische hypervigilantie’. Zulk wantrouwen snijdt mensen af va „‡Žƒ‰”‹Œ‡„”‘‡˜ƒ‹ˆ‘”ƒ–‹‡‘˜‡”Š‡–œ‡Žˆ‹”‡Žƒ–‹‡–‘–ƒ†‡”‡ǡƒŽ†—• ‘ƒ‰›‡ŽŽ‹•‘

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(2014). Daardoor ontwikkelen zij een ‘rigiditeit’ ten opzichte van het perspectief van anderen. ‘†‘‡†‡œ‹Œœ‹Œ‹†‡”‹•–ƒƒ–‘‘˜‡”–—‹‰‹‰‡‘˜‡”œ‹ Šœ‡Žˆǡƒ†‡”‡‡†‡™‡”‡Ž†–‡ ™‹Œœ‹‰‡Ǥ‡•‘ ‹ƒƒŽ‰‡ ‘•–”—‡‡”†’‡”•’‡ –‹‡ˆ‘’†‡”‡ƒŽ‹–‡‹–™‘”†–†ƒ˜‡”˜ƒ‰‡†‘‘”‡‡ ’‡”•‘‘Ž‹Œ‡„‡–‡‡‹•‰‡˜‹‰†‹‡„‡–‡‡‹•˜‘Ž‹•˜‘‘”Š‡–‹†‹˜‹†—ǡƒƒ”†‘‘”ƒ†‡”‡ƒŽ• ˜”‡‡†™‘”†–‰‡œ‹‡ȋ„‹Œ˜‘‘”„‡‡Ž†‡”‡‹”ƒƬ‡„ƒ±ǡʹͲͳͺȌǤ Deel II, Hoofdstuk 3.

 Š‘‘ˆ†•–—†”‹‡‘„•‡”˜‡‡”†‡™‡ǡ‘˜‡”‡‡‘•–‹‰‡‡”†‡”‘†‡”œ‘‡ȋ„‹Œ˜Ǥƒ”†‹‘‹•ǡ Lataster, Mengelers, Van Os, & Myin‐Germeys, ʹͲͳͳȌǡ†ƒ–‰‡”ƒ’’‘”–‡‡”†‡•–”‡••‹Š‡–†ƒ‰‡Ž‹Œ• Ž‡˜‡‰‡”‡Žƒ–‡‡”†‹•ƒƒ†‡‹–‡•‹–‡‹–˜ƒ‡‰ƒ–‹‡ˆƒˆˆ‡ –‡’•› Š‘–‹• Š‡•›’–‘‡Ǥ‡”†‡”‡ •–—†‹‡•ȋ„‹Œ˜Ǥƒ”†‹‘‹•‡–ƒŽǤǡʹͲͳͳǢ”‹•–‘„ƒŽǦƒ˜ƒ‡œ‡–ƒŽǤǡʹͲͳͺȌ•–‡Ž†‡‘‘˜ƒ•–†ƒ–’ƒ–‹´–‡ ‡–†‹‡‹†‡”‹•Šƒ†‡Ž‹‰Šƒ††‡‡‡‰‡ƒƒ–ǡ‡‡‡‡”‹–‡•‡’•› Š‘–‹• Š‡‡ ‡‘–‹‘‡Ž‡”‡ƒ –‹‡Ž‹‡–‡œ‹‡‘’•–”‡••Ǥœ‡”‡•—Ž–ƒ–‡–‘‘†‡‡ Š–‡”‹‡–‡‡†—‹†‹‰ƒƒ†ƒ– ‰‡”ƒ’’‘”–‡‡”†‡‹•Šƒ†‡Ž‹‰‹†‡‹†‡”–‹Œ††‡‹–‡•‹–‡‹–˜ƒ†‡œ‡ƒˆˆ‡ –‹‡˜‡‘ˆ’•› Š‘–‹• Š‡ ”‡ƒ –‹‡‘’•–”‡••‹†‡˜‘Ž™ƒ••‡Š‡‹†˜‡”‰”‘‘–Ǥ‘‰‡Ž‹Œ—‡†‡˜‡”• Š‹ŽŽ‡†‡•–ƒ–‹•–‹• Š‡ „‡ƒ†‡”‹‰‡†‹‡‰‡Šƒ–‡‡”†œ‹ŒŠ‡–˜‡”• Š‹Ž‹—‹–‘•–‡˜‡”Žƒ”‡Ǥ ‡‡”†‡”‡•–—†‹‡•‹• ‰‡„”—‹‰‡ƒƒ–˜ƒ‡‡ƒƒŽ›•‡‡–Š‘†‡†‹‡‘‰‡Ž‹Œ‘‰‡• Š‹–‹•˜‘‘”Š‡–ƒƒŽ›•‡”‡˜ƒ ‹‡–Ǧ‘”ƒƒŽ˜‡”†‡‡Ž†‡†ƒ–ƒǤ‘ Ž—†‡”‡†ƒ‰‡•–‡Ž†™‘”†‡†ƒ–†‡”‡Žƒ–‹‡–—••‡•–”‡••‡ †‡‹–‡•‹–‡‹–˜ƒ‡‰ƒ–‹‡˜‡ƒˆˆ‡ –‘ˆ’•› Š‘–‹• Š‡‡”˜ƒ”‹‰‡ȋ‹†‹‡ƒƒ™‡œ‹‰Ȍ”‘„——•–Ž‹Œ–Ǥ” „‡•–ƒƒ–‡ Š–‡”‘‰•–‡‡†•‘œ‡‡”Š‡‹†‘˜‡”†‡˜”ƒƒ‰‘ˆ†‡”‡Žƒ–‹‡–—••‡•–”‡••‡†‡‹–‡•‹–‡‹– ˜ƒ’•› Š‘–‹• Š‡‡”˜ƒ”‹‰‡‡‡‰ƒ–‹‡ˆƒˆˆ‡ –‹†‡˜‘Ž™ƒ••‡Š‡‹††ƒƒ†™‡”‡Ž‹Œ™‘”†– ‰‡‘†‡”‡‡”††‘‘”‡‡˜‘‘”‰‡• Š‹‡†‡‹•˜ƒ‹•Šƒ†‡Ž‹‰‹†‡‹†‡”–‹Œ†Ǥ Deel II, Hoofdstuk 4.

 ‘‘ˆ†•–—˜‹‡”–‘‘†‡„‹Œ’ƒ–‹´–‡‡–‡‡„‡•–ƒƒ†‡’•› Š‘–‹• Š‡•–‘‘”‹•ƒƒ†ƒ– ‡‡˜‡”Š‘‘‰†‡‡‹‰‹‰–‘–‡‡œƒƒŠ‡‹†‡‡’‘–‡–‹‡‡Ž‡ Šƒ‹•‡‹•™ƒƒ”†‘‘”‹•Šƒ†‡Ž‹‰ ‹†‡‹†‡”–‹Œ††‡‡”•–˜ƒ’•› Š‘–‹• Š‡•›’–‘‡‘’˜‘Ž™ƒ••‡Ž‡‡ˆ–‹Œ†„‡Ã˜Ž‘‡†–Ǥ‡ ”‡Žƒ–‹‡–—••‡‡‡œƒƒŠ‡‹†‡’•› Š‘–‹• Š‡•›’–‘‡ƒ‘’Šƒƒ”„‡—”–™‘”†‡˜‡”Žƒƒ”† †‘‘”–‘‡‰‡‘‡ƒ‰•–‹‰‡‡†‡’”‡••‹‡˜‡‰‡˜‘‡Ž‡•Ǥ‡œ‡„‡˜‹†‹‰‡‘†‡”•–‡—‡†‡ ‰”‘‡‹‡†‡ ‘•‡•—•†ƒ–’‡”•‘‡‡–‡‡˜‡”Ž‡†‡˜ƒ‹•Šƒ†‡Ž‹‰‘ˆ‹•„”—‹‰‡‡‹‰†œ‹Œ ‘‘’˜‘Ž™ƒ••‡Ž‡‡ˆ–‹Œ†‡‡œƒƒ–‡œ‹Œȋ‡”œ‡ ƒǡʹͲͳ͵Ǣ—”’Š›ǡŠ‡˜Ž‹ǡ†ƒ•‘ǡƬ ‘—•–‘ǡʹͲͳ͵Ȍ‡‡‡˜‡”Š‘‘‰†”‹•‹ ‘Š‡„„‡‘‡‡’•› Š‘•‡–‡‘–™‹‡Ž‡ȋƒ”‡•‡‡–ƒŽǤǡ ʹͲͳʹȌǤ‡œ‡„‡˜‹†‹‰‡œ‹Œ‘‘‹Ž‹Œ‡–‡‡”†‡”‘†‡”œ‘‡†ƒ–ƒƒ–‘‘†‡†ƒ–‡‡œƒƒŠ‡‹† ‰‡”‡Žƒ–‡‡”†‹•ƒƒ’•› Š‘–‹• Š‡•›’–‘‡ȋSocial‹ ŠƒŽ•ƒǡŠ Defeat ‘†‡•ǡƒ•‹Ž‘’‘—Ž‘—ǡƬ —––‘ǡʹͲͳ͹Ȍ en biedt verdere ondersteuning voor de ‘ ’ theorie van psychoseǦ‡–‹‘Ž‘‰‹‡ǡ†‹‡•–‡Ž– †ƒ–‡‡‘†‡”‰‡• Š‹–‡•‘ ‹ƒŽ‡’‘•‹–‹‡‘ˆ•‘ ‹ƒŽ‡„—‹–‡•Ž—‹–‹‰„‹Œ†”ƒƒ‰–ƒƒ†‡•‡•‹–‹•‡”‹‰

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˜ƒŠ‡–‡•‘Ž‹„‹• Š†‘’ƒ‹‡Ǧ•›•–‡‡ȋ‡Ž–‡ǡ˜ƒ†‡”‡ǡ—––‡ǡƬƒ–‘”Ǧ ”ƒƒ‡ǡʹͲͳ͵ȌǤ ”‹•‡–†‡Š—‹†‹‰‡•–—†‹‡‘‘‡‡”„‡™‹Œ•‰‡˜‘†‡˜‘‘”†‡•–‡ŽŽ‹‰†ƒ–‡‡œƒƒŠ‡‹†‡‡ †‡‡Ž˜ƒ†‡”‡Žƒ–‹‡–—••‡‹†‡”‹•Šƒ†‡Ž‹‰‡’•› Š‘–‹• Š‡‡”˜ƒ”‹‰‡˜‡”Žƒƒ”–ȋ‘›†ƒƬ  ‡‡–‡”•ǡʹͲͳͷȌ‡†ƒ–‡‡œƒƒŠ‡‹†‡‡‹˜Ž‘‡†—‹–‘‡ˆ‡–‘’’•› Š‘–‹• Š‡•›’–‘‡ ‹††‡Ž•†‡’”‡••‹‡‡ƒ‰•–ȋ ƒ›ƒǡ ‹ŽŽƒǡ‡‹‹‰‡”ǡ ‘ŽŽ™‹–œ‡”ǡƬ‹ ‘ŽǡʹͲͳ͸Ǣ ò†‡”ƒǡ™—‡”‡ǡƒ‡ǡ‘”‰ƒǡƬ—‹’‡”•ǡʹͲͳͶȌǤ Deel II, Hoofdstuk 5.

 ‡œ‡•–—†‹‡–‡•––‡†‡Š›’‘–Š‡•‡†ƒ–‡‡„‡’‡”–‡–ƒŽ‹•‡”‡†˜‡”‘‰‡‡‡‘‰‡Ž‹Œ‡ ˜‡”Žƒ”‹‰‰‡‡ˆ–˜‘‘”†‡”‡Žƒ–‹‡–—••‡‹•Šƒ†‡Ž‹‰†‘‘”‘—†‡”•‹†‡‹†‡”–‹Œ†‡†‡‡”•– ˜ƒŽ‹‹• Š‡•›’–‘‡‘ˆ†‡ƒ–‡˜ƒŠ‡–•‘ ‹ƒƒŽ†‹•ˆ— –‹‘‡”‡‘’˜‘Ž™ƒ••‡Ž‡‡ˆ–‹Œ†Ǥ ‡– ‘†‡”œ‘‡™‡‡•—‹–†ƒ–‡‡‡‡”†‡”Š‡‹†˜ƒ†‡’ƒ–‹´–‡‹‘œ‡•–‡‡’”‘‡ˆ‡Ž††‡†ƒ–œ‡ ‘—†‡”Ž‹Œ ‘ˆŽ‹ –ǡ‹•Šƒ†‡Ž‹‰‘ˆ‹•„”—‹Šƒ††‡‡”˜ƒ”‡–‹Œ†‡•Š—‹†‡”–‹Œ†Ǥ‡‡”•–˜ƒ †‹–‹•„”—‹™ƒ•‰‡ƒ••‘ ‹‡‡”†‡–†‡‡”•–˜ƒ’‘•‹–‹‡˜‡‡‡‰ƒ–‹‡˜‡•›’–‘‡‡‡–†‡ ƒ–‡˜ƒ„‡’‡”‹‰˜ƒŠ‡–‡–ƒŽ‹•‡”‡†˜‡”‘‰‡ǡƒƒ”‹‡–‡–†‡ƒ–‡˜ƒ•‘ ‹ƒƒŽ †‹•ˆ— –‹‘‡”‡Ǥ‘˜‡†‹‡‘„•‡”˜‡‡”†‡™‡†ƒ–‡‡˜‡”‹†‡”†‡–ƒŽ‹•‡”‡†˜‡”‘‰‡ ‘‰‡˜‡‡”ͶͲΨ˜ƒŠ‡–˜‡”„ƒ†–—••‡‹•„”—‹‹†‡‹†‡”–‹Œ†‡†‡‡”•–˜ƒ‡‰ƒ–‹‡˜‡ •›’–‘‡‹†‡˜‘Ž™ƒ••‡Š‡‹†˜‡”Žƒƒ”†‡Ǥ Deel III, Hoofdstuk 6.

 ‘‘ˆ†•–—͸„‡˜ƒ–Š‡–‘†‡”œ‘‡•’”‘–‘ ‘Ž˜ƒ‘œ‡•–—†‹‡ƒƒ”†‡‡ˆˆ‡ –‹˜‹–‡‹–˜ƒ ‡–ƒŽ‹•‡”‡‡˜‘”†‡”‡†‡Š‡”ƒ’‹‡˜‘‘”•› Š‘–‹• Š‡•–‘‘”‹••‡ȋ’ȌǤ‹–Š‘‘ˆ†•–— „‡• Š”‹Œˆ–†‡Š›’‘–Š‡•‡‡‡–Š‘†‡‹‡‡˜‘‘”ƒˆ‰‡’—„Ž‹ ‡‡”†ƒ”–‹‡ŽǤ‡œ‡•–—†‹‡‹•‡‡ ‰‡”ƒ†‘‹•‡‡”†ǡ‰‡ ‘–”‘Ž‡‡”†‘†‡”œ‘‡‡–‰‡„Ž‹†‡‡”†‡„‡‘‘”†‡Žƒƒ”•Ǥ‡’”‹ƒ‹”‡ treatment as usual

‘†‡”œ‘‡•˜”ƒƒ‰˜ƒ†‹–‘†‡”œ‘‡™ƒ•ǣ‡‹†–†‡–‘‡˜‘‡‰‹‰˜ƒ’ƒƒ  A ȋȌ˜‘‘”–‘–‡‡‰”‘–‡”‡˜‡”„‡–‡”‹‰˜ƒ•‘ ‹ƒƒŽˆ— –‹‘‡”‡‡‡–ƒŽ‹•‡”‡† ˜‡”‘‰‡ȋƒƒ•–ƒ†‡”‡—‹–‘•–˜ƒ”‹ƒ„‡Ž‡Ȍǫ ‹‡”‘†‡”‰‡˜‡™‡‡‡‘”–‘˜‡”œ‹ Š–˜ƒ†‡ ‡–Š‘†‡˜ƒŠ‡–‘†‡”œ‘‡Ǥ Participanten.  ƒ”–‹ ‹’ƒ–‡†‹‡ƒƒŠ‡–‘†‡”œ‘‡‡‡†‡†‡™ƒ”‡’ƒ–‹´–‡‡– ȋǦ Ǧ ”‹–‡”‹ƒǢǡʹͲͲͲȌǡ™ƒƒ”‘†‡”†‡†‹ƒ‰‘•‡•• Š‹œ‘ˆ”‡‹‡ǡ• Š‹œ‘ˆ”‡‹ˆ‘”‡‘ˆ • Š‹œ‘ƒˆˆ‡ –‹‡˜‡•–‘‘”‹•ȋʹͻͷǤšȌǡ™ƒƒ•–‘‘”‹•ȋʹͻ͹ǤͳȌǡ‘”–‡’•› Š‘–‹• Š‡•–‘‘”‹•ȋʹͻͺǤͺȌ‘ˆ ’•› Š‘–‹• Š‡•–‘‘”‹•‹‡–ƒ†‡”•‰‡•’‡ ‹ˆ‹ ‡‡”†ȋʹͻͺǤͻȌǤ  Ž—•‹‡ ”‹–‡”‹ƒ™ƒ”‡ǣ‡‡Ǧ †‹ƒ‰‘•‡ǡ‹‹ƒƒŽ͸ƒƒ†‡‹„‡Šƒ†‡Ž‹‰ǡƒƒ”‹‡–‡‡”†ƒͳͲŒƒƒ”Ǣ–—••‡†‡ͳͺ‡ͷͷ Œƒƒ”‘—†Ǥš Ž—•‹‡ ”‹–‡”‹ƒ™ƒ”‡ǣ˜‡”•–ƒ†‡Ž‹Œ‡„‡’‡”‹‰‡Ȁ‘ˆƒƒŽˆƒ„‡–‹•‡Ǣ‡‡‰‡„”‡ƒƒ „‡Š‡‡”•‹‰˜ƒ†‡‡†‡”Žƒ†•‡–ƒƒŽǢ‹††‡Ž‡‹•„”—‹‹†—•†ƒ‹‰‡ƒ–‡†ƒ–‡‡ ‘–™‡‹‰•„‡Šƒ†‡Ž‹‰˜‘‘”†‡’ƒ–‹´–‘‘†œƒ‡Ž‹Œ™ƒ•ȋƒ•— ‡•˜‘ŽŽ‡„‡Šƒ†‡Ž‹‰™ƒ

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†‡’ƒ–‹´–™‡‡”‹ƒƒ‡”‹‰˜‘‘”†‡‡Žƒ‡ƒƒŠ‡–‘†‡”œ‘‡Ǥƒ–‹´–‡™‡”†‡‹‡– –‘‡‰‡Žƒ–‡–‘–Randomisatie.Ǧ•‡••‹‡•‘†‡”‹˜Ž‘‡†˜ƒ‹††‡Ž‡ȌǤ  ƒ Ž‹‹ ‹†‹‡™‡”œƒƒ™ƒ”‡‹ Ǧ–‡ƒ•˜ƒŠ‡–’•› Š‹ƒ–”‹• Š‡ ‹•–‹–——–‹˜‹‡”†—‹‡ȋ—‹†Ǧ ‘ŽŽƒ†Ȍ‘ˆŽ–”‡ Š–ȋ‡‹•–Ȍǡ™‡”†‰‡˜”ƒƒ‰†Š— ƒ•‡Ž‘ƒ††‘‘”–‡ ‡‡‡–‡„‡’ƒŽ‡™‹‡˜‘Ž†‡‡†ƒƒ†‡‹ Ž—•‹‡ ”‹–‡”‹ƒ˜ƒ†‡•–—†‹‡Ǥ‡”˜‘Ž‰‡•™‡”†‡ ’ƒ–‹´–‡†‹‡‹–‡”‡••‡–‘‘†‡‡™ƒ‡‡”œ‹Œ†ƒƒ”˜‘‘”‰‘‡†‡—”‹‰‰ƒ˜‡ǡ„‡ƒ†‡”††‘‘” ‡‡‘†‡”œ‘‡•ƒ••‹•–‡–Ǥƒ–‹´–‡”‡‰‡—‹–Ž‡‰‘˜‡”Š‡–‘†‡”œ‘‡‡‡‡™‡‡„‡†‡–‹Œ† ‘–‡„‡•Ž‹••‡‘ˆœ‡™‹Ž†‡†‡‡Ž‡‡ǤƒŠ‡–‘†‡”–‡‡‡˜ƒ‡‡–‘‡•–‡‹‰•ˆ‘”—Ž‹‡”ǡ ™‡”†‡œ‹Œ‘ˆˆ‹ ‹‡‡Ž’ƒ”–‹ ‹’ƒ–‡‡˜‘Ž‰†‡†‡—Ž‡–‹‰Ǥ†‡‰‡„Ž‹†‡‡”†Š‡‹†˜ƒ†‡ „‡‘‘”†‡Žƒƒ”•–‡‰ƒ”ƒ†‡”‡ǡ™‡”†‡’ƒ”–‹ ‹’ƒ–‡’ƒ•ƒ†‡—Ž‡–‹‰‰‡”ƒ†‘‹•‡‡”†Ǥ‡ ‘ƒˆŠƒ‡Ž‹Œ‡‘†‡”œ‘‡• ‘Ú”†‹ƒ–‘”™‡‡•˜‡”˜‘Ž‰‡•’ƒ”–‹ ‹’ƒ–‡™‹ŽŽ‡‡—”‹‰–‘‡ƒƒ†‡Treatment as Usual ȋȌǦ ‘†‹–‹‡‘ˆ†‡’Ž—•’Ǧ ‘†‹–‹‡Ǥ‡‘†‡”œ‘‡‡”‡ ’ƒ”–‹ ‹’ƒ–‡™ƒ”‡‰‡†—”‡†‡Š‡–‘†‡”œ‘‡‘’†‡Š‘‘‰–‡˜ƒ†‡„‡Šƒ†‡Ž–‘‡™‹Œœ‹‰ǡƒƒ” ƒŽŽ‡‡–‹‰‡™‡”†‡—‹–‰‡˜‘‡”††‘‘”‘†‡”œ‘‡‡”•†‹‡„Ž‹†™ƒ”‡˜‘‘”†‡ „‡Šƒ†‡Ž–‘‡™‹Œœ‹ ‰Ǥ Therapie.

TAU. ‡’•› Š‹ƒ–”‹• Š‡‹•–‹–—–‡‹˜‹‡”†—‹‡‡Ž–”‡ Š–„‹‡†‡Ž‹‹• Š‡‡ ’‘Ž‹Ž‹‹• Š‡„‡Šƒ†‡Ž‹‰ƒƒ†—‹œ‡†‡’ƒ–‹´–‡‡–’•› Š‹ƒ–”‹• Š‡•–‘‘”‹••‡‹ ”‡•’‡ –‹‡˜‡Ž‹Œ—‹†Ǧ ‘ŽŽƒ†‡’”‘˜‹ ‹‡–”‡ Š–Ǥƒ–‹´–‡™‘”†‡‡”„‡Šƒ†‡Ž†˜‘Ž‰‡•†‡ ‡†‡”Žƒ†•‡—Ž–‹†‹• ‹’Ž‹ƒ‹”‡”‹ Š–Ž‹Œ˜‘‘”• Š‹œ‘ˆ”‡‹‡Flexible ȋ˜ƒŽ’Š‡‡–ƒŽǤʹͲͳʹȌ‡†‡Assertive Community Treatment’ behandelteams werkten volgens het zogenaamde ‘  ȋ ȌǦ‘†‡Ž™ƒƒ”‹†‡„‡Šƒ†‡Ž‹‰™‘”†–‰‡Ã–‡•‹˜‡‡”†™ƒ‡‡”’ƒ–‹´–‡‹‡‡ ”‹•‹• ˜‡”‡”‡ǡ‡–ƒŽ•†‘‡Ž‘‡‡Ž‹‹• Š‡‘’ƒ‡–‡˜‘‘”‘‡Ǥ Ǧ–‡ƒ•„‡•–ƒƒ—‹– ˜‡”’Ž‡‡‰—†‹‰‡ǡ’•› Š‘Ž‘‰‡‡’•› Š‹ƒ–‡”•ǡ†‹‡’•› Š‘Ǧ‡†— ƒ–‹‡ǡˆƒ”ƒ ‘Ž‘‰‹• Š‡ „‡Šƒ†‡Ž‹‰ǡ‘†‡”•–‡—‡†‡–Š‡”ƒ’‹‡‘ˆ ‘‰‹–‹‡˜‡‰‡†”ƒ‰•–Š‡”ƒ’‹‡ȋ Ȍ‰‡˜‡Ǥ Ǧ–‡ƒ• Š‡„„‡˜‡”†‡”‘‘’”‘ˆ‡••‹‘ƒŽ•†‹‡‰‡•’‡ ‹ƒŽ‹•‡‡”†œ‹Œ‹Š‡–Š‡Ž’‡˜ƒ’ƒ–‹´–‡„‹ŒŠ‡– •–”— –—”‡”‡˜ƒŠ—•‘ ‹ƒŽ‡Ž‡˜‡ǡ™ƒƒ”‘†‡”ƒƒ–• Šƒ’’‡Ž‹Œ™‡”‡”•ǡ†‹‡Œ—”‹†‹• Š‡‡ Individual Placement and Support (IPS) •‘ ‹ƒŽ‡Š—Ž’„‹‡†‡ǡ‡ Ǧ ‘ƒ Š‡•†‹‡’ƒ–‹´–‡Š‡Ž’‡‘ –‡”‡Ǧ‹–‡‰”‡”‡†‘‘”Š‡–TAU plu MBT. ˜‹†‡˜ƒ‡‡„ƒƒ‘ˆ‘’Ž‡‹†‹‰Ǥ  • ƒ–‹´–‡‹†‡’Ž—•’Ǧ ‘†‹–‹‡‘–˜‹‰‡†‡œ‡Žˆ†‡Š‹‡”„‘˜‡ „‡• Š”‡˜‡„‡Šƒ†‡Ž‹‰ǡƒƒ”˜‘Ž‰†‡†ƒƒ”ƒƒ•–‘‘‹†‹˜‹†—‡Ž‡‡‰”‘‡’••‡••‹‡•’Ǥ‡ „‡Žƒ‰”‹Œ•–‡‡Ž‡‡–‡˜ƒŠ‡–‘”‹‰‹‡Ž‡ǦŠƒ†„‘‡ȋƒ–‡ƒƬ ‘ƒ‰›ǡʹͲͲ͸Ȍ˜‘”†‡ –‡˜‡•†‡Ž‡‹†”ƒƒ†˜‘‘”’Ǥ‡–Š‡”ƒ’‡—–‹• Š‡Š‘—†‹‰„‹‡Ǧ•‡••‹‡•™‘”†– gekenmerkt door de ‘niet wetende houding’ waarbij de therapeut actief vragen stelt en een ‘’”‡ Š–‡‹–‡”‡••‡‹†‡ƒ –—‡Ž‡‰‡‘‡†•–‘‡•–ƒ†˜ƒ†‡’ƒ–‹´– —Ž–‹˜‡‡”–Ǥ‹–‰‡‡ˆ–†‡’ƒ–‹´–

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†‡‡”˜ƒ”‹‰†‘‘”‹‡ƒ†‰‡Š‘‘”†–‡™‘”†‡ǡƒƒ”•–‹—Ž‡‡”–‘‘†‡‹‡—™•‰‹‡”‹‰Š‡‹†˜ƒ†‡ ’ƒ–‹´–ƒƒ”†‹‡•‡‹‰‡‡–ƒŽ‡–‘‡•–ƒ†Ǥƒƒ”ƒƒ•–‹•Š‡–„‡Žƒ‰”‹Œ†ƒ–†‡–Š‡”ƒ’‡—– ”‡‡‹‰Š‘—†–‡–†‡ƒ–‡˜ƒ‡–ƒŽ‹•‡”‡†˜‡”‘‰‡˜ƒ†‡’ƒ–‹´–Ǥ†‡”‹˜Ž‘‡†˜ƒ •–”‡••ƒ†ƒ–˜‡”‘‰‡ƒ‡Ž‹Œ‹‘ˆ‡‡”˜‡”Ž‘”‡‰ƒƒǡ™ƒƒ”†‘‘”†‡’ƒ–‹´–‹‡–‰‘‡† ‡‡”ƒ”‡ˆŽ‡ –‡”‡‘’œ‹Œ‡‹‰‡‘ˆƒ†‡”ƒ•‰‡‘‡†•–‘‡•–ƒ†Ǥ‡‡‡•–‡ǡ™ƒ– ‘’Ž‡š‡”‡ǡ ’•› Š‘Ž‘‰‹• Š‡‹–‡”˜‡–‹‡•Š‡„„‡†ƒ‰‡‡œ‹‡‡”Ǥ‡‰‡Ž‹Œ‡”–‹Œ†‹•Š‡–˜ƒ„‡Žƒ‰‘ •ƒ‡‡–†‡’ƒ–‹´–‡‘–‹‘‡‡Ž„‡Žƒ†‡‰‡†ƒ Š–‡•‡Š‡”‹‡”‹‰‡–‡ ‘ˆ”‘–‡”‡‡ „‡•’”‡‡„ƒƒ”–‡ƒ‡ǡœ‘†ƒ–†‹‡‰‡‡‹†‡”‘˜‡”•’‘‡Ž†”ƒƒ–†‘‘”œ‹Œ‘ˆŠƒƒ”‡‘–‹‡•Ǥ‘‡Ž ˜ƒ†‡„‡Šƒ†‡Ž‹‰‹•†ƒ–†‡’ƒ–‹´–‘’‡‡‰‡‰‡˜‡‘‡–‹•–ƒƒ–‹•‘–‡—‡„Ž‹Œ˜‡ ”‡ˆŽ‡ –‡”‡‘’œ‹ Šœ‡Žˆ‡†‡ƒ†‡”ǡœ‡Žˆ•ƒŽ•‡”ȋŠ‡˜‹‰‡Ȍ‡‘–‹‡•‡”˜ƒ”‡™‘”†‡Ǥ Interventies.  ‹ŒŠ‡––‘‡’ƒ••‡˜ƒ‹–‡”˜‡–‹‡•‘‡–ƒŽ–‹Œ†™‘”†‡„‡†ƒ Š–†ƒ–•–”‡•• Š‡–‡–ƒŽ‹•‡”‡†˜‡”‘‰‡‘†‡”‹Œ–Ǥƒƒ”‘™‘”†–‡”„‹Œ‰‡™‡”–‡–˜‹‡” ‹–‡”˜‡–‹‡Ǧ‹˜‡ƒ—•ǡ†‹‡•–ƒ’•‰‡™‹Œ•‰‡„”—‹–—‡™‘”†‡ǡƒˆŠƒ‡Ž‹Œ˜ƒ†‡ƒ–‡˜ƒ •–”‡••Ǥ’Š‡–Š‡˜‹‰•–‡•–”‡••‹˜‡ƒ—œ‹Œ‹–‡”˜‡–‹‡•˜‘‘”ƒŽ‰‡”‹ Š–‘’Š‡–˜‡”‹†‡”‡˜ƒ •–”‡••„‹Œ†‡’ƒ–‹´–Ǥƒ–ƒ‹††‡Ž••–‡—‡†‡‹–‡”˜‡–‹‡•œ‘ƒŽ•†‡‡’ƒ–Š‹• Š‡˜ƒŽ‹†ƒ–‹‡˜ƒ †‡‰‡˜‘‡Ž‡•˜ƒ†‡’ƒ–‹´–Ǥ †‡–™‡‡†‡ˆƒ•‡ǡ™ƒ‡‡”†‡•–”‡••™ƒ–ƒˆ‰‡‘‡‹•ǡ˜”ƒƒ‰–†‡ –Š‡”ƒ’‡—–‘‘’Š‡Ž†‡”‹‰˜ƒ‡‡•‹–—ƒ–‹‡‘ˆ—‹–Ž‡‰„‹Œ†‡‰‡˜‘‡Ž‡•‡‰‡†ƒ Š–‡˜ƒ†‡ ’ƒ–‹´–Ǥ ˆ‡‹–‡‰ƒƒ–†‡–Š‡”ƒ’‡—–ƒƒ•–†‡’ƒ–‹´–œ‹––‡‘•ƒ‡‡–†‹‡‰‡‡‡‡” †—‹†‡Ž‹ŒŠ‡‹†–‡”‹Œ‰‡‘˜‡”†‹‡•„‹‡™‡”‡Ž†Ǥƒƒ™‘”†‡†‡–ƒ‹Ž•‘†‡”œ‘ Š–†‹‡†‡ ’ƒ–‹´–‡‘–‹‘‡‡ŽŽ‹Œ‡–‡”ƒ‡ǡ‘ˆ†‡’ƒ–‹´–œ‘—†‡‘‡–‡„‡Ã˜Ž‘‡†‡ǡƒƒ”†ƒ–‹‡– doen. Dit leidt vervolgens tot de volgende fase, die ook wel ‘gementaliseerde emotionaliteit’ ‰‡‘‡†™‘”†–Ǥ †‡œ‡ˆƒ•‡‹•Š‡–˜ƒ„‡Žƒ‰‘†‡’ƒ–‹´–ƒƒ–‡•’‘”‡–‡”‡ˆŽ‡ –‡”‡‘’ ‡‘–‹‡•ǡ–‡”™‹ŒŽ†‡œ‡‹Š‡–Š‹‡”Ǧ‡Ǧ—™‘”†‡‡”˜ƒ”‡Ǥ ‡–‡š’Ž‹ ‹‡–‡–ƒŽ‹•‡”‡˜ƒ‡‡ ’”‹ƒ‹”‡ǡƒˆˆ‡ –‹‡˜‡‡”˜ƒ”‹‰‰‡‡ˆ–†‡’ƒ–‹´–†‡‘‰‡Ž‹ŒŠ‡‹†‘‡”‡‡”ƒˆ•–ƒ†˜ƒ–‡‡‡ǡ

™ƒƒ”†‘‘”‡””—‹–‡‘–•–ƒƒ–‘ƒ†‡”‡ǡ‡‡”†‘‘”†ƒ Š–‡‡—œ‡•–‡—‡ƒ‡Ǥ †‡ A Žƒƒ–•–‡ˆƒ•‡™‘”†–‡”‡š’Ž‹ ‹‡–‰‡’”ƒƒ–‘˜‡”†‡”‡Žƒ–‹‡–—••‡–Š‡”ƒ’‡—–‡’ƒ–‹´–Ǥ †‡œ‡ˆƒ•‡ ”‡ˆŽ‡ –‡”‡œ‘™‡Ž’ƒ–‹´–ƒŽ•–Š‡”ƒ’‡—–‘’Š—‡‘–‹‘‡Ž‡‡”˜ƒ”‹‰‡‘–‡™‡–‡–‡‘‡ Š‘‡†‡œ‡†‘‘”Š—”‡Žƒ–‹‡™‘”†‡„‡Ã˜Ž‘‡†ǤDuur en frequentie.   ˜‡”‰‡Ž‹Œ‹‰‡–†‡‘”‹‰‹‡Ž‡‹•†‡Ž‡‰–‡˜ƒ’ ‘‰‡™‹Œœ‹‰†‰‡„Ž‡˜‡ǣͳͺƒƒ†‡Ǥ‡ˆ”‡“—‡–‹‡‡†——”˜ƒ•‡••‹‡•‹•‡ Š–‡”˜‡”‹†‡”†Ǥ œ‡‡”˜ƒ”‹‰‘’„ƒ•‹•˜ƒ‡‡’”‘‡ˆǦ‹–‡”˜‡–‹‡‹•†ƒ–‰‡ƒ••‘ ‹‡‡”†‹•‡–‡”•–‹‰‡”‡ „‡’‡”‹‰‡‹Š‡–‡–ƒŽ‹•‡”‡†˜‡”‘‰‡†ƒ„‹Œ’ƒ–‹´–‡‡–‡‡‘”†‡”Ž‹‡ ‡”•‘‘Ž‹ŒŠ‡‹†••–‘‘”‹•Ǥ ‡œ‹‡Š‡–‰‡˜ƒƒ”˜ƒ‘˜‡”’”‹‡Ž‹‰„‹Œ–Š‡”ƒ’‡—–‹• Š‡‹–‡”˜‡–‹‡•ǡ ‹•‰”‘‡’•–Š‡”ƒ’‹‡„‡’‡”––‘–‡‡™‡‡Ž‹Œ•‡•‡••‹‡•˜ƒͳ——”ǡ–‡”™‹ŒŽ‹†‹˜‹†—‡Ž‡–Š‡”ƒ’‹‡ ’Žƒƒ–•˜‹†–‹–™‡‡™‡‡Ž‹Œ•‡•‡••‹‡•˜ƒ‡‡ŠƒŽˆ——”Ǥ

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Groepstherapie.

 †ƒ–’ƒ–‹´–‡‡–†‡‡‹‰‹‰Š‡„„‡‘˜‡‡Ž•–”‡••–‡‡”˜ƒ”‡ ‹•‘ ‹ƒŽ‡•‹–—ƒ–‹‡•ǡ„‹‡†–‰”‘‡’•–Š‡”ƒ’‹‡„‹Œ—‹–•–‡†‡‘‰‡Ž‹ŒŠ‡‹†–‡‘‡ˆ‡‡‡– ‡–ƒŽ‹•‡”‡‹‡‡•–”‡••˜‘ŽŽ‡‘‰‡˜‹‰Ǥ ”‘‡’•–Š‡”ƒ’‹‡ƒ‘‘‡‡‰‡˜‘‡Ž˜ƒ ˜‡”„‘†‡Š‡‹†‡‰‡Š‡ Š–Š‡‹†‰‡‡”‡”‡ǡ†ƒ–‡–ƒŽ‹•‡”‡„‡˜‘”†‡”–Ǥ‡‰”‘‡’‡„‡˜ƒ––‡ ƒš‹ƒƒŽƒ Š–’ƒ–‹´–‡‡™‡”†‡‰‡‰‡˜‡†‘‘”±±‡”˜ƒ”‡’Ǧ–Š‡”ƒ’‡—–‡‡‡ ‘Ǧ –Š‡”ƒ’‡—–ǤIndividuele therapie.  ƒƒ•–†‡‰”‘‡’•–Š‡”ƒ’‹‡„‘‘†‹†‹˜‹†—‡Ž‡–Š‡”ƒ’‹‡†‡‘‰‡Ž‹ŒŠ‡‹† ˜‘‘”‹–‡•‹‡˜‡” ‘–ƒ ––—••‡’ƒ–‹´–‡–Š‡”ƒ’‡—–Ǥ ‡–Š‘‘ˆ††‘‡Ž˜ƒ‹†‹˜‹†—‡Ž‡–Š‡”ƒ’‹‡ ™ƒ•Š‡–‘’„‘—™‡˜ƒ‡‡˜‡”–”‘—™‡•„ƒ††‹‡ˆ—‰‡‡”†‡ƒŽ•‡‡˜‡‹Ž‹‰‡„ƒ•‹•˜ƒ™ƒƒ”—‹– ‡‘–‹‘‡‡Ž„‡Ž Metingen.ƒ†‡‰‡†ƒ Š–‡•‡Š‡”‹‡”‹‰‡‘†‡™‘”†‡‘†‡”œ‘ Š–Ǥ  ‡–‘†‡”œ‘‡„‡˜ƒ––‡˜‹‡”„‡‘‘”†‡Ž‹‰•‘‡–‡˜‡”•’”‡‹†‘˜‡”‡‡ ’‡”‹‘†‡˜ƒʹŒƒƒ”Ǥ‡—Ž‡–‹‰ȋͲȌ˜‘†’Žƒƒ–•˜‘‘”†ƒ–’™‡”†‰‡•–ƒ”–Ǥ ƒŽ˜‡”™‡‰‡†‡ ’„‡Šƒ†‡Ž‹‰ǡƒ‡‰‡ƒƒ†‡ǡ˜‘†‡”ƒŽŽ‡‡‡‡‡–‹‰’Žƒƒ–•‡–†‡•›ƒ–‡Ǥƒͳͺ ƒƒ†‡ȋ†‹”‡ –ƒ†ƒ–’™ƒ•„‡´‹†‹‰†Ȍ‡ƒʹͶƒƒ†‡ȋ͸ƒƒ†‡ƒ†ƒ–’™ƒ• „‡´‹†‹‰†Ȍ˜‘†‡‡”—‹–‰‡„”‡‹†‡‡–‹‰‡’Žƒƒ–•‡–ƒŽŽ‡—‹–‘•–ƒ–‡Ǥ‡’”‹ƒ‹”‡ —‹–‘•–ƒƒ–ǡ•‘ ‹ƒƒŽˆ— –‹‘‡”‡ǡ™‡”†„‹Œƒƒ˜ƒ‰ȋͲȌ†‹”‡ –ƒ„‡Šƒ†‡Ž‹‰ȋʹȌ‡‡‡ Š ƒŽˆŒƒƒ”ƒŠ‡–‡‹†‡˜ƒ†‡„‡Šƒ†‡Ž‹‰‰‡‡–‡ȋ͵ȌǤ Deel III, Hoofdstuk 7.

 ‡”‡•—Ž–ƒ–‡˜ƒŠ‘‘ˆ•–—͹•—‰‰‡”‡”‡†ƒ–’ƒ–‹´–‡‹œ‘™‡Ž†‡ Ǧ ‘†‹–‹‡ƒŽ•†‡ ’Ž—•’Ǧ ‘†‹–‹‡‡‡‰”‘–‡˜‡”„‡–‡”‹‰Ž‹‡–‡œ‹‡‘’‰‡„‹‡†˜ƒ•‘ ‹ƒƒŽˆ— –‹‘‡”‡Ǥ ƒ–’ƒ–‹´–‡ƒŽŽ‡‡‘’„ƒ•‹•˜ƒ ƒŽ‡‡‰”‘–‡˜‡”„‡–‡”‹‰Ž‹‡–‡œ‹‡‘’Š‡–‰‡„‹‡†˜ƒ •‘ ‹ƒƒŽˆ— –‹‘‡”‡œƒŽ˜‘‘”•‘‹‰‡‡‡”•‰‡‡˜‡””ƒ••‹‰œ‹ŒǤ‘ƒŽ•‰‡œ‡‰†Š‡„„‡ Ǧ –‡ƒ•‡‡”†‡”‡’”‘ˆ‡••‹‘ƒŽ•†‹‡‰‡•’‡ ‹ƒŽ‹•‡‡”†œ‹Œ‹Š‡–Š‡Ž’‡˜ƒ’ƒ–‹´–‡„‹ŒŠ‡– •–”— –—”‡”‡˜ƒŠ—•‘ ‹ƒŽ‡Ž‡˜‡ǡ™ƒƒ”‘†‡”ƒƒ–• Šƒ’’‡Ž‹Œ™‡”‡”•‡ Ǧ ‘ƒ Š‡•Ǥƒ– ƒŽŽ‡‡Š‡–•‘ ‹ƒƒŽˆ— –‹‘‡”‡ƒ˜‡”„‡–‡”‡ǡ™‘”†–‘†‡”•–‡—††‘‘”‡‡Ž‡‡‡”†‡”‡ „‡˜‹†‹‰‡ȋ„‹Œ˜Ǥ”—‡”ǡ‹••‡”ǡ›–‡ƒǡƬƒ•ǡʹͲͳ͵Ȍǡƒƒ”–‡‰‡‰‡•’”‘‡†‘‘”‡‡ ƒ†‡”‘†‡”œ‘‡ȋ›•–‡ƒǡ—†‡”‹ǡŽ‘‡‡”•ǡ‘‘”†ƒǡƬ‹‡”•ƒǡʹͲͲ͹ȌǤƒƒ”ƒƒ•–ƒ†‡ –‘‡˜‘‡‰‹‰˜ƒ ‘‰‡Ž‹Œ‘‘Š‡„„‡„‹Œ‰‡†”ƒ‰‡ƒƒ‡‡’‘•‹–‹‡˜‡”‡ˆˆ‡ –‘’Š‡–•‘ ‹ƒƒŽ ˆ— –‹‘‡”‡ǡœ‘ƒŽ•‡‡”†‡”‘†‡”œ‘‡‹’Ž‹ ‡‡”†‡ȋ ‘ˆˆƒǡ ¡ ‡Žǡ Žƒ—•‡”Ƭ—’’‡”ǡʹͲͳʹǢ ‘•‡–ƒŽǤǡʹͲͳͻȌǤ‡•Ž‘––‡Š‡„„‡‡‡”‡•‡‹†‡ ‰”‘‡’ ‰‡‘–‡ȋα͸Ȍ†ƒ‹†‡ ’‰”‘‡’ȋαͳȌǡ™ƒ–ƒ„‹Œ‰‡†”ƒ‰‡Š‡„„‡ƒƒ†‡–‘‡ƒ‡˜ƒŠ‡–•‘ ‹ƒƒŽˆ— –‹‘‡”‡‹ †‡ Ǧ ‘†‹–‹‡Ǥ  ‡”‡•—Ž–ƒ–‡•—‰‰‡”‡‡”†‡˜‡”†‡”™‡Ž†ƒ–Š‡–‡ˆˆ‡ –˜ƒ ’Ž—•’”‘„——•–‡” ™ƒ•†ƒ ƒŽŽ‡‡‡œ‡•ƒƒ†‡ƒŠ‡–‡‹†‡˜ƒ„‡Šƒ†‡Ž‹‰„‡Š‘—†‡„Ž‡‡ˆǤ‡ˆ‘ŽŽ‘™Ǧ —’’‡”‹‘†‡˜ƒœ‡•ƒƒ†‡‹•‡ Š–‡”˜‡‡Ž–‡‘”–‘†ƒƒ”‘˜‡”†‡ˆ‹‹–‹‡˜‡—‹–•’”ƒ‡–‡†‘‡Ǥ

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ƒ–‡ƒ‡ ‘ƒ‰›ȋʹͲͲͳȌ˜‘†‡‡‡”†‡”†ƒ–”‘„——•–‡˜‡”ƒ†‡”‹‰‡„‡™‡”•–‡ŽŽ‹‰†‡„‹Œ ’ƒ–‹´–‡‡–‘”†‡”Ž‹‡‡”•‘‘Ž‹ŒŠ‡‹†••–‘‘”‹•ǡ†‹‡œ‡Žˆ•–‘–ƒ Š–Œƒƒ”ƒŠ‡–„‡´‹†‹‰‡˜ƒ †‡„‡Šƒ†‡Ž‹‰ƒƒŠ‹‡Ž†‡ȋƒ–‡ƒƬ ‘ƒ‰›ǡʹͲͲͺȌǤ‡‘‘”œƒƒ˜ƒ†‡œ‡”‘„——•–‡”‡ ˜‡”„‡–‡”‹‰• Š”‡˜‡œ‹Œ–‘‡ƒƒ˜‡”„‡–‡”‹‰‡˜ƒŠ‡–‡–ƒŽ‹•‡”‡†˜‡”‘‰‡ǡ†ƒ–’ƒ–‹´–‡ „‡–‡”‹•–ƒƒ–œ‘—•–‡ŽŽ‡‘†‡•–”‡••˜ƒŠ‡–†ƒ‰‡Ž‹Œ•Ž‡˜‡Š‡–Š‘‘ˆ†–‡„‹‡†‡‡„‡–‡” ’•› Š‘•‘ ‹ƒƒŽ–‡ˆ— –‹‘‡”‡Ǥ  ‡–‹•†ƒƒ”‘‹–‡”‡••ƒ––‡‘‡‡†ƒ–ǡŠ‘‡™‡ŽŠ‡–„‡™‹Œ•˜‘‘”Š‡–˜‘‘”‰‡•–‡Ž†‡ ˜‡”ƒ†‡”‹‰•‡ Šƒ‹•‡˜ƒǦ†‡˜‡”„‡–‡”‹‰˜ƒŠ‡–‡–ƒŽ‹•‡”‡†˜‡”‘‰‡Ǧ‘‰ •–‡‡†•• Šƒƒ”•‹•ȋ‘••‘—™Ƭ ‘ƒ‰›ǡʹͲͳʹǢ†‡‡—Ž‡‡‡•–‡”ǡƒ•–‡‡Žƒ†–ǡ—›–‡ǡƬ‘™› ǡ ʹͲͳͺȌǡ†‡Š—‹†‹‰‡”‡•—Ž–ƒ–‡•—‰‰‡”‡”‡†ƒ–’ƒ–‹´–‡‹†‡’Ǧ‰”‘‡’„‡–‡”’”‡•–‡‡”†‡‘’ ˜‡”• Š‹ŽŽ‡†‡ƒ–‡˜ƒ‡–ƒŽ‹•‡”‡†˜‡”‘‰‡Ǥƒ–‹´–‡’”‡•–‡‡”†‡„‡–‡”‘’†‡ ǡ‘’†‡ dimensies ‘begrip van sociale causaliteit’ en ‘complexiteit van representaties’ van de SCORS, en ‘’Š‡–‹–‡œ‹‡–‡Ǧ‹œ‹ Š–˜ƒ†‡Ǥ‡†‹ƒ–‹‡ǦƒƒŽ›•‡•Ž‡˜‡”†‡‡ Š–‡”•Ž‡ Š–•„‡’‡”– „‡™‹Œ•†ƒ–‡‡˜‡”„‡–‡”‹‰˜ƒŠ‡–‡–ƒŽ‹•‡”‡†˜‡”‘‰‡‘‘‡ Š–„‹Œ†”‘‡‰ƒƒŠ‡– „‡Šƒ†‡Ž‡ˆˆ‡ –Ǥ  ‡”†‡”–‘‘†‡‡‡‘†‡”ƒ–‹‡ǦƒƒŽ›•‡ƒƒ†ƒ–’ƒ–‹´–‡‡–‡‡‘”–‡”‡œ‹‡–‡†——”‡‡ „‡–‡”‡„‡Šƒ†‡Ž”‡•’‘•˜‡”–‘‘†‡ǡ‘˜‡”‡‡‘•–‹‰‡‡”†‡”‘†‡”œ‘‡ȋ„‹Œ˜‘‘”„‡‡Ž†‹ ‘Ž ‡–ƒŽǤʹͲͳͶȌǤ‡œ‡”‡•—Ž–ƒ–‡•–”‘‡‘‘‡–‡‡‰”‘‡‹‡†ƒƒ–ƒŽƒ”–‹‡Ž‡†ƒ–•—‰‰‡”‡‡”–†ƒ– †‡‡‡”•–‡˜‹ŒˆŒƒƒ”˜ƒ‡‡ ”— ‹ƒŽ‡’‡”‹‘†‡˜‘‘”‹–‡”˜‡–‹‡˜‘”‡ȋ‹” Š™‘‘†Ƭ ƒ ‹ŽŽƒǡͳͻͻ͵Ǣ ‘””›ǡ‡Ž•‘ǡ ‘Ž†•–‘‡ǡƬ—‰ǡʹͲͳͲȌǤ ‡–•‘ ‹ƒƒŽˆ— –‹‘‡”‡ ˜‡”•Ž‡ Š–‡”–ƒ‡Ž‹ŒŠ‡–‡‡•–‹†‡‡‡”•–‡ͷŒƒƒ”ƒŠ‡–‘–•–ƒƒ˜ƒ†‡‡‡”•–‡’•› Š‘•‡ ȋ‹” Š™‘‘†Ƭƒ ‹ŽŽƒǡͳͻͻ͵Ȍ‡œ‹‡–‡†——”‹•‰‡Ã†‡–‹ˆ‹ ‡‡”†ƒŽ•‡‡„‡Žƒ‰”‹Œ‡˜‘‘”•’‡ŽŽ‡” ˜ƒ‡‡•Ž‡ Š–‡„‡Šƒ†‡Ž”‡•’‘•ȋ‹‡„‡”ƒǡ‹š‘ǡƬ ‘Ž†ƒǡʹͲͳ͵ȌǤ˜‡”‘‘”œƒƒ–‡‡ ‰”‘–‡Š‘‡˜‡‡ŽŠ‡‹†ƒƒ’”‘„Ž‡‡†‹‡–Š‡”ƒ’‡—–‹• Š‡‹–‡”˜‡–‹‡•—‡ ‘’Ž‹ ‡”‡

ƒƒ”ƒ–‡†‡•–‘‘”‹•˜‘”†‡”–ǡ™ƒƒ”‘†‡” ‘‰‹–‹‡˜‡ƒ Š–‡”—‹–‰ƒ‰ȋ›‡•ǡ —††›ǡ‡ŽŽƒ”†ǡ A  —”ǡƬœ‘„‘”ǡʹͲͳͳȌ‡‰”‘–‡”‡”‹‰‹†‹–‡‹––‡‘’œ‹ Š–‡˜ƒ†‡‡‹‰‡‘˜‡”–—‹‰‹‰‡ȋ‹ ‘Ž ‡–ƒŽǤʹͲͳͶȌǤƒƒ”‘Š‡„„‡˜‡”• Š‡‹†‡‡‘†‡”œ‘‡‡”•‡ Ž‹‹ ‹‰‡‘’’‡”††ƒ–†‡„‡Šƒ†‡Ž‹‰ ˜ƒ˜‡”• Š‹ŽŽ‡†‡•–ƒ†‹ƒ˜ƒ‘‘‡‡˜‡”• Š‹ŽŽ‡†‡„‡ƒ†‡”‹‰‡˜‡”‡‹•–ȋ ‘””›ǡ ‡Ž•‘ǡ ‘Ž†•–‘‡ǡƬ—‰ǡʹͲͳͲȌǤ  ‡‘„•‡”˜‡‡”†‡˜‡”†‡”†ƒ–’ƒ–‹´–‡‹†‡ ’Ž—•’ ‘†‹–‹‡‡‡‰”‘–‡”‡ ƒˆƒ‡˜ƒ•‘ ‹ƒŽ‡•–”‡••‹Š‡–„‹Œœ‹Œ˜ƒƒ†‡”‡Ž‹‡–‡œ‹‡Ǥ‡œƒ‰‡‡ Š–‡”‰‡‡‰”‘–‡”‡ ˜‡”„‡–‡”‹‰‡‹†‡ ’Ž—•’ ‘†‹–‹‡‘’™ƒŽ‹–‡‹–˜ƒŽ‡˜‡ȋȌǢƒˆˆ‡ –Ǧ–‘‘˜ƒ ”‡Žƒ–‹‡•‡˜‡”‘‰‡‘‡‘–‹‘‡‡Ž–‡‹˜‡•–‡”‡ȋȌǢ‘’‹††‡Ž‡‰‡„”—‹ǡ’•› Š‘–‹• Š‡ •›’–‘‡ǡ‡‰ƒ–‹‡ˆƒˆˆ‡ –‡•–”‡••”‡ƒ –‹˜‹–‡‹–‹Š‡–†ƒ‰‡Ž‹Œ•Ž‡˜‡ȋȌǢ‘ˆ’‘•‹–‹‡˜‡ǡ ‡‰ƒ–‹‡˜‡ǡƒ‰•–‹‰‡‡†‡’”‡••‹‡˜‡•›’–‘‡ȋȌǤ‡‘‰‡Ž‹Œ˜‡”Žƒ”‹‰˜‘‘”Š‡– ‰‡„”‡ƒƒ˜‡”†‡”‡„‡Šƒ†‡Ž”‡•—Ž–ƒ–‡‹•†ƒ–†‡’ƒ–‹´–‡‹‘œ‡•–‡‡’”‘‡ˆƒƒ”‡Žƒ–‹‡ˆ‹Ž†‡

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146807_JonasWeijers_BNW_def.indd 201 28-10-2020 15:09 Summary in Dutch

•›’–‘‡Ž‡†‡Ǥ ‘”‡•˜‘‘”’‘•‹–‹‡˜‡‡‡‰ƒ–‹‡˜‡•›’–‘‡„‹Œƒƒ˜ƒ‰™ƒ”‡ ˜‡”‰‡Ž‹Œ„ƒƒ”‡–†‹‡˜ƒȋ†‡‡Ž•ȌŠ‡”•–‡Ž†‡’ƒ–‹´–‡ȋČešková, Přikryl, Kašpárek, & Ondrušova, ʹͲͲͷǢŠƒŠŽƒ†‹”ƒ‡–ƒŽǤʹͲͳͺȌǤ‡œ‡„ƒ•‹•• ‘”‡•™‡‡”•’‹‡‰‡Ž‡™ƒƒ”• Š‹ŒŽ‹Œrecruitment bias ‡‡œ‘‰‡ƒƒ†‡ ǡ™ƒƒ”„‹Œ˜‘‘”ƒ‡Ž‹Œ”‡Žƒ–‹‡ˆ•–ƒ„‹‡Ž‡’ƒ–‹´–‡†‡‡Žƒ‡ƒƒŠ‡–‘†‡”œ‘‡Ǥ ‹Œ†‡•†‡•‡Ž‡ –‹‡’”‘ ‡†—”‡™‡”†ƒƒ Ž‹‹ ‹‰‡˜”ƒƒ‰†‘Š— ƒ•‡Ž‘ƒ†•†‘‘”–‡‡‡‘’ ’ƒ–‹´–‡†‹‡‘‰‡Ž‹Œ‹ƒƒ‡”‹‰œ‘—†‡—‡‘‡˜‘‘”†‡‡Žƒ‡ƒƒŠ‡–‘†‡”œ‘‡Ǥ ƒ‰‡œ‹‡•Ž‡ Š–•‘‰‡˜‡‡”ʹͲΨ˜ƒ†‡„‡• Š‹„ƒ”‡’ƒ–‹´–‡™‡”††‘‘”˜‡”™‡œ‡ƒƒ”Š‡– ‹–ƒ‡‰‡•’”‡˜ƒŠ‡–‘†‡”œ‘‡ǡ‹•Š‡–‘‰‡Ž‹Œ†ƒ– Ž‹‹ ‹˜‘‘”ƒŽ†‡•–ƒ„‹‡Ž‡”‡’ƒ–‹´–‡ Š‡„„‡„‡ƒ†‡”†Ǥ Implicaties voor de klinische praktijk

‡Ž‹‹• Š‡‹œ‹ Š–‡˜‡””‡‰‡—‹–†‹–’”‘‡ˆ• Š”‹ˆ–‰‡˜‡‡‡Ž‡ƒƒ™‹Œœ‹‰‡˜‘‘”†‡ ˜‡”„‡–‡”‹‰˜ƒ’•› Š‘–Š‡”ƒ’‡—–‹• Š‡‹–‡”˜‡–‹‡•˜‘‘”Ǥ‡œ‹Œ˜ƒ‡‹‰†ƒ–Š‡–˜‘‘” Ž‹‹ ‹—––‹‰ƒœ‹Œ‘ƒƒ”†‡ƒƒ™‡œ‹‰Š‡‹†˜ƒ‹•Šƒ†‡Ž‹‰‹†‡‹†‡”–‹Œ†–‡˜”ƒ‰‡ǡ ‘†ƒ–™‡Š‡„„‡ƒƒ‰‡–‘‘††ƒ–†‹–‘’˜‡”• Š‹ŽŽ‡†‡ƒ‹‡”‡‹˜Ž‘‡†Š‡‡ˆ–‘’†‡‡”•–˜ƒ •›’–‘‡‹†‡˜‘Ž™ƒ••‡Š‡‹†Ǥ ‡–˜ƒ•–•–‡ŽŽ‡˜ƒ†‡ƒƒ™‡œ‹‰Š‡‹†˜ƒ‹•Šƒ†‡Ž‹‰‹†‡ ‹†‡”–‹Œ†ƒœ‘™‡Ž’ƒ–‹´–‡ƒŽ•ƒ”–•‡‡‡”‹œ‹ Š–‰‡˜‡‹†‡’ƒ–Š‘‰‡‡•‡˜ƒ†‡ ƒƒ†‘‡‹‰Ǥƒƒ”ƒƒ•–ƒ‡‹•˜ƒ†‡ƒ‹‡”™ƒƒ”‘’‹†‡”‹•Šƒ†‡Ž‹‰„‹Œ†”ƒƒ‰–ƒƒŠ‡– ‘–•–ƒƒ˜ƒ’•› Š‘•‡Š‡Ž’‡„‹ŒŠ‡–‘–™‹‡Ž‡˜ƒ’”‡˜‡–‹‡•–”ƒ–‡‰‹‡´Ǥ  ‡”†‡”œ‹Œ™‹Œ˜ƒ‡‹‰†ƒ–†‡”‡Žƒ–‹‡ˆ”‘„——•–‡˜‡”„‡–‡”‹‰‡‘’Š‡–‰‡„‹‡†˜ƒ •‘ ‹ƒƒŽˆ— –‹‘‡”‡‡‡–ƒŽ‹•‡”‡†˜‡”‘‰‡†‹‡œ‹Œ‰‡‘„•‡”˜‡‡”†‹†‡’ ‘†‹–‹‡ǡ˜ƒ Ž‹‹• Š„‡Žƒ‰œ‹ŒǤ ‘‡™‡Ž”‡†‡Ž‹Œ‡”™‹Œ•„‡ƒ”‰—‡–‡‡”†œ‘——‡™‘”†‡†ƒ–’‹‡– ˜‡‡Ž–‘‡˜‘‡‰–ƒƒ ǡ‘†ƒ–„‡‹†‡‡‡‰”‘‘–‡ˆˆ‡ –•‘”–‡”‡‘’Š‡–‰‡„‹‡†˜ƒ•‘ ‹ƒƒŽ ˆ— –‹‘‡”‡ǡ„Ž‡‡†‹‡˜‡”„‡–‡”‹‰‡‹†‡’Ǧ ‘†‹–‹‡œ‡•ƒƒ†‡ƒŠ‡–‡‹†‡˜ƒ†‡ „‡Šƒ†‡Ž‹‰‹•–ƒ†–‡„Ž‹Œ˜‡‡”‘„——•–‡”–‡œ‹Œ†ƒ ƒŽŽ‡‡Ǥƒ–‹•‹–‡”‡••ƒ–˜‘‘”†‡ Ž‹‹• Š‡’”ƒ–‹Œ‘†ƒ–‡”–‘–—–‘‡™‡‹‹‰„‡™‹Œ•‹•‰‡™‡‡•–†ƒ–’•› Š‘•‘ ‹ƒŽ‡‹–‡”˜‡–‹‡• Š‡–•‘ ‹ƒƒŽˆ— –‹‘‡”‡†——”œƒƒ—‡˜‡”„‡–‡”‡ȋƒ–Š‡”‡–ƒŽǤǡʹͲͲͷǢƒ™•ǡƒ”Ž‹‰–‘ǡ ‘†‡Žǡ ‡ƒǡƬ ƒ—Šƒ”ǡʹͲͳͺǢ ”‡‡Ƭ ‘”ƒǡʹͲͳͻȌǤƒ‰‡œ‹‡•‘ ‹ƒƒŽ†‹•ˆ— –‹‘‡”‡ ˜‘‘”•’‡ŽŽ‡†‹•˜‘‘”–‡”—‰˜ƒŽ‹’•› Š‘•‡ȋ‘—–—”‡ǡ‡Ƭ‘„‡”–•ǡʹͲͲ͸Ȍǡœ‘—†‡–‘‡˜‘‡‰‹‰ ˜ƒ’ƒƒ ǡ‘†ƒ•†‡ƒ”„‡‹†•‹–‡•‹‡˜‡ƒƒ”†˜ƒ†‡–Š‡”ƒ’‹‡ǡ‘•–‡‡ˆˆ‡ –‹‡˜‡” —‡„Ž‹Œ‡Ǥ ‡–„‡’‡”–‡ƒƒ–ƒŽ‰‡‘„•‡”˜‡‡”†‡œ‹‡‡Š—‹•‘’ƒ‡•˜ƒ’ƒ–‹´–‡†‹‡ƒ –‹‡ˆ †‡‡Žƒ‡ƒƒ’Ž‹Œ–Š‹‡”‹†‡”†ƒƒ†˜‘‘”–‡’Ž‡‹–‡ȋœ‹‡Š‘‘ˆ†•–—͹ȌǡŠ‘‡™‡Ž‡‡” ‘†‡”œ‘‡‘†‹‰‹•‘Š‹‡”‘˜‡”†‡ˆ‹‹–‹‡˜‡—‹–•’”ƒ‡–‡†‘‡Ǥ  ‡–™ƒƒ”‰‡‘‡‡ˆˆ‡ –˜ƒ’‘’•‘ ‹ƒƒŽˆ— –‹‘‡”‡ǡŽ‹Œ–‹†‡•—„‰”‘‡’˜ƒ ”‡Žƒ–‹‡ˆ”‡ ‡–‡’ƒ–‹´–‡Š‡–‰”‘‘–•–Ǥ‡ ‡–‡’ƒ–‹´–‡‹†‡’‰”‘‡’˜‡”–‘‘†‡”‡Žƒ–‹‡ˆ ‰”‘–‡˜‡”„‡–‡”‹‰‡ǡ™ƒƒ”„‹Œ‹˜‡ƒ—•˜ƒˆ— –‹‘‡”‡™‡”†‡„‡”‡‹–ȋαͳͳ͸ǤͷͺǢœ‹‡

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146807_JonasWeijers_BNW_def.indd 202 28-10-2020 15:09 Summary in Dutch

Š‘‘ˆ†•–—͹Ȍ†‹‡œ‹ Š„‡˜‹†‡–—••‡†‹‡˜ƒ’ƒ–‹´–‡ȋαͳͲͺǤͲ͹Ȍ‡‰‡œ‘†‡‡•‡ ȋαͳʹ͵Ǥ͵͸Ȍǡœ‘ƒŽ•‡‡”†‡”‹•˜ƒ•–‰‡•–‡Ž††‘‘”††‹‰–‘‡††‹‰–‘ȋʹͲͲͺȌǤ‡‰”‘–‡”‡ „‡Šƒ†‡Ž”‡•’‘•˜ƒ”‡Žƒ–‹‡ˆ”‡ ‡–‡’ƒ–‹´–‡ƒ„‡–‡‡‡†ƒ–’‡‡”†‡”‹’Žƒƒ–•˜ƒ Žƒ–‡”œ‘—‘‡–‡™‘”†‡‰‡Ã’Ž‡‡–‡‡”† Maatschappelijke implicaties en toekomstig onderzoek

‡”‡Ž†™‹Œ†‘–™‹‡Ž‡‘‰‡˜‡‡”͹ǡͷ’‡”ͳͲͲͲ’‡”•‘‡‡‡’•› Š‘–‹• Š‡•–‘‘”‹•‰‡†—”‡†‡ Š—Ž‡˜‡ȋ‘”‡‘Ǧò•–‡”ǡƒ”–‹ǡƬƒ•–‘”ǡʹͲͳͺȌǤƒ–„‡–‡‡–†ƒ–‡”ǡ‰‡„ƒ•‡‡”†‘’Š‡– Š—‹†‹‰‡„‡˜‘Ž‹‰•ƒƒ–ƒŽȋ‹–‡d Nations Population Division), wereldwijd naar schatting zo’n ͷͺ‹ŽŒ‘‡‡•‡‘’‡‡„‡’ƒƒŽ†‘‡–‹Š—Ž‡˜‡‡‡’•› Š‘–‹• Š‡•–‘‘”‹•œ—ŽŽ‡ ‘–™‹‡Ž‡Ǥƒ‰‡œ‹‡’•› Š‘–‹• Š‡•–‘‘”‹••‡†‡‡‹‰‹‰Š‡„„‡‘’ƒ–‹´–‡‡”•–‹‰–‡ ‹˜ƒŽ‹†‡”‡ǡŽ‡˜‡”‡’•› Š‘–‹• Š‡•–‘‘”‹••‡‡‡•—„•–ƒ–‹´Ž‡„‹Œ†”ƒ‰‡ƒƒ†‡™‡”‡Ž†™‹Œ†‡ œ‹‡–‡Žƒ•–ǡ‹‡‡”•–‡’Žƒƒ–•˜‘‘”’ƒ–‹´–‡œ‡Žˆǡƒƒ”‘‘˜‘‘”•ƒ‡Ž‡˜‹‰‡ȋƒ–Š‡”•ǡ ƒ–Ƭ ‘‡”ƒǡʹͲͲͺȌǤ‡„‡Žƒ‰”‹Œ‡‘‘”œƒƒ˜ƒ†‹–Š‘‰‡‹˜‡ƒ—˜ƒ‹˜ƒŽ‹†‡”‹‰‹•˜‡”‘‡†‡Ž‹Œ†‡ ƒ Š–‡”—‹–‰ƒ‰˜ƒŠ‡–•‘ ‹ƒƒŽˆ— –‹‘‡”‡Ǥ ‘‡™‡Ž‡”‹†‡Žƒƒ–•–‡†‡ ‡‹ƒ˜‡”• Š‹ŽŽ‡†‡ ’•› Š‘–Š‡”ƒ’‡—–‹• Š‡‹–‡”˜‡–‹‡•œ‹Œ‘–™‹‡Ž†˜‘‘”’•› Š‘–‹• Š‡•–‘‘”‹••‡„Ž‹Œˆ–„‡™‹Œ• †ƒ–œ—Ž‡‹–‡”˜‡–‹‡•œ‘”‰‡˜‘‘”†——”œƒ‡˜‡”„‡–‡”‹‰‡‘’‰‡„‹‡†˜ƒ•‘ ‹ƒƒŽˆ— –‹‘‡”‡ ‘ˆ ‘‰‹–‹‡‘‡–‡‡Ž„‡’‡”–ȋ ”‡‡ǡ ‘”ƒƬ‡‡ǡʹͲͳͻǢƒ™•ǡƒ”Ž‹‰–‘ǡ‘†‡Žǡ ‡ƒǡ Ƭ ƒ—Šƒ”ǡʹͲͳͺȌǤ ‹–’”‘‡ˆ• Š”‹ˆ–Ž‡˜‡”–‡‡„‹Œ†”ƒ‰‡ƒƒ†‡‘–™‹‡Ž‹‰˜ƒ’•› Š‘•‘ ‹ƒŽ‡‹–‡”˜‡–‹‡• †‹‡œ‹ Š”‹ Š–‘’†——”œƒ‡˜‡”„‡–‡”‹‰˜ƒŠ‡–•‘ ‹ƒƒŽ ‘‰‹–‹‡ˆ‡ˆ— –‹‘‡”‡†‹˜‡ƒ—Ǥ”œ‹Œevidence based ‡ Š–‡”‘‰˜‡‡Ž˜”ƒ‰‡‘˜‡”†‡‡ˆˆ‡ –‡˜ƒ’ǡ˜‘‘”†ƒ–†‡œ‡ƒŽ• „‡Šƒ†‡Ž‹‰ ‹‰‡œ‡–ƒ™‘”†‡Ǥ ‡–„Ž‹Œˆ–†‡˜”ƒƒ‰Š‘‡’Š‡–„‡•–‰‡Ã’Ž‡‡–‡‡”†ƒ™‘”†‡ǡ „‹Œ˜‘‘”„‡‡Ž†‘ˆŠ‡–‡ˆˆ‡ –‹‡˜‡”œ‘—œ‹Œ™ƒ‡‡”†‡‹–‡”˜‡–‹‡Žƒ‰‡”†——”–ǡ™ƒ‡‡”†‡œ‡‘‰

•’‡ ‹ˆ‹‡‡”™‘”†–ƒˆ‰‡•–‡†‘’’•› Š‘–‹• Š‡’ƒ–‹´–‡ȋƒœǡʹͲͳͺȌǡ‘ˆ™ƒ‡‡”†‹‡™‘”†– A ‰‡Ã’Ž‡‡–‡‡”†‹†‡˜”‘‡‰‡ˆƒ•‡˜ƒ†‡•–‘‘”‹•ȋ‡„„ƒ±‡–ƒŽǤǡʹͲͳ͸ȌǤ‘˜‡†‹‡œ‹Œ™‡ ˜ƒ‡‹‰†ƒ–’‹–‘‡‘•–‹‰‡•–—†‹‡•‘‡–™‘”†‡˜‡”‰‡Ž‡‡‡–ƒ†‡”‡ǡ„‹Œ˜‘‘”‡—” ˜‡”‰‡Ž‹Œ„ƒ”‡„‡Šƒ†‡Ž‹‰‡˜‘‘”’•› Š‘–‹• Š‡•–‘‘”‹••‡œ‘ƒŽ• ǡ‹†ˆ—Ž‡••ƒ•‡† ‘‰‹–‹˜‡Š‡”ƒ’›ȋ‡‰ƒŽǡ‡ƒ•†ƒŽ‡ǡƬ‹ŽŽ‹ƒ•ʹͲͲͶȌ‘ˆ‡–ƒ ‘‰‹–‹˜‡‡ˆŽ‡ –‹‘ •‹‰Š– Š‡”ƒ’›ȋ†‡ ‘‰‡–ƒŽǤǡʹͲͳͺȌǡ‘†ƒ–™‡—‹‡–‡–œ‡‡”Š‡‹†—‡˜ƒ•–•–‡ŽŽ‡‘ˆ ƒ•’‡ ‹ˆ‹‡‡ˆƒ –‘”‡œ‘ƒŽ•Š‡––‘‡˜‘‡‰‡˜ƒ’•› Š‘–Š‡”ƒ’‹‡‘ˆ„‡Šƒ†‡Ž‹‰‹‰”‘‡’•˜‘”ƒƒ †‡‰‡‘„•‡”˜‡‡”†‡‡ˆˆ‡ –‡Š‡„„‡˜‡”‘‘”œƒƒ–Ǥ‘‹•Š‡–˜ƒ„‡Žƒ‰‘–‡‘†‡”œ‘‡‡ ‘ˆ†‡‡ˆˆ‡ –‡˜ƒ’Žƒ‰‡”†ƒœ‡•ƒƒ†‡„‡Ž‹Œ˜‡Ǥ –‡”˜‡–‹‡•†‹‡Š‡–•‘ ‹ƒƒŽ ˆ— –‹‘‡”‡˜ƒ’ƒ–‹´–‡‡–ƒ‡Ž‹Œ†——”œƒƒ—‡˜‡”„‡–‡”‡ǡœ‘—†‡‹ ’‘–‡–‹‡‹ŽŒ‘‡‡’ƒ–‹´–‡—‡Š‡Ž’‡‡‡„‡–‡”„‡•–ƒƒ‘’–‡„‘—™‡Ǥ  

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146807_JonasWeijers_BNW_def.indd 203 28-10-2020 15:09 Summary in Dutch

Algemene sterke punten en beperkingen

’‡ ‹ˆ‹‡‡•–‡”‡’—–‡‡„‡’‡”‹‰‡˜ƒ‡Ž‡•–—†‹‡œ‹Œ‡‡”†‡”„‡• Š”‡˜‡‹†‡ ˜‡”• Š‡‹†‡‡Š‘‘ˆ†•–—‡˜ƒŠ‡–’”‘‡ˆ• Š”‹ˆ–Ǥ‡Ž‡ƒŽ‰‡‡‡•–‡”‡’—–‡œ‹Œ†‡ ™ƒŽ‹–ƒ–‹‡ˆ•–‡”‡‡‡–‹•–”—‡–‡†‹‡™‡Š‡„„‡‰‡„”—‹–Ǥ”‹•†ƒƒ”ƒƒ•–—‹–‰‡„”‡‹†‡ –”ƒ‹‹‰‰‡‰‡˜‡ƒƒ†‡„‡‘‘”†‡Žƒƒ”•‘œ‘†‡„‡–”‘—™„ƒƒ”Š‡‹†˜ƒ†‡‡–‹‰‡–‡ ƒš‹ƒŽ‹•‡”‡Ǥ‡–™‡‡†‡Š‡„„‡™‡‰‡„”—‹‰‡ƒƒ–˜ƒ‰‡„Ž‹†‡‡”†‡„‡‘‘”†‡Žƒƒ”•‘ ‘‰‡Ž‹Œ‡˜‘‘”‹‰‡‘‡Š‡‹†˜ƒ„‡‘‘”†‡Žƒƒ”•–‡‡Ž‹‹‡”‡Ǥ‡†‡”†‡•‡Ž‡ –‡‡”†‡™‡ ’ƒ–‹´–‡‡–‡‡—‹–Ž‘’‡†‡Ž‡‰–‡˜ƒœ‹‡–‡†——”‡‡‡˜‡‡ŽŠ‡‹†ƒƒ’•› Š‘–‹• Š‡ †‹ƒ‰‘•‡•Ǥ‘†‘‡†‡˜‹†‡™‹Œ†ƒ–‘œ‡”‡•—Ž–ƒ–‡†‡ƒŽ‰‡‡‡’”ƒ–‹Œ‘’‡‡ƒ†‡“—ƒ–‡™‹Œœ‡ ™‡‡”•’‹‡‰‡Ž‡Ǥ‡‡Ž•–—†‹‡•ƒ‡‰‡„”—‹˜ƒ•–”‹–‡‹ Ž—•‹‡ ”‹–‡”‹ƒ™ƒ–†‡ ‰‡‡”ƒŽ‹•‡‡”„ƒƒ”Š‡‹†˜ƒ”‡•—Ž–ƒ–‡‹‡––‡‰‘‡†‡‘–ȋ ‘‡”–‡Ž‡–ƒŽǤǡʹͲͳͷȌǤ  ‡„‡Žƒ‰”‹Œ•–‡„‡’‡”‹‰˜ƒ‘œ‡•–—†‹‡•‹•†ƒ–œ‡ƒŽŽ‡ƒƒŽ‰‡„”—‹ƒƒ–‡˜ƒ †‡œ‡Žˆ†‡•–‡‡’”‘‡ˆǤ‹–†‘‡–ƒˆƒƒ†‡‰‡‡”ƒŽ‹•‡‡”„ƒƒ”Š‡‹†˜ƒ‘œ‡„‡˜‹†‹‰‡ǡ‘†ƒ–‘œ‡ ”‡•—Ž–ƒ–‡‘‘•‹’‡Ž™‡‰‡‡”‡—‡™‡‡”•’‹‡‰‡Ž‡†‹‡•’‡ ‹ˆ‹‡œ‹Œ˜‘‘”†‡œ‡ •–‡‡’”‘‡ˆǤƒ‰‡œ‹‡‘œ‡•–‡‡’”‘‡ˆ”‡Žƒ–‹‡ˆ‹Ž†‡’‘•‹–‹‡˜‡‡‡‰ƒ–‹‡˜‡•›’–‘‡Šƒ†„‹Œ ƒƒ˜ƒ‰ȋœ‹‡Š‘‘ˆ†•–—œ‡˜‡Ȍǡ‘‡–‡‘œ‡‰‡‰‡˜‡•‡–˜‘‘”œ‹ Š–‹‰Š‡‹†™‘”†‡ ‰‡Ã–‡”’”‡–‡‡”†Ǥ‡–™‡‡†‡˜‡”‰”‘‘–Š‡––‘‡–•‡˜ƒ‡‡”†‡”‡Š›’‘–Š‡•‡•„‹‡†‡œ‡Žˆ†‡ steekproef, de aanwezigheid van zogenaamde ‘type 1’ fouten. Met elke toetsing be•–ƒƒ–‡” ƒ‡Ž‹Œ‡‡ƒ•˜ƒͷΨ†ƒ–‰‡˜‘†‡‡ˆˆ‡ –‡„‹‡†‡œ‡•–‡‡’”‘‡ˆǡ†ƒƒ”„—‹–‡‹‡– ™‡”‡Ž‹Œ„‡•–ƒƒǤ ‡”ŠƒƒŽ†‡–‘‡–•‹‰‡˜‡”‰”‘–‡†ƒƒ”‡‡‘‘†‡ƒ•‘’Š‡–˜‹†‡˜ƒ‹‡–Ǧ „‡•–ƒƒ†‡‡ˆˆ‡ –‡Ǥ‡†‡”†‡„‡˜ƒ––‡†‡•–—†‹‡•˜ƒ†‡Š‘‘ˆ†•–—‡†”‹‡ǡ˜‹‡”‡˜‹Œˆ‰‡‡ ‰‡œ‘†‡ ‘–”‘Ž‡‰”‘‡’‡ǡ™ƒƒ”†‘‘”Š‡–‘‘‰‡Ž‹Œ‹•‘–‡ƒƒ–‡‰‡˜‡‘ˆ†‡™ƒƒ”‰‡‘‡ ‘””‡Žƒ–‹‡••’‡ ‹ˆ‹‡œ‹Œ˜‘‘”’ƒ–‹´–‡‡–ǡ‘ˆ‘‘„‡•–ƒƒ‹†‡ƒŽ‰‡‡‡„‡˜‘Ž‹‰Ǥ Referenties

††‹‰–‘ǡ ǤǡƬ††‹‰–‘ǡǤȋʹͲͲͺȌǤ‘ ‹ƒŽƒ† ‘‰‹–‹˜‡ˆ— –‹‘‹‰‹Schizophrenia research 99 ’•› Š‘•‹•Ǥ ǡ ȋͳǦ͵Ȍǡͳ͹͸ǦͳͺͳǤ ƒ–‡ƒǡǤǡƬ ‘ƒ‰›ǡǤȋʹͲͲͳȌǤ”‡ƒ–‡–‘ˆ„‘”†‡”Ž‹‡’‡”•‘ƒŽ‹–›†‹•‘”†‡”™‹–ŠAmerican ’•› Š‘ƒƒŽ›–‹ ƒŽŽ›‘”‹‡–‡†’ƒ”–‹ƒŽŠ‘•’‹–ƒŽ‹œƒ–‹‘ǣƒͳͺJournal of psychiatry, 158 Ǧ‘–Šˆ‘ŽŽ‘™Ǧ—’Ǥ ȋͳȌǡ͵͸MentalisationǦͶʹǤ based treatment: a practical guide. ƒ–‡ƒǡǤǡƬ ‘ƒ‰›ǡǤȋʹͲͲ͸ȌǤ šˆ‘”†ǣ šˆ‘”†‹˜‡”•‹–›”‡••Ǥ ƒ–‡ƒǡǤǡƬ ‘ƒ‰›ǡǤȋʹͲͲͺȌǤͺǦ›‡ƒ”ˆ‘ŽŽ‘™Ǧ—’‘ˆ’ƒ–‹‡–•–”‡ƒ–‡†ˆ‘”„‘”†‡”Ž‹‡’‡”•‘ƒŽ‹–›American Journal of †‹•‘”†‡”ǣ‡–ƒŽ‹œƒ–‹‘Psychiatry, 165 Ǧ„ƒ•‡†–”‡ƒ–‡–˜‡”•—•–”‡ƒ–‡–ƒ•—•—ƒŽǤ ȋͷȌǡ͸͵ͳǦ͸͵ͺǤ

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146807_JonasWeijers_BNW_def.indd 204 28-10-2020 15:09 Summary in Dutch

‡ Š‹ǡǤǡ‘•‹ƒǡǤǡ—‘‘ ‘”‡ǡǤǡ‰‘•–‘‹ǡ Ǥǡ‘•‹‡ŽŽ‹ǡ Ǥǡ‹Ž˜‡•–”‹ǡǤǤǡǤǤǤƬƒ˜ƒŽŽƒ”‘ǡǤ ȋʹͲͳͻȌǤ–ƒ„‹Ž‹–›ƒ†‰‡‡”ƒŽ‹œƒ–‹‘‘ˆ ‘„‹‡†–Š‡‘”›‘ˆ‹†ƒ† ‘‰‹–‹˜‡Psychiatric rehabilitation ”‡‡†‹ƒ–‹‘‹–‡”˜‡–‹‘•‹• Š‹œ‘’Š”‡‹ƒǣ ‘ŽŽ‘™journal. Ǧ—’”‡•—Ž–•Ǥ

‹ˆ—Ž ‘ǡǤǡ”‘™ǡ ǤǤǡƬ ƒ””‹•ǡǤǤȋͳͻͻͶȌǤŠ‹Ž†Š‘‘†š’‡”‹‡ ‡‘ˆƒ”‡ƒ†„—•‡ȋJournal of Child Psychology and Psychiatry, 35 Ȍǣ ƒ ”‡–”‘•’‡ –‹˜‡ ‹–‡”˜‹‡™ ‡ƒ•—”‡Ǥ ȋͺȌǡ ͳͶͳͻǦͳͶ͵ͷǤ ‹” Š™‘‘†ǡǤǡ‹–Šǡ Ǥǡ‘ Š”ƒ‡ǡǤǡ‡––‘ǡǤǡƬ‘’‡•–ƒ‡ǡǤȋͳͻͻͲȌǤŠ‡‘ ‹ƒŽ — –‹‘‹‰  ƒŽ‡ǤŠ‡†‡˜‡Ž‘’‡–ƒ†˜ƒŽ‹†ƒ–‹‘‘ˆƒ‡™• ƒŽ‡‘ˆ•‘ ‹ƒŽƒ†Œ—•–‡–ˆ‘”—•‡‹The British Journal of ˆƒ‹Ž›‹–‡”˜‡–‹‘’”‘‰”ƒ‡•™‹–Š• Š‹œ‘’Š”‡‹ ’ƒ–‹‡–•ǤPsychiatry, 157 ȋ͸Ȍǡͺͷ͵ǦͺͷͻǤ Australian and New ‹” Š™‘‘†ǡǤǡƬƒ ‹ŽŽƒǡ Ǥȋͳͻͻ͵ȌǤƒ”Ž›‹–‡”˜‡–‹‘‹• Š‹œ‘’Š”‡‹ƒǤZealand Journal of Psychiatry  ǡʹ͹ȋ͵Ȍǡ͵͹ͶǦ͵͹ͺǤ ‹” Š™‘‘†ǡǤǡ‘‘”ǡǤǡ‡•–‡”ǡ Ǥǡƒ––‡”•‘ǡǤǡ ”‡‡ƒ–Ž‡ǡǤǡƒ”•ŠƒŽŽǡǤǡǤǤǤƬ˜‡”ƒ”†ǡǤ ȋʹͲͳ͵ȌǤ‡†— ‹‰†—”ƒ–‹‘‘ˆ—–”‡ƒ–‡†’•› Š‘•‹•ǣ ƒ”‡’ƒ–Š™ƒ›•–‘‡ƒ”Ž›‹–‡”˜‡–‹‘The British Journal of Psychiatry 203 ‹’•› Š‘•‹••‡”˜‹ ‡•Ǥ ǡ ȋͳȌǡͷͺǦ͸ͶǤ ‘™Ž„›ǡ Ǥȋͳͻ͹͵ȌǤ––ƒ Š‡–ƒ†Ž‘••ǡ˜‘ŽǤ ǣ‡’ƒ”ƒ–‹‘Ǥ‡™‘”ǡǣƒ•‹ ‘‘•Ǥ ‘›†ƒǡǤǡƬ ‡‡–‡”•ǡǤȋʹͲͳͷȌǤŠ‹Ž†Š‘‘†ƒŽ–”‡ƒ–‡–ƒ†•‘ ‹ƒŽˆ— –‹‘‹‰‹ƒ†—Ž–•™‹–ŠPsychiatry research, 226 •—„Ǧ Ž‹‹ ƒŽ’•› Š‘•‹•Ǥ ȋͳȌǡ͵͹͸Ǧ͵ͺʹǤ ”‡–ǡǤǤǡƬ ‘ƒ‰›ǡǤȋʹͲͳͶȌǤ‡–ƒŽ‹œƒ–‹‘Ǧ„ƒ•‡†–”‡ƒ–‡–ƒ’’”‘ƒ Š–‘†‹•–—”„ƒ ‡•‘ˆ •‘ ‹ƒŽ—†‡”•–ƒ†‹‰‹• Š‹œ‘’Š”‡‹ƒǤ Ǥ Ǥ›•ƒ‡”ǡ Ǥ‹ƒ‰‰‹‘ǡƒ†Ǥ”ò‡Social cognition and metacognition in schizophrenia: Psychopathology and treatmentȋ†•ǤȌǡ approaches ǡʹͶͷǦʹͷͻǤƒ‹‡‰‘ǡǣŽ•‡˜‹‡” ƒ†‡‹ ”‡••Ǥ ”—‡Ž‹ǡ Ǥǡ†̵ƒ–‘ǡǤǡ”—ǡǤǡ‡†‹‘—ǡǤǡƒŽŽ‡ŽǡǤǡ‡ǡǤǡǤǤǤƬƒ‘—†ǡǤȋʹͲͲ͹ȌǤ ’ƒ‹”‡†

Schizophrenia˜‡”„ƒŽ•‘—” ‡‘‹–‘”‹‰‹• Š‹œ‘’Š”‡‹ƒǣƒ Research 89 ‹–‡”‡†‹ƒ–‡–”ƒ‹–˜—Ž‡”ƒ„‹Ž‹–›ƒ”‡”ǫ A ǡ ȋͳǦ͵Ȍǡʹͺ͹ǦʹͻʹǤ Češková, E., Přikryl, R., Kašpárek, T., & Ondrušova, M. (2005). PsychopathologyNeuropsychiatric and treatment Disease ”‡•’‘•‹˜‡‡••‘ˆ’ƒ–‹‡–•™‹–Šˆ‹”•–and Treatment 1 Ǧ‡’‹•‘†‡• Š‹œ‘’Š”‡‹ƒǤ ǡ ȋʹȌǡͳ͹ͻǤ ‘” ‘”ƒǡǤǡ‡” ‡”ǡ ǤǡƬ ”‹–ŠǡǤǤȋͳͻͻͷȌǤ Š‹œ‘’Š”‡‹ƒǡ•›’–‘ƒ–‘Ž‘‰›ƒ†•‘ ‹ƒŽSchizophrenia inference:research, 17 investigating “theory of mind” in people with schizophrenia. ȋͳȌǡͷǦͳ͵Ǥ ‘—–—”‡ǡǤǤǡ‡ǡǤǤǡƬ‘„‡”–•ǡǤǤȋʹͲͲ͸ȌǤŠ‡ˆ— –‹‘ƒŽ•‹‰‹ˆ‹ ƒ ‡‘ˆ•‘ ‹ƒŽ ‘‰‹–‹‘‹Schizophrenia bulletin, 32 • Š‹œ‘’Š”‡‹ƒǣƒ”‡˜‹‡™Ǥ ȋͳȌǡͶͶǦ͸͵Ǥ ”‹•–ׄƒŽǦƒ”˜ž‡œǡǤǡŠ‡‹„ƒ—ǡǤǡƒŽŽ‡•’ÀǡǤǡ‹–Œƒ˜‹ŽƒǡǤǡ›‹Ǧ ‡”‡›•ǡ Ǥǡ™ƒ’‹ŽǡǤǤǡƬ ƒ””ƒ–‡•Ǧ‹†ƒŽǡǤȋʹͲͳ͸ȌǤ ’ƒ –‘ˆƒ†˜‡”•‡ Š‹Ž†Š‘‘†‡š’‡”‹‡ ‡•‘’•› Š‘–‹ ǦŽ‹‡

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. Focus, 14

•›’–‘•ƒ†•–”‡••”‡ƒ –‹˜‹–›‹†ƒ‹Ž›Ž‹ˆ‡‹‘ Ž‹‹ ƒŽ›‘—‰ƒ†—Ž–• ȋ͵Ȍǡ ͵ͺ͹Ǧ͵ͻͷǤ †‡ ‘‰ǡǤǡ˜ƒ‘‡”•‰‘‡†ǡǤ ǤǤǡ‹‡”ƒǡǤǤǡƒ ‡–‘–ǡǤǡ—†‡”‹ǡǤǡ”‡†•ǡ ǤǡǤǤǤƬ‹Œ‡„‘”‰ǡ Ǥ ǤǤȋʹͲͳͻȌǤ‡–ƒ ‘‰‹–‹˜‡”‡ˆŽ‡ –‹‘ƒ†‹•‹‰Š––Š‡”ƒ’›ȋ ȌPsychological Medicine 49 ˆ‘”’ƒ–‹‡–•™‹–Š• Š‹œ‘’Š”‡‹ƒǤ ǡ ȋʹȌǡ͵Ͳ͵Ǧ͵ͳ͵Ǥ †‡‡—Ž‡‡‡•–‡”ǡǤǡƒ•–‡‡Žƒ†–ǡǤǡ—›–‡ǡǤǡƬ‘™› ǡǤȋʹͲͳͺȌǤ‡–ƒŽ‹œ‹‰ƒ•ƒ ‡ Šƒ‹•‘ˆ Šƒ‰‡‹–Š‡–”‡ƒ–‡–‘ˆ’ƒ–‹‡–•™‹–Š„‘”†‡”Ž‹‡’‡”•‘ƒŽ‹–›†‹•‘”†‡”ǣPersonality Disorders: Theory, Research, ’ƒ”ƒŽŽ‡Ž’”‘ ‡••‰”‘™–Š‘†‡Ž‹‰ƒ’’”‘ƒ ŠǤand Treatment 9  ǡ ȋͳȌǡʹʹǤ ‡„„ƒ±ǡǤǡ‡‹Ž‘—†ǡ ǤǡƒŽƒ‹‹‘•ǡ Ǥǡ‘Ž‹†ƒǦ‘œœ‹ǡǤǡ”ƒ†‘ǡǤǡ ‘ƒ‰›ǡǤǡƬƒ–‡ƒǡ ǤȋʹͲͳ͸ȌǤ‡–ƒŽ‹œƒ–‹‘JournalǦ„ƒ•‡†–”‡ƒ–‡–‹ Ž‹‹ ƒŽŠ‹‰Š of Contemporary Psychotherapy,Ǧ”‹•ˆ‘”’•› Š‘•‹•ǣƒ”ƒ–‹‘ƒŽ‡ 4 ƒ† Ž‹‹ ƒŽ‹ŽŽ—•–”ƒ–‹‘Ǥ ͸ȋͶȌǡʹͳ͹ǦʹʹͷǤ ‡„„ƒ±ǡǤǡƬ‘ˆˆ‡ŽǡǤȋʹͲͳͻȌǤ‡–ƒŽ‹œ‹‰–Š”‘—‰Š–Š‡‡ƒ”Ž›•–ƒ‰‡•‘ˆ–Š‡•› Š‘•‹•The Neurobiology-Psychotherapy-Pharmacology Intervention Triangle: The ‘–‹——Ǥneed for common sense in 21st century mental health ǡͳͶͳǤ ‡Ž‡•’ƒ—ŽǡǤǡ†‡”‹‡•ǡǤǡƬ˜ƒ•ǡ ǤȋʹͲͲʹȌǤSocial psychiatry‡–‡”‹ƒ–•‘ˆ‘ —””‡ ‡ƒ†”‡ ‘˜‡”›ˆ”‘ and psychiatric epidemiology, 37 ŠƒŽŽ— ‹ƒ–‹‘•‹†ƒ‹Ž›Ž‹ˆ‡Ǥ ȋ͵Ȍǡͻ͹ǦͳͲͶǤ ”—‡”ǡǤǡ‹••‡”ǡǤǡ›–‡ƒǡǤǡƬƒ•ǡ ǤȋʹͲͳ͵ȌǤ Ž‡š‹„Ž‡ƒ••‡”–‹˜‡ ‘—‹–›–”‡ƒ–‡–ǣ ‡˜‡”‹–›‘ˆ•›’–‘•ƒ†’•› Š‹ƒ–”‹ Š‡ƒŽ–Š•‡”˜‹ ‡—•‡Ǣƒ”‡ƒŽŽ‹ˆ‡‘„•‡”˜ƒ–‹‘ƒŽ•–—†›ǤClinical Practice & Epidemiology in Mental Health, 9 ǡʹͲʹ–ʹͲͻǤ ‹•‡•–ƒ†–ǡǤǡ‘–‡‹”‘ǡǤǤǡ‹Early‹œǡǤ ǤǡƬŠƒ˜‡•ǡǤǤȋʹͲͳʹȌǤš’‡”‹‡ ‡‘ˆ”‡ ‘˜‡”›ˆ”‘ƒ intervention in psychiatry, 6(4) first‐episode psychosis. ǡͶ͹͸ǦͶͺͲǤ Žƒ•‡”ǡ ǤǦǤǡƒ•ǡ Ǥǡ‘”–‡‰‹Œ•ǡǤ ǤǡƬ›‹Ǧ ‡”‡›•ǡ ǤȋʹͲͲ͸ȌǤŠ‹Ž†Š‘‘†–”ƒ—ƒƒ† ‡‘–‹‘ƒŽ”‡ƒ –‹˜‹–›–‘†Journal of psychosomaticƒ‹Ž›Ž‹ˆ‡•–”‡••‹ƒ†—Ž–ˆ”‡“—‡–ƒ––‡†‡”•‘ˆ‰‡‡”ƒŽ research, 61 ’”ƒ –‹–‹‘‡”•Ǥ ȋʹȌǡʹʹͻǦʹ͵͸Ǥ ”‡‡ǡǤ Ǥǡ‡ǡǤǤǡ‡–ƒŽŽǡǤǡƒ”’‡–‡”ǡǤǤǡ ƒ‡„‡ŽǡǤǡ —”ǡǤǤǡǤǤǤƬ ‡‹••‡ǡǤ ȋʹͲͲͺȌǤ‘ ‹ƒŽ ‘‰‹–‹‘‹• Š‹œ‘’Š”‡‹ƒǣƒ  ™‘”•Š‘’‘†‡ˆ‹‹–‹‘•ǡSchizophrenia bulletin, 34 ƒ••‡••‡–ǡƒ†”‡•‡ƒ” Š‘’’‘”–—‹–‹‡•Ǥ ȋ͸ȌǡͳʹͳͳǦͳʹʹͲǤ ”‡‡ǡǤ Ǥǡ ‘”ƒǡǤǤǡƬ‡‡ǡ ǤȋʹͲͳͷȌǤ‘ ‹ƒŽ ‘‰‹–‹‘‹• Š‹œ‘’Š”‡‹ƒǤƒ–—”‡‡˜‹‡™• ‡—”‘• ‹‡ ‡ǡͳ͸ȋͳͲȌǡ͸ʹͲǤ ‘ƒ‰›ǡǤǡƬŽŽ‹•‘ǡǤȋʹͲͳͶȌǤŠ‡”‘Ž‡‘ˆ‡–ƒŽ‹œ‹‰ƒ†Psychotherapy, 51 ‡’‹•–‡‹ –”—•–‹–Š‡–Š‡”ƒ’‡—–‹ ”‡Žƒ–‹‘•Š‹’Ǥ ȋ͵Ȍǡ͵͹ʹǤ ”‡‡ǡǤ Ǥǡ ‘”ƒǡǤǤǡƬ‡‡ǡ ǤȋʹͲͳͻȌǤ‘•‘ ‹ƒŽƒ†•‘ ‹ƒŽ ‘‰‹–‹‘‹• Š‹œ‘’Š”‡‹ƒǣWorld Psychiatry 18 —””‡–‡˜‹†‡ ‡ƒ†ˆ—–—”‡†‹”‡ –‹‘•Ǥ ǡ ȋʹȌǡͳͶ͸Ǧͳ͸ͳǤ ‡––ǡǤǤ Ǥǡ‹‡ Š–„ƒ—‡”ǡǤǡ‡ǡǤǤǡ˜ƒ•ǡ ǤǡƬ”ƒ„„‡†ƒǡǤȋʹͲͳͳȌǤŠ‡”‡Žƒ–‹‘•Š‹’ „‡–™‡‡‡—”‘ ‘‰‹–‹‘ƒ†•‘ ‹ƒŽ ‘‰‹–‹‘™‹–Šˆ— –‹‘ƒŽ‘—– ‘‡•‹• Š‹œ‘’Š”‡‹ƒǣNeuroscience & Biobehavioral Reviews 35 ƒ‡–ƒǦƒƒŽ›•‹•Ǥ ǡ ȋ͵Ȍǡͷ͹͵ǦͷͺͺǤ

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‘ƒ‰›ǡǤǡƬŽŽ‹•‘ǡǤȋʹͲͳͶȌǤŠ‡”‘Ž‡‘ˆ‡–ƒŽ‹œ‹‰ƒ†‡’‹•–‡‹ –”—•–‹–Š‡–Š‡”ƒ’‡—–‹ Psychotherapy 51 ”‡Žƒ–‹‘•Š‹’Ǥ ǡ ȋ͵Ȍǡ͵͹ʹǤ ‘ƒ‰›ǡǤǡ—›–‡ǡǤǡŽŽ‹•‘ǡǤǡƬƒ’„‡ŽŽǡǤȋʹͲͳ͹ȌǤŠƒ–™‡Šƒ˜‡ Šƒ‰‡†‘—”‹†• ƒ„‘—–ǣƒ”–ͳƬʹǤ‘”†‡”Ž‹‡’‡”•‘ƒŽ‹–›†‹•‘”†‡”ǡ‡’‹•–‡‹ –”—•–ƒ†–Š‡Borderline personality disorder and †‡˜‡Ž‘’‡–ƒŽ•‹‰‹ˆ‹ ƒ ‡‘ˆ•‘ ‹ƒŽ ‘—‹ ƒ–‹‘Ǥemotion dysregulation, 4 The cognitiveȋͳȌǡͻǤ neuropsychology of schizophrenia. ”‹–ŠǡǤǤȋͳͻͻʹȌǤ ‘†‘ǡ‹–‡†‹‰†‘ǣ •› Š‘Ž‘‰›”‡••Ǥ —•ƒ”Ǧ‘Ž‹ǡǤǡ›”‡ǡǤǡƒŽƒ‰‰‹ƒǡǤǡƒ›ǡ Ǥǡƒ„”ƒŠƒǡǤǡ ‘Š•ǡǤǡǤǤǤƬ ‡ƒǤȋʹͲͳͲȌǤ ‘ ‹ƒŽ†›•ˆ— –‹‘’”‡†‹ –•–™‘›‡ƒ”• Ž‹‹ ƒŽ‘—– ‘‡‹’‡‘’Ž‡ƒ–—Ž–”ƒJournal of psychiatric research 44 ǦŠ‹‰Š”‹•ˆ‘” ’•› Š‘•‹•Ǥ ǡ ȋͷȌǡʹͻͶǦ͵ͲͳǤ ‹„„ƒ”†ǡǤǡ‹– Š‡ŽŽǡǤǡƬ‘” ‡”‡ŽŽ‹ǡ ǤȋʹͲͲͳȌǤ –‡”ƒŽ ‘•‹•–‡ ›‘ˆ–Š‡‘„Œ‡ –”‡Žƒ–‹‘•ƒ†Journal of Personality •‘ ‹ƒŽ ‘‰‹–‹‘• ƒŽ‡•ˆ‘”–Š‡–Š‡ƒ–‹ ƒ’’‡” ‡’–‹‘–‡•–ǤAssessment, 77 ȋ͵ȌǡͶͲͺ–ͶͳͻǤ ‘‡”–‡ŽǡǤǡג‡œǡǤǡƒ‰ǡǤǡ ‘œžŽ‡œǦ‹–‘ǡǤǡ‹‘•‹ǡ ǤǡƬŽƒ ‘ǡǤȋʹͲͳͷȌǤ ‡‡”ƒŽ‹œƒ„‹Ž‹–›‘ˆ’Šƒ”ƒ ‘Ž‘‰‹ ƒŽƒ†’•› Š‘–Š‡”ƒ’› Ž‹‹ ƒŽ–”‹ƒŽ”‡•—Ž–•ˆ‘”Personality Disorders: Theory, „‘”†‡”Ž‹‡’‡”•‘ƒŽ‹–›†‹•‘”†‡”–‘ ‘—‹–›•ƒ’Ž‡•ǤResearch, and Treatment 6  ǡ ȋͳȌǡͺͳǤ ‘ˆˆƒǡ Ǥǡ ¡ ‡ŽǡǤǡ Žƒ—•‡”ǡǤǡƬ—’’‡”ǡActaǤȋʹͲͳʹȌǤ”ƒ†‘‹•‡† ‘–”‘ŽŽ‡†–”‹ƒŽ‘ˆ–Š‡ Psychiatrica Scandinavica 125 ‡ˆˆ‹ ƒ ›‘ˆ•—’’‘”–‡†‡’Ž‘›‡–Ǥ ǡ ȋʹȌǡͳͷ͹Ǧͳ͸͹Ǥ ‘Ž–Šƒ—•‡ǡǤǤǡ‹‡”•ƒǡǤǡƒŠǡǤǡƒŠǡǤǤǡ‹‰‡ƒ•ǡǤǤǡ Š‡‡ǡǤ Ǥǡ˜ƒ†‡ ‘• ŠǡǤ ǤȋʹͲͲ͹ȌǤ”‡†‹ –‹˜‡˜ƒŽ—‡‘ˆ ‘‰‹–‹‘ˆ‘”†‹ˆˆ‡”‡–†‘ƒ‹•‘ˆ‘—– ‘‡‹Psychiatry Research, 149, ”‡ ‡–Ǧ‘•‡–• Š‹œ‘’Š”‡‹ƒǤ ͹ͳ–ͺͲǤ ‘”ƒǡǤǤǡƬ ”‡‡ǡǤ ǤȋʹͲͳͻȌǤ”‡ƒ–‡–‘ˆ•‘ ‹ƒŽ ‘‰‹–‹‘‹• Š‹œ‘’Š”‡‹ƒǣ—””‡–Schizophrenia research, 203

•–ƒ–—•ƒ†ˆ—–—”‡†‹”‡ –‹‘•Ǥ ǡ͵ǦͳͳǤ A ‘™‡•ǡǤǤǡƬ—””ƒ›ǡǤǤȋʹͲͳͶȌǤ Š‹œ‘’Š”‡‹ƒǣƒ‹–‡‰”ƒ–‡†•‘ ‹‘†‡˜‡Ž‘’‡–ƒŽThe Lancet 383 Ǧ ‘‰‹–‹˜‡‘†‡ŽǤ ǡ ȋͻͻʹͻȌǡͳ͸͹͹Ǧͳ͸ͺ͹Ǥ ƒ›ƒǡǤǤǡ ‹ŽŽƒǡǤǤǡ‡‹‹‰‡”ǡǤǤǡ ‘ŽŽ™‹–œ‡”ǡǤǡƬ‹ ‘ŽǡǤǤȋʹͲͳ͸ȌǤ‘‡Ž‹‡••ƒ†Cognitive Therapy and Research, ’•› Š‘–‹ •›’–‘•ǣŠ‡‡†‹ƒ–‹‰”‘Ž‡‘ˆ†‡’”‡••‹‘Ǥ  ͳǦͳͳǤ ƒ›ǡǤǤǡ ‹•œ„‡‹ǡǤǡ’ˆ‡”ǡǤǤȋͳͻͺ͹ȌǤŠ‡’‘•‹–‹˜‡ƒ†‡‰ƒ–‹˜‡•›†”‘‡• ƒŽ‡ȋȌˆ‘”Schizophrenia bulletin, 13 • Š‹œ‘’Š”‡‹ƒǤ ȋʹȌǡʹ͸ͳǦʹ͹͸Ǥ ‡ŽŽ‡Š‡”ǡ Ǥǡ‡‡Ž‡›ǡ Ǥǡ‘” ‘”ƒǡǤǡƒ•ƒ›ǡ Ǥǡƒ••‡”ƒǡǤǡƒ”Ž‹ǡǤǡǤǤǤƬƒ‘ǡǤȋʹͲͳ͵ȌǤ Š‹Ž†Š‘‘†–”ƒ—ƒƒ†’•›American Journal Š‘•‹•‹ƒ’”‘•’‡ –‹˜‡ ‘Š‘”–•–—†›ǣ ƒ—•‡ǡ‡ˆˆ‡ –ǡƒ† of Psychiatry, 170 †‹”‡ –‹‘ƒŽ‹–›Ǥ ȋ͹Ȍǡ͹͵ͶǦ͹ͶͳǤ

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‹ǡǤȋʹͲͳͷȌǤŠ‡‹†‹–Š‡ƒ‹‰ǣ‡˜‡Ž‘’‡–ƒŽƒ†‡—”‘„‹‘Ž‘‰‹ ƒŽ‘”‹‰‹•‘ˆPersonality Disorders: Theory, Research, and Treatment 6 ‡–ƒŽ‹œ‹‰Ǥ ǡ ȋͶȌǡ͵ͷ͸Ǥ ‹Š›ǡǤǡ‡Ž‡•’ƒ—ŽǡǤǡ‘” ‘”ƒǡǤǡŠǡ ǤǡƒŽ‡ǡǤǡƬƒŽƒ•’‹ƒǡǤȋʹͲͲ͸ȌǤ‘’—–‡”‹œ‡† ‡š’‡”‹‡ ‡•ƒ’Ž‹‰‡–Š‘†ȋ Ȍǣƒ••‡••‹‰ˆ‡ƒ•‹„‹Ž‹–›ƒ†˜ƒŽ‹†‹–›ƒ‘‰Journal of psychiatric research, 40 ‹†‹˜‹†—ƒŽ•™‹–Š• Š‹œ‘’Š”‡‹ƒǤ ȋ͵ȌǡʹʹͳǦʹ͵ͲǤ ƒ”†‹‘‹•ǡǤǡƒ–ƒ•–‡”ǡǤǡ‡‰‡Ž‡”•ǡǤǡƒ•ǡ ǤǡƬ›‹Acta PsychiatricaǦ ‡”‡›•ǡ Ǥȋ Scandinavica,ʹͲͳͳȌǤŠ‹Ž†Š‘‘†–”ƒ—ƒ 123 ƒ†‹ ”‡ƒ•‡†•–”‡•••‡•‹–‹˜‹–›‹’•› Š‘•‹•Ǥ ȋͳȌǡʹͺǦ ͵ͷǤ ƒ™•ǡǤǤǡƒ”Ž‹‰–‘ǡǤǡ‘†‡ŽǡǤǤǡ ‡ƒǡǤ ǤǡƬ ƒ—Šƒ”ǡǤȋʹͲͳͺȌǤ‘‰‹–‹˜‡ ‡Šƒ˜‹‘—”ƒŽŠ‡”ƒ’›ˆ‘”• Š‹œ‘’Š”‡BMC psychology ‹ƒ6Ǧ‘—– ‘‡•ˆ‘”ˆ— –‹‘‹‰ǡ†‹•–”‡••ƒ†“—ƒŽ‹–›‘ˆ Ž‹ˆ‡ǣƒ‡–ƒǦƒƒŽ›•‹•Ǥ ǡ ȋͳȌǡ͵ʹǤ ‡‘Šƒ”†–ǡǤǤǡ —Ž‹‰ǡǤǡ ƒǡ ǤǤǡ‘‡ǡǤǡ ƒ••‘ǦŠƒ›‘ǡ Ǥǡ ‡‘†ǡ Ǥ ǤǡƬ›•ƒ‡”ǡǤ Ǥ ȋʹͲͳ͹ȌǤ‡ ‘˜‡”›ƒ†•‡”‹‘—•‡–ƒŽ‹ŽŽ‡••ǣƒ”‡˜‹Expert Review of Neurotherapeutics,‡™‘ˆ —””‡– Ž‹‹ ƒŽƒ†”‡•‡ƒ” Š 17(11) ’ƒ”ƒ†‹‰•ƒ†ˆ—–—”‡†‹”‡ –‹‘•Ǥ ǡͳͳͳ͹Ǧͳͳ͵ͲǤ ‹‡„‡”ƒǡ ǤǤǡ‹š‘ǡǤǤǡƬ ‘Ž†ƒǡ Ǥ ǤȋʹͲͳ͵ȌǤƒ”Ž›†‡–‡ –‹‘ƒ†‹–‡”˜‡–‹‘‹JAMA 310 • Š‹œ‘’Š”‡‹ƒǣƒ‡™–Š‡”ƒ’‡—–‹ ‘†‡ŽǤ ǡ ȋ͹Ȍǡ͸ͺͻǦ͸ͻͲǤ ‹ ‘ŽǡǤǤǡ‹‡ˆǡǤǡ‡•–‡”ƒǡǤǡ‹‡‰Ž‡”ǡǤǡ‡•–‹‰ǡǤǤǡ ‡‹„ƒ ŠǡǤǡ‡ŠŽǡǤȋʹͲͳͶȌǤ Š‘•–ƒ›•ǡ™Š‘„‡‡ˆ‹–•ǫ”‡†‹ –‹‰†”‘’‘—–ƒ† Šƒ‰‡‹ ‘‰‹–‹˜‡„‡Šƒ˜‹‘—”–Š‡”ƒ’›Psychiatry Research 216 ˆ‘”’•› Š‘•‹•Ǥ ǡ ȋʹȌǡͳͻͺǦʹͲͷǤ —›–‡Ǥǡ ‘ƒ‰›Ǥǡ‘™› Ǥǡ‡”‘–‡ǤȋʹͲͳʹȌǤ••‡••‡–‘ˆ‡–ƒŽ‹œƒ–‹‘Ǥ ƒ–‡ƒƬHandbook of mentalizing in mental health practice, ‘ƒ‰›ȋʹͲͳʹȌǤ Ͷ͵–͸ͷǤƒ•Š‹‰–‘ǡ ǣ‡”‹ ƒ•› Š‹ƒ–”‹ —„Ǥ The global burden of disease: 2004 update. ƒ–Š‡”•ǡǤǡ ƒ–ǡǤǤǡƬ‘‡”ƒǡ ǤǤȋʹͲͲͺǤȌ ‡‡˜ƒǣ ‘”Ž† ‡ƒŽ–Š”‰ƒ‹œƒ–‹‘Ǥ  —– Š‡‘ǡǤǤǡƒ”“—‡•ǡǤǤǡƬ ‘™‡•ǡǤǤȋʹͲͳͻȌǤ Š‹œ‘’Š”‡‹ƒ—˜‡”˜‹‡™Ǥ  ’•› Š‹ƒ–”›ǡͳǦͳͲǤ›‹Ǧ ‡”‡›• ǡƬ˜ƒ• ǤȋʹͲͲ͹ȌǤ–”‡••Clinical psychologyǦ”‡ƒ –‹˜‹–›‹’•› review, 2 Š‘•‹•ǣ ‡˜‹†‡ ‡ˆ‘”ƒƒˆˆ‡ –‹˜‡’ƒ–Š™ƒ›–‘’•› Š‘•‹•Ǥ ͹ȋͶȌǡͶͲͻǦ ͶʹͶǤ  ‘””›ǡǤǤȋʹͲͳͲȌǤ‹••›†”‘‡•ǡ Ž‹‹ ƒŽ•–ƒ‰‹‰ƒ†ǣ‡™†‹ƒ‰‘•–‹ Schizophrenia Research 120 ‹ˆ”ƒ•–”— –—”‡ˆ‘”‡ƒ”Ž›‹–‡”˜‡–‹‘‹’•› Š‹ƒ–”›Ǥ ǡ ȋͳǦ͵ȌǡͶͻǦ ͷ͵Ǥ ‡”œǡǤǦǤǡƬ ƒǡǤȋʹͲͳ͵ȌǤŠ‡Ž‘‰”‡ƒ Š‘ˆ Š‹Ž†Š‘‘†ǤŠ‹Ž†Š‘‘†‡š’‡”‹‡ ‡•‹ˆŽ—‡ ‡ Ž‘•‡Advances in life course research, 18 ”‡Žƒ–‹‘•Š‹’•ƒ†Ž‘‡Ž‹‡••ƒ ”‘••Ž‹ˆ‡Ǥ ȋ͵ȌǡʹͳʹǦʹʹʹǤ ‡›‡”ǡ Ǥ ǤȋʹͲͲͶȌǤŠ‡”‡Ž‹ƒ„‹Ž‹–›ƒ†˜ƒŽ‹†‹–›‘ˆ–Š‡‘”• Šƒ Šƒ†Š‡ƒ–‹ ’’‡” ‡’–‹‘ ‡•–ȋȌ ‘’ƒ”‡†–‘‘–Š‡”’•› Š‘Ž‘‰‹ ƒŽƒ†‡†‹ ƒŽ’”‘ ‡†—”‡•ǣƒƒŽ›•‹•‘ˆ

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Comprehensive handbook of psychological assessment,

•›•–‡ƒ–‹ ƒŽŽ›‰ƒ–Š‡”‡†‡˜‹†‡ ‡Ǥ2, ͵ͳͷǦ͵ͶʹǤ ‹ ŠƒŽ•ƒǡǤǤǤǡŠ‘†‡•ǡǤǡƒ•‹Ž‘’‘—Ž‘—ǡǤǡSchizophrenia Ƭbulletin. —––‘ǡǤȋʹͲͳ͹ȌǤ‘‡Ž‹‡••‹•› Š‘•‹•ǣ ‡–ƒǦƒƒŽ›–‹ ƒŽ‡˜‹‡™Ǥ ‘”‡‘Ǧò•–‡”ǡ Ǥǡ ƒ”–‹ǡ Ǥǡ Ƭ ƒ•–‘”ǡ Ǥ ȋʹͲͳͺȌǤ ”‡˜ƒŽ‡ ‡ ‘ˆ ’•› Š‘–‹  †‹•‘”†‡”• ƒ† ‹–• ƒ••‘ ‹ƒ–‹‘™‹–Š‡–Š‘†‘Ž‘‰‹ ƒŽ‹••—‡•Ǥ•›•–‡ƒ–‹ ”‡˜‹‡™ƒ†‡–ƒǦƒƒŽ›•‡•ǤŽ‘‘‡ǡ ͳ͵ȋͶȌǤ ‘”‰ƒǡ Ǥǡ Ƭ ‹•Š‡”ǡ Ǥ ȋʹͲͲ͹ȌǤ ˜‹”‘‡– ƒ† • Š‹œ‘’Š”‡‹ƒǣSchizophrenia ‡˜‹”‘‡–ƒŽ bulletin 33 ˆƒ –‘”• ‹ • Š‹œ‘’Š”‡‹ƒǣ Š‹Ž†Š‘‘†–”ƒ—ƒ—ƒ ”‹–‹ ƒŽ”‡˜‹‡™Ǥ ǡ ȋͳȌǡ͵ǦͳͲǤ —”’Š›ǡ ǤǡŠ‡˜Ž‹ǡǤǡ†ƒ•‘ǡ ǤǡƬ ‘—•–‘ǡ ǤǤȋʹͲͳ͵ȌǤ ”‘•‡š—ƒŽƒ„—•‡–‘’•› Š‘•‹•ǣƒ ’‹Ž‘–•–—†›‡š’Ž‘”‹‰–Š‡•‘ ‹ƒŽ†‡ƒˆˆ‡”‡–ƒ–‹‘Š›’‘–Š‡•‹•ƒ†–Š‡‡†‹ƒ–‹‰”‘Ž‡‘ˆPsychosis, 5 ƒ˜‘‹†ƒ ‡Ǥ ThematicȋͳȌǡ͵͸ ApperceptǦͶ͹Ǥion Test. —””ƒ›ǡ ǤǤȋͳͻͶ͵ȌǤ ƒ„”‹†‰‡ǡǣ ƒ”˜ƒ”†‹˜‡”•‹–›”‡••Ǥ ›‹Ǧ ‡”‡›• ǡƬ˜ƒ• ǤȋʹͲͲ͹ȌǤ–”‡••Clinical psychologyǦ”‡ƒ –‹˜‹–›‹’•› Š‘•‹•ǣ‡˜‹†‡ ‡ˆ‘”ƒƒˆˆ‡ –‹˜‡ review, ’ƒ–Š™ƒ›–‘’•› Š‘•‹•Ǥ ʹ͹ȋͶȌǡͶͲͻǦͶʹͶǤ

‘”†±ǡǤǡƒŽǡǤǡƬ‘”Žƒ†‡”ǡǤȋʹͲͳʹȌǤ‡•‘—” ‡ ”‘—’••‡”–‹˜‡‘—‹–›”‡ƒ–‡– ȋȌƒ•ƒ–‘‘Ž‘ˆ‡’‘™‡”‡–ˆ‘” Ž‹‡–•™‹–Š•‡˜‡”‡‡–ƒŽ‹ŽŽ‡••ǣƒ‡–ƒǦƒƒŽ›•‹•Ǥ Ž‹‹ ƒŽ’”ƒ –‹ ‡ƒ†‡’‹†‡‹‘Ž‘‰›‹‡–ƒŽŠ‡ƒŽ–ŠǣƬ ǡͺǡͳͶͶǤ ‘”ƒǡǤǤǡ‹†‡ŽŽǡǤǡ› Šǡ ǤǡƬƒ Šƒ†ƒǡǤȋʹͲͳ͵ȌǤ‘””‡Žƒ–‡•‘ˆ•—„Œ‡ –‹˜‡”‡ ‘˜‡”›Early intervention in psychiatry, 7(3) ‹ƒ‡ƒ”Ž›‹–‡”˜‡–‹‘’”‘‰”ƒˆ‘”’•› Š‘•‡•Ǥ ǡ ʹ͹ͺǦʹͺͶǤ ̵”‹• ‘ŽŽǤǡƒ‹‰ǡ ǤǡƬƒ•‘ǡǤȋʹͲͳͶȌǤ‘‰‹–‹˜‡‡‘–‹‘”‡‰—Žƒ–‹‘•–”ƒ–‡‰‹‡•ǡƒŽ‡š‹–Š›‹ƒClinical Psychology ƒ††‹••‘ ‹ƒ–Review, 34 ‹‘‹• Š‹œ‘’Š”‡‹ƒǡƒ”‡˜‹‡™ƒ†‡–ƒǦƒƒŽ›•‹•Ǥ ȋ͸ȌǡͶͺʹǦͶͻͷǤ A ‡”ƒŽ–ƒǡǤǡƬ—‡•–ƒǡǤ ǤȋͳͻͻͶȌǤ•› Š‘‡–”‹ ’”‘’‡”–‹‡•‘ˆ–Š‡’‘•‹–‹˜‡ƒ†‡‰ƒ–‹˜‡Psychiatry research, 53 •›†”‘‡• ƒŽ‡ȋȌ‹• Š‹œ‘’Š”‡‹ƒǤ ȋͳȌǡ͵ͳǦͶͲǤ ‡”‡‹”ƒǡ Ǥ ǤǡƬ‡„„ƒ±ǡǤȋʹͲͳͺȌǤ –‡‰”ƒ–‹˜‡Ǧ‡Žƒ–‹‘ƒŽ’’”‘ƒ Š‹ Š‹œ‘’Š”‡‹ƒǣ ”‘ Š‹Ž‘•‘’Š‹ ƒŽ”‹ ‹’Ž‡•–‘‡–ƒŽ‹œƒ–‹‘Schizophrenia and CommonǦƒ•‡†”ƒ –‹ ‡Ǥ  ‹’׎‹–‘ǡ Ǥǡ ‘­ƒŽ˜‡•ǡ Ǥǡ Sense ‡”‡‹”ƒǡ Ǥ Ǥȋ†•ǤȌǡ ǡͳͻ͵ǦʹͲ͹ǤŠƒǡ™‹–œ‡”Žƒ†ǣ ’”‹‰‡”Ǥ ŠƒŠŽƒ†‹”ƒǡǤǡ•ƒŽǡǤǡ‹Ž‹ƒǡǤǡŠ‹Ž‹œƒǡǤǡ Š‡ˆˆŽ‡”ǡ Ǥǡ— Š‘ˆˆǡ ǤǤǡǤǤǤƬ•Ž‡›ǡǤȋʹͲͳͺȌǤ Šƒ‰‡•‹‹•‹‰Š–‘˜‡”–Š‡ˆ‹”•–ʹͶ‘–Š•‘ˆ–”‡ƒ–‡–‹• Š‹œ‘’Š”‡‹ƒ•’‡ –”—Schizophrenia research , 206, †‹•‘”†‡”•Ǥ  ͵ͻͶǦ͵ͻͻǤ

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‹ŠƒǡǤǤǡ‡ǡǤǤǡ ”‡‡ǡǤ Ǥǡ— ǡǤǡ ‡ƒŽ‡›ǡǤǡƬ ƒ”˜‡›ǡǤǤȋʹͲͳ͵ȌǤŠ‡•‘ ‹ƒŽ ‘‰‹–‹‘’•› Š‘‡–”‹ ‡˜ƒŽ—ƒ–‹‘•–—†›ǣ”‡•—Ž–•‘ˆ–Š‡‡š’‡”–•—”˜‡›ƒ†’ƒ‡ŽǤSchizophrenia bulletin, 40 ȋͶȌǡͺͳ͵Ǧͺʹ͵Ǥ ‘•ǡǤǡ ”ƒ‡ǡǤǡ‹–ǡ Ǥǡ‹Œ‡ǡǤ Ǥǡ–ƒ”‹‰ǡǤǤǡƒ†‡” ƒƒ‰ǡǤǡǤǤǤƬ Š‹”„‡ ǡ Ǥ ȋʹͲͳͻȌǤ‘‰‹–‹˜‡„‡Šƒ˜‹‘”ƒŽ–Š‡”ƒ’›ˆ‘”•‘ ‹ƒŽƒ –‹˜ƒ–‹‘‹”‡ ‡–Journal of consulting and clinical psychǦology‘•‡–’•› Š‘•‹•ǣ87 ƒ†‘‹œ‡† ‘–”‘ŽŽ‡†–”‹ƒŽǤ ǡ ȋʹȌǡͳͷͳǤ ‡ƒ†ǡ Ǥǡ˜ƒ•ǡ Ǥǡ‘””‹•‘ǡǤǤǡƬ‘••ǡǤǤȋʹͲͲͷȌǤŠ‹Ž†Š‘‘†–”ƒ—ƒǡ’•› Š‘•‹•ƒ†Acta • Š‹œ‘’Š”‡‹ƒǣƒŽ‹–‡”ƒ–—”‡”‡˜‹‡™™‹–Š–Š‡‘”‡–‹ ƒŽƒ† Ž‹‹ ƒŽ‹’Ž‹ ƒ–‹‘•ǤPsychiatrica Scandinavica, 112 ȋͷȌǡ͵͵ͲǦ͵ͷͲǤ ‡‹‹‰Šƒ—•ǡǤǡ‡’–‘ǡǤ ǤǡƒŽƒ‰‰‹ƒǡǤǡ”ƒ‹‰ǡǤǤǡ ƒ”‡–›ǡǤǡ›‡Œ‹ƒƒǡǤǡǤǤǤǡƬƒœœƒǡǤ ȋʹͲͳ͸ȌǤ–”‡•••‡•‹–‹˜‹–›ǡƒ„‡””ƒ–•ƒŽ‹‡ ‡ǡƒ†–Š”‡ƒ–ƒ–‹ ‹’ƒ–‹‘‹‡ƒ”Ž›’•› Š‘•‹•ǣSchizophrenia bulletin, 42 ƒ‡š’‡”‹‡ ‡•ƒ’Ž‹‰•–—†›Ǥ ȋ͵Ȍǡ͹ͳʹǦ͹ʹʹǤ ‘„‡”–•ǡǤǤǡƬ‡ǡǤǤȋʹͲͲͻȌǤ‘ ‹ƒŽ ‘‰‹–‹‘ƒ†‹–‡”ƒ –‹‘–”ƒ‹‹‰ȋ Ȍˆ‘”Psychiatry research, 166 ‘—–’ƒ–‹‡–•™‹–Š• Š‹œ‘’Š”‡‹ƒǣƒ’”‡Ž‹‹ƒ”›•–—†›Ǥ ȋʹǦ͵ȌǡͳͶͳǦ ͳͶ͹Ǥ ‘••‘—™ǡǤ ǤǡƬ ‘ƒ‰›ǡǤȋʹͲͳʹȌǤ‡–ƒŽ‹œƒ–‹‘Journal of theǦ„ƒ•‡†–”‡ƒ–‡–ˆ‘”•‡Žˆ American Academy of ǦChildŠƒ”‹ƒ†‘Ž‡• ‡–•ǣ & Adolescent ”ƒ†‘‹œ‡† ‘–”Psychiatry 51 ‘ŽŽ‡†–”‹ƒŽǤ Technicalǡ ȋͳʹȌǡͳ͵ͲͶ adaptationsǦͳ͵ͳ͵Ǥ from MBT to Schizophrenic Psychosis. Working on the Self ƒœǡǤȋʹͲͳͺȌǤBoundaries ǡ’”‡•‡–‡†ƒ– –‡”ƒ–‹‘ƒŽ‘ˆ‡”‡ ‡‘ˆ‡–ƒŽ‹œƒ–‹‘ƒ•‡†”‡ƒ–‡–ˆ‘” •› Š‘•‹•ǡƒ†”‹†ǡ’ƒ‹Ǥ ‡‰ƒŽǡǤǤǡ‡ƒ•†ƒŽ‡ǡ ǤǤǡƬ‹ŽŽ‹ƒ•ǡ ǤǤ ǤȋʹͲͲͶȌǤ‹†ˆ—Ž‡••Ǧƒ•‡†‘‰‹–‹˜‡Š‡”ƒ’›ǣ Š‡‘”‡–‹ ƒŽƒ–‹‘ƒŽ‡ƒ†’‹”‹ ƒŽ–ƒ–—•Ǥ  ƒ›‡•ǡǤǤǡ ‘ŽŽ‡––‡ǡǤǤǡƬ‹‡ŠƒǡǤMindfulness and acceptance: Expanding the cognitive-behavioral tradition Ǥȋ†•ǤȌǡ ǡͶͷ– ͸ͷǤ‡™‘”ǡǣ —‹Žˆ‘”†”‡••Ǥ ‡Ž–‡ǡ ǤǦǤǡ˜ƒ†‡”‡ǡǤǡ—––‡ǡǤǤǡSchizophreniaƬƒ–‘”Ǧ ”ƒƒ‡ǡǤȋʹͲͳ͵ȌǤŠ‡•‘ ‹ƒŽ†‡ˆ‡ƒ–Š›’‘–Š‡•‹• bulletin, 39 ‘ˆ• Š‹œ‘’Š”‡‹ƒǣƒ—’†ƒ–‡Ǥ ȋ͸ȌǡͳͳͺͲǦͳͳͺ͸Ǥ ’”‘‰ǡǤǡ Š‘–Š‘”•–ǡǤǡ‘•ǡǤǡ ‘šǡ ǤǡƬƒ‰‡Žƒ†ǡ ǤȋʹͲͲ͹ȌǤThe British Journal of Psychiatry,Š‡‘”›‘ˆ‹†‹ 191 • Š‹œ‘’Š”‡‹ƒǣ‡–ƒǦƒƒŽ›•‹•Ǥ ȋͳȌǡͷǦͳ͵Ǥ ò†‡”ƒǡǤǡ™—‡”‡ǡ Ǥǡƒ‡ǡ Ǥǡ‘”‰ƒǡǤǡƬ—‹’‡”•ǡǤȋʹͲͳͶȌǤ‘ ‹ƒŽ‡–™‘”•ƒ†Social •—’’‘”–‹ˆ‹”•–psychiatry and psychiatricǦ‡’‹•‘†‡’•› Š‘•‹•ǣ‡š’Ž‘”‹‰–Š‡”‘Ž‡‘ˆŽ‘‡Ž‹‡••ƒ†ƒš‹‡–›Ǥ epidemiology, 49 ȋ͵Ȍǡ͵ͷͻǦ͵͸͸Ǥ ›•–‡ƒǡǤǡ—†‡”‹ǡǤǡŽ‘‡‡”•ǡǤǡ‘‘”†ƒǡǤǡƬ‹‡”•ƒǡǤȋʹͲͲ͹ȌǤ••‡”–‹˜‡Acta ‘—‹–›–”‡ƒ–‡–‹–Š‡‡–Š‡”Žƒ†•ǣ”ƒ†‘‹œ‡† ‘–”‘ŽŽ‡†–”‹ƒŽǤPsychiatrica Scandinavica, 116 ǡͳͲͷ–ͳͳʹǤ

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146807_JonasWeijers_BNW_def.indd 210 28-10-2020 15:09 Summary in Dutch

Š‡™‹••‡ǡǤǡ‡–ƒŽŽǡǤǤǡ‘”• Š‘–ǡǤǡ ǡǤǤǡ˜ƒ‹‡”‘’ǡǤǡ˜ƒ•ǡ ǤǡƬ›‹Ǧ ‡”‡›•ǡ Ǥ BritishȋʹͲͳͳȌǤ‘–‹‘•ǡ•‡Žˆ Journal of ClinicalǦ‡•– Psychology,‡‡ǡƒ†’ƒ”ƒ‘‹†‡’‹•‘†‡•ǣƒ‡š’‡”‹‡ ‡•ƒ’Ž‹‰•–—†›Ǥ 50 ȋʹȌǡͳ͹ͺǦͳͻͷǤ Š‘ƒ•ǡǤǤǡ—”ƒŽ‹†Šƒ”ƒǡǤǡ‡†‘ˆˆǡǤǡƬ”ƒ’ƒŽ•‹ǡǤǤȋʹͲͳ͸ȌǤ‡ŽˆǦ‡ˆˆ‹ ƒ ›ƒ•ƒ‡†‹ƒ–‘” ‘ˆ–Š‡”‡Žƒ–‹‘•Š‹’„‡–™‡‡•‘ ‹ƒŽ•—’’‘”–Psychiatric rehabilitation journal, 39(4) ƒ†”‡ ‘˜‡”›‹•‡”‹‘—•‡–ƒŽ‹ŽŽ‡••Ǥ ǡ͵ͷʹǤ Dialogues in clinical ”±‡ƒ—ǡ ǤȋʹͲͲ͸ȌǤ”‡˜‹‡™‘ˆ‡‘–‹‘†‡ˆ‹ ‹–•‹• Š‹œ‘’Š”‡‹ƒǤneuroscience 8 ǡ ȋͳȌǡͷͻǤ ˜ƒƒǡǤǤǡ˜ƒ‹‡”‘’ǡǤǡ‹‡ Š–„ƒ—‡”ǡǤǡ‡Ž–Š‘”•–ǡǤǡ˜ƒ‹‡ŽǡǤǡ”—‰‰‡ƒǡǤǡǤǤǤƬ ›‹Ǧ ‡”‡›•ǡ ǤȋʹͲͳͷȌǤŠ‹Ž†Š‘‘†ƒ„—•‡ƒ†‡‰Ž‡ –‹”‡Žƒ–‹‘–‘–Š‡’”‡•‡ ‡ƒ†Psychological Medicine 4 ’‡”•‹•–‡ ‡‘ˆ’•› Š‘–‹ ƒ††‡’”‡••‹˜‡•›’–‘ƒ–‘Ž‘‰›Ǥ ǡ ͷȋ͹Ȍǡ ͳ͵͸͵Ǧͳ͵͹͹Ǥ ˜ƒ‹‡”‘’ǡǤǡ‡ ‡‹ǡǤǡ›‹Ǧ ‡”‡›•ǡ Ǥǡ‘ŽŽ‹’ǡǤǡ‹‡ Š–„ƒ—‡”ǡǤǡ ƒ ‘„•ǡǤǡ‡”‘ǡǤǡŠ‹‡”›ǡ Ǥǡ˜ƒ•ǡ ǤǡƬ˜ƒ‹‡ŽǡǤȋʹͲͳͺȌǤ–”‡••”‡ƒ –‹˜‹–›Ž‹• Š‹Ž†Š‘‘†–”ƒ—ƒ‡š’‘•—”‡Psychiatry research, –‘1 ƒ ƒ†‹š–—”‡ ‘ˆ †‡’”‡••‹˜‡ǡ ƒš‹‡–›ǡ ƒ† ’•› Š‘•‹• •›’–‘•Ǥ ȋʹ͸ͲȌǡͶͷͳǦͶͷ͹Ǥ World Population Prospects: the 2019 revision ‹–‡†ƒ–‹‘•‘’—Žƒ–‹‘‹˜‹•‹‘ȋʹͲͳͻȌǡ Ǥ ‡–”‹‡˜‡†ˆ”‘ Š––’•ǣȀȀ™™™Ǥ™‘”Ž†‘‡–‡”•Ǥ‹ˆ‘Ȁ™‘”Ž†Ǧ’‘’—Žƒ–‹‘Ȁƒ ‡••‡† ƒ—ƒ”›ʹ ʹͲʹͲǤ ƒ”‡•‡ǡ Ǥǡ‡‡–•ǡ Ǥǡ”—‡”ǡǤǡ‹‡˜‡”•‡ǡǤǡƒ–ƒ•–‡”ǡǤǡ‹‡ Š–„ƒ—‡”ǡǤǡǤǤǤƬ‡–ƒŽŽǡǤǤ ȋʹͲͳʹȌǤŠ‹Ž†Š‘‘†ƒ†˜‡”•‹–‹‡•‹ ”‡ƒ•‡–Š‡”‹•‘ˆ’•› Š‘•‹•ǣƒ‡–ƒSchizophreniaǦƒƒŽ›•‹•‘ˆ’ƒ–‹´– bulletin, 38 Ǧ ‘–”‘Žǡ’”‘•’‡ –‹˜‡Ǧƒ† ”‘••Ǧ•‡ –‹‘ƒŽ ‘Š‘”–•–—†‹‡•Ǥ ȋͶȌǡ ͸͸ͳǦ͸͹ͳǤ ‡Ž‹‰ǡǤǡ‘—‘––‡ǡ Ǥǡ‘–Ǧ‘Ž†‡”ǡǤǡ˜ƒ•ǡ ǤǡƬ˜ƒ†‡” ƒƒ‰ǡǤȋʹͲͳ͸ȌǤŠ‹Ž†Š‘‘†–”ƒ—ƒǡPsychological

’•› Š‘•‹•medicine, 46 Ž‹ƒ„‹Ž‹–› ƒ† •‘ ‹ƒŽ •–”‡•• ”‡ƒ –‹˜‹–›ǣ ƒ ˜‹”–—ƒŽ ”‡ƒŽ‹–› •–—†›Ǥ A ȋͳ͸Ȍǡ͵͵͵ͻǦͶͺǤ ‡‹Œ‡”•ǡ Ǥǡ–‡ƒ–‡ǡǤǡ—”‡Ž‹‰•Ǧ‘–‡‘‡ǡǤǡ‹‡ Š–„ƒ—‡”ǡǤǡƒ’ƒƒ”–ǡǤǡƒ–‡ƒǡǤǡƬ ‡Ž–‡ǡ ǤǦǤȋʹͲͳ͸ȌǤ‡–ƒŽ‹œƒ–‹‘BMC Ǧpsychiatry,„ƒ•‡†–”‡ƒ–‡–ˆ‘”’•› Š‘–‹ †‹•‘”†‡”ǣ’”‘–‘ ‘Ž‘ˆƒ 16 ”ƒ†‘‹œ‡† ‘–”‘ŽŽ‡†–”‹ƒŽǤ ȋͳȌǡͳͻͳǤ ‘Ž–Šƒ—•ǡ ǤǤǡ‹‰‡ƒ•ǡǤǤǡƬ Š‡‡ǡǤ ǤȋʹͲͲͲȌǤ‘’‘‡–•–”— –—”‡‘ˆ–Š‡‘•‹–‹˜‡ƒ† ‡‰ƒ–‹˜‡›†”‘‡ ƒŽ‡ȋȌ‹’ƒ–‹‡–•™‹–Š”‡ ‡–‘•‡–• Š‹œ‘’Š”‡‹ƒƒ†Psychopharmacology, 150 •’‡ –”—†‹•‘”†‡”•Ǥ ǡ͵ͻͻ–ͶͲ͵Ǥ ›‡•ǡǤǡ–‡‡ŽǡǤǡ˜‡”‹––ǡǤǡƬƒ””‹‡”ǡǤȋʹͲͲͺȌǤ‘‰‹–‹˜‡„‡Šƒ˜‹‘”–Š‡”ƒ’›ˆ‘”Schizophrenia • Š‹œ‘’Š”‡‹ƒǣ‡ˆˆ‡ –•‹œ‡•ǡ Ž‹‹ ƒŽ‘†‡Ž•ǡƒ†‡–Š‘†‘Ž‘‰‹ ƒŽ”‹‰‘”Ǥbulletin 34  ǡ ȋ͵Ȍǡͷʹ͵Ǧͷ͵͹Ǥ

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146807_JonasWeijers_BNW_def.indd 211 28-10-2020 15:09 Valorization

Valorization

 ƒƒ•–”‹ Š–—‹˜‡”•‹–›‡’Šƒ•‹œ‡•–Šƒ–‘™Ž‡†‰‡‘„–ƒ‹‡†–Š”‘—‰Šƒ ƒ†‡‹ ”‡•‡ƒ” Š•Š‘—Ž† ƒŽ•‘„‡–”ƒ•ˆ‡””‡†„ƒ ‹–‘‰‡‡”ƒŽ•‘ ‹‡–›–‘„‡‹’Ž‡‡–‡†‹‡˜‡”›†ƒ›Ž‹ˆ‡ǤŠ‹• transference of knowledge is sometimes referred to as ‘valorization’, defined as “the process of ”‡ƒ–‹‰˜ƒŽ—‡ˆ”‘‘™Ž‡†‰‡ǡ„›ƒ‹‰–Š‹•‘™Ž‡†‰‡ƒ˜ƒ‹Žƒ„Ž‡ƒ†•—‹–ƒ„Ž‡ˆ‘”‡ ‘‘‹  ƒ†•‘ ‹ƒŽ‡š’Ž‘‹–ƒ–‹‘ƒ†–‘–”ƒ•Žƒ–‡–Š‹•‘™Ž‡†‰‡‹–‘’”‘†— –•ǡ•‡”˜‹ ‡•ǡ’”‘ ‡••‡•ƒ† new businesses” (Knowledge Transfer Office, Maastricht University).   „‡Ž‹‡˜‡–Šƒ––Š‡‘™Ž‡†‰‡‘„–ƒ‹‡†ˆ”‘–Š‹•†‹••‡”–ƒ–‹‘‘ˆˆ‡”•‹•‹‰Š–•–Šƒ–ƒ› ’”‘˜‡–‘„‡˜ƒŽ—ƒ„Ž‡–‘•‘ ‹‡–›Ǥ‹–Šƒ‡†‹ƒŽ‹ˆ‡–‹‡’”‡˜ƒŽ‡ ‡‘ˆ͹Ǥͷ’‡”ͳͲͲͲ’‡”•‘• ȋò•–‡”‡–ƒŽǤǡʹͲͳͺȌƒ‡•–‹ƒ–‡†–‘–ƒŽ‘”ͷͺ‹ŽŽ‹‘’‡‘’Ž‡™‹ŽŽ†‡˜‡Ž‘’ƒ–‘‡’‘‹–‹ –Š‡‹”Ž‹˜‡•ǡ„ƒ•‡†‘–Š‡ —””‡–™‘”Ž†’‘’—Žƒ–‹‘ȋ‹–‡†ƒ–‹‘•‘’—Žƒ–‹‘‹˜‹•‹‘ȌǤ• –‡†•–‘•‡˜‡”‡Ž›‹˜ƒŽ‹†ƒ–‡’ƒ–‹‡–•ƒ†ƒ ‘—–•ˆ‘”ƒ•—„•–ƒ–‹ƒŽ’ƒ”–‘ˆ–Š‡™‘”Ž†™‹†‡ „—”†‡‘ˆ†‹•‡ƒ•‡ȋƒ–Š‡”•ǡ ƒ–Ƭ‘‡”ƒǡʹͲͲͺȌǡ–Š‹•’”‡•‡–•ƒŒ‘” ŠƒŽŽ‡‰‡•–‘‹†‹˜‹†—ƒŽ• ƒ†•‘ ‹‡–‹‡•ƒŽ‹‡ǤƒŒ‘” ‘–”‹„—–‘”–‘–Š‹•Š‹‰ŠŽ‡˜‡Ž‘ˆ†‹•ƒ„‹Ž‹–›‹•–Š‘—‰Š––‘„‡–Š‡†‡ Ž‹‡ ‹•‘ ‹ƒŽˆ— –‹‘‹‰ƒ••‘ ‹ƒ–‡†™‹–Šǡ™Š‹ Š‹ Ž—†‡•†‹ˆˆ‹ —Ž–‹‡•™‹–Š‹†‡’‡†‡–Ž‹˜‹‰ǡ ƒ†–Š‡ƒ‹–‡ƒ ‡‘ˆ”‡Žƒ–‹‘•Š‹’•ƒ†‡’Ž‘›‡–Ǥ –—”ǡ’‘‘”•‘ ‹ƒŽˆ— –‹‘‹‰’”‡†‹ –• ”‡Žƒ’•‡‹–‘’•› Š‘–‹ ‡’‹•‘†‡•ȋ‘—–—”‡ǡ‡Ƭ‘„‡”–•ǡʹͲͲ͸ȌǤ‘”‡‘˜‡”ǡ–Š‡Žƒ•–ͳͲͲ›‡ƒ”• Šƒ˜‡•‡‡Ž‹––Ž‡‹’”‘˜‡‡–‹–Š‡–”‡ƒ–‡–‘ˆ•‘ ‹ƒŽˆ— –‹‘‹‰‹’ƒ–‹‡–•™‹–Š ȋ ”‡‡ǡ ‘”ƒƬ‡‡ǡʹͲͳͷȌǡ™Š‡–Š‡”–Š”‘—‰Š’•› Š‘•‘ ‹ƒŽ‹–‡”˜‡–‹‘•ȋƒ–Š‡”‡–ƒŽǤǡʹͲͲͷǢ†‡ ‘‰‡–ƒŽǤʹͲͳͺǢ‘•‡–ƒŽǤǡʹͲͳͻȌ‘”’Šƒ”ƒ ‘Ž‘‰‹ ƒŽ–”‡ƒ–‡–ȋƒ”„‘Ƭ‘””‡ŽŽǡʹͲͳͶȌǤ† ƒŽ–Š‘—‰Š–Š‡Žƒ•–†‡ ƒ†‡Šƒ••‡‡–Š‡”‹•‡‘ˆ•‡˜‡”ƒŽ‹–‡”˜‡–‹‘•–ƒ”‰‡–‹‰•‘ ‹ƒŽ ‘‰‹–‹˜‡ǡ‘” ‘mentalizing’, impairments in NAPD (see Lana et al., 2017 for an overview), evidence that social ‘‰‹–‹˜‡–”ƒ‹‹‰’”‘‰”ƒ•ȋ ”‡‡ǡ ‘”ƒƬ‡‡ǡʹͲͳͻȌ‘” ‘‰‹–‹˜‡„‡Šƒ˜‹‘”ƒŽ–Š‡”ƒ’›ȋƒ™•ǡ ƒ”Ž‹‰–‘ǡ‘†‡Žǡ ‡ƒǡƬ ƒ—Šƒ”ǡʹͲͳͺȌ’”‘˜‹†‡•—•–ƒ‹‡†‹’”‘˜‡‡–•‹•‘ ‹ƒŽ ˆ— –‹‘‹‰‘” ‘‰‹–‹‘‹• —””‡–Ž›Ž‹‹–‡†ǡƒŽ–Š‘—‰Š‘‡”‡ ‡–•–—†›•Š‘™‡†–Šƒ––Š‹•‹• ’‘••‹„Ž‡ȋ‡ Š‹‡–ƒŽǤǡʹͲͳͻȌǤ  –Š‡”‡ˆ‘”‡ˆ‡‡Ž–Šƒ––Š‹•†‹••‡”–ƒ–‹‘ ‘–”‹„—–‡•–‘–Š‡ —””‡–„‘†›‘ˆ‘™Ž‡†‰‡ǡƒ• ‘—””‡•—Ž–••‡‡–‘•—‰‰‡•––Šƒ–‡–ƒŽ‹œƒ–‹‘ƒ•‡†”‡ƒ–‡–ˆ‘”•› Š‘–‹ †‹•‘”†‡”ȋ’Ȍ ’”‘†— ‡•ƒ•—•–ƒ‹‡†ǡ‰”‡ƒ–‡”’‡”ˆ‘”ƒ ‡‘‹•–”—‡–•–Šƒ–‡ƒ•—”‡•‘ ‹ƒŽˆ— –‹‘‹‰ƒ† •‘ ‹ƒŽ ‘‰‹–‹‘Ǥ—•–ƒ‹‡†‹’”‘˜‡‡–•–Šƒ–’”‡˜ƒ‹Ž‡˜‡ƒˆ–‡”–Š‡–‡”‹ƒ–‹‘‘ˆ–”‡ƒ–‡–– ‘ˆ–‡referred to as the ‘sleeper effect’ –Šƒ˜‡„‡‡‘„•‡”˜‡†™‹†‡Ž›‹•–—†‹‡•‡šƒ‹‹‰–Š‡ Ž‘‰–‡” ‘•‡“—‡ ‡•‘ˆ’•› Š‘†›ƒ‹ –”‡ƒ–‡–•‹‰‡‡”ƒŽȋ•‡‡†‡ƒƒ–ǡ†‡ ‘‰Š‡ǡ  Š‘‡˜‡”•ǡƬ‡‡”ǡʹͲͲͻǢ‘™ǡ‡–ƒŽǤǡʹͲͳʹǢ‡‹ Š•‡”‹‰‡–ƒŽǤǡʹͲͳͷˆ‘”‘˜‡”˜‹‡™•Ȍƒ† •’‡ ‹ˆ‹ ƒŽŽ›ȋƒ–‡ƒƬ ‘ƒ‰›ǡʹͲͲͳǢʹͲͲͺȌǤŠ‹Ž‡‘”‡Žƒ„‘”‹–‡•‹˜‡ǡ–Š‡ƒ††‹–‹‘‘ˆ’

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ƒ›–Š‡”‡ˆ‘”‡’”‘˜‡–‘„‡‹˜ƒŽ—ƒ„Ž‡ǡ„‡ ƒ—•‡‹–•”‡•—Ž–•ƒ›Žƒ•–ƒˆ–‡”–”‡ƒ–‡––‡”‹ƒ–‹‘Ǥ –—”•—•–ƒ‹‡†‹’”‘˜‡‡–•‹•‘ ‹ƒŽˆ— –‹‘‹‰ƒ”‡‡š’‡ –‡†–‘†‡ ”‡ƒ•‡‹˜ƒŽ‹†ƒ–‹‘ǡ ”‡Žƒ’•‡ǡŠ‘•’‹–ƒŽ‹œƒ–‹‘ƒ†–Š‡”‡„›•‘ ‹‡–ƒŽ ‘•–•Ǥ  ‘™‡˜‡”ǡ–Š‡ˆ‘ŽŽ‘™Ǧ—’’‡”‹‘†‘ˆ•‹š‘–Š•‹–Š‡ —””‡–•–—†›‹•ˆƒ”–‘‘•Š‘”––‘ ƒ””‹˜‡ƒ–ƒ›†‡ˆ‹‹–‹˜‡ ‘ Ž—•‹‘•Ǥ••— Šǡ–Š‹•†‹••‡”–ƒ–‹‘•Š‘—Ž†„‡‘Ž›„‡ ‘•‹†‡”‡†ƒ•ƒ ˆ‹”•–•–‡’‹–Š‡‡šƒ‹ƒ–‹‘ƒ††‡˜‡Ž‘’‡–‘ˆ’Ǥƒ›“—‡•–‹‘•”‡ƒ‹”‡‰ƒ”†‹‰ ǦP’s effects and the best way to implement it. Future research should establish whether ’’”‘†— ‡•Ž‘‰Ǧ–‡”•‘ ‹ƒŽ ‘‰‹–‹˜‡ƒ†ˆ— –‹‘ƒŽ Šƒ‰‡•Ǥ‹ŽŽ‹‘•‘ˆ’ƒ–‹‡–•ƒ› „‡‡ˆ‹–ˆ”‘‹–‡”˜‡–‹‘•–Šƒ–Ž‡ƒ†–‘†—”ƒ„Ž‡•‘ ‹ƒŽ ‘‰‹–‹˜‡ƒ†ˆ— –‹‘ƒŽ‹’”‘˜‡‡–•Ǥ  ††‹–‹‘ƒŽŽ›ǡ‘—””‡•—Ž–••—‰‰‡•––Šƒ–‹–‡”˜‡–‹‘•‡ƒ”Ž›‹Ž‹ˆ‡ƒ›’”‘˜‡–‘„‡ ”— ‹ƒŽ ‹–Š‡’”‡˜‡–‹‘ƒ†‡ˆˆ‡ –‹˜‡–”‡ƒ–‡–‘ˆǤ ‹”•–Ž›ǡ–Š‡”‡•—Ž–•‘ˆ–Š‹•†‹••‡”–ƒ–‹‘ •Š‘™‡†–Šƒ– Š‹Ž†Š‘‘†ƒ„—•‡‹’ƒ –•–Š‡•‡˜‡”‹–›‘ˆ‘—– ‘‡‘ˆ–Š”‘—‰Š•‡˜‡”ƒŽ ’ƒ–Š™ƒ›•Ǥ‘™Ž‡†‰‡‘ˆ–Š‡•‡’ƒ–Š™ƒ›•ǡƒ›Š‡Ž’–‘†‡˜‡Ž‘’’”‡˜‡–‹‘•–”ƒ–‡‰‹‡•–Šƒ– ƒ •–›‹‡–Š‡†‡˜‡Ž‘’‡–‘ˆǤ‡ ‘†Ž›ǡ’•‡‡•–‘Š‘Ž†‰”‡ƒ–‡”’”‘‹•‡ˆ‘”–Š‘•‡ ”‡Žƒ–‹˜‡Ž›”‡ ‡–‘•‡–’ƒ–‹‡–•ǡ™Š‹ Šƒ›‡ƒ–Šƒ–’•Š‘—Ž†„‡‹’Ž‡‡–‡†•‘‘‡” ”ƒ–Š‡”–ŠƒŽƒ–‡”ǤŠ—•ǡ‡ƒ”Ž›‹–‡”˜‡–‹‘ƒ›ˆ—”–Š‡”Š‡Ž’–‘”‡†— ‡‹†‹˜‹†—ƒŽ•—ˆˆ‡”‹‰ƒ† •‘ ‹‡–ƒŽ ‘•–•Ǥ  ƒŽ‘”‹œƒ–‹‘ƒŽ•‘‹˜‘Ž˜‡•–Š‡—–‹Ž‹œƒ–‹‘ƒ††‹••‡‹ƒ–‹‘‘ˆ‰ƒ‹‡†‘™Ž‡†‰‡Ǥ •ƒ• ‹‡ ‡Ǧ’”ƒ –‹–‹‘‡”ǡ  ‘•‹†‡”‹––‘„‡›†—–›–‘ ‘—‹ ƒ–‡–Š‡‹’‘”–ƒ ‡‘ˆ Š‹Ž†Š‘‘†ƒ„—•‡‹–Š‡†‡˜‡Ž‘’‡–‘ˆȋƒ”‡•‡‡–ƒŽǤǡʹͲͳʹȌƒ†‘ˆƒ†Œ— –’•› Š‘–Š‡”ƒ’› ‹–Š‡–”‡ƒ–‡–‘ˆȋ˜ƒ†‡‡”‰‡–ƒŽǤǡʹͲͳͷǢ‹‡”ƒǡ ƒ˜”‘†ǡ”‹‡—ǡƬ‘‹‹ǡ ʹͲͲͷȌǡ‡•’‡ ‹ƒŽŽ›•‹ ‡–Š‡‹’Ž‡‡–ƒ–‹‘‘ˆ’•› Š‘–Š‡”ƒ’‡—–‹ –”‡ƒ–‡–ˆ‘”’•› Š‘•‹•‹–Š‡ ‡–Š‡”Žƒ†•‹••–‹ŽŽ ‘•‹†‡”‡†–‘„‡•—„Ǧ‘’–‹ƒŽȋ‹‡”ƒ•ǡʹͲͳͻȌǤ –Š‡ ‘—”•‡‘ˆ–Š‹• ’”‘Œ‡ –ǡ Šƒ˜‡•–”‹˜‡†–‘”‡ƒ Šˆ‡ŽŽ‘™ Ž‹‹ ‹ƒ•ǡˆ‘”‡šƒ’Ž‡‹› —””‡– ‘—‹–›

–”‡ƒ–‡––‡ƒǡ™‹–ŠŽ‡ –—”‡• ‘ ‡”‹‰–Š‡ ‘–‡–•‘ˆ–Š‹•†‹••‡”–ƒ–‹‘Ǥ –Š‡Š‘’‡‘ˆ A ‹’ƒ –‹‰ Ž‹‹ ƒŽ’”ƒ –‹ ‡ǡ™‡Šƒ˜‡’”‘˜‹†‡†’–”ƒ‹‹‰•‡‹ƒ”•ˆ‘” Ž‹‹ ‹ƒ•ǡƒ†Šƒ˜‡ ’—„Ž‹•Š‡†ƒƒ”–‹ Ž‡†‡–ƒ‹Ž‹‰–Š‡’”ƒ –‹ ƒŽƒ•’‡ –•‘ˆˆ‘”’•› Š‘–‹ †‹•‘”†‡”•‹ƒ–”ƒ†‡ Œ‘—”ƒŽˆ‘”’•› Š‘Ž‘‰‹•–•ȋ–‡ƒ–‡‡–ƒŽǤǡʹͲͳ͸ȌǤ References

ƒ–‡ƒǡǤǡƬ ‘ƒ‰›ǡǤȋʹͲͲͳȌǤ”‡ƒ–‡–‘ˆ„‘”†‡”Ž‹‡’‡”•‘ƒŽ‹–›†‹•‘”†‡”™‹–ŠAmerican ’•› Š‘ƒƒŽ›–‹ ƒŽŽ›‘”‹‡–‡†’ƒ”–‹ƒŽŠ‘•’‹–ƒŽ‹œƒ–‹‘ǣƒͳͺJournal of psychiatry, 158 Ǧ‘–Šˆ‘ŽŽ‘™Ǧ—’Ǥ ȋͳȌǡ͵͸ǦͶʹǤ ƒ–‡ƒǡǤǡƬ ‘ƒ‰›ǡǤȋʹͲͲͺȌǤͺǦ›‡ƒ”ˆ‘ŽŽ‘™Ǧ—’‘ˆ’ƒ–‹‡–•–”‡ƒ–‡†ˆ‘”„‘”†‡”Ž‹‡’‡”•‘ƒŽ‹–›American Journal of †‹•‘”†‡”ǣ‡–ƒŽ‹œƒ–‹‘Psychiatry, 165 Ǧ„ƒ•‡†–”‡ƒ–‡–˜‡”•—•–”‡ƒ–‡–ƒ•—•—ƒŽǤ ȋͷȌǡ͸͵ͳǦ͸͵ͺǤ

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‡ Š‹ǡǤǡ‘•‹ƒǡǤǡ—‘‘ ‘”‡ǡǤǡ‰‘•–‘‹ǡ Ǥǡ‘•‹‡ŽŽ‹ǡ Ǥǡ‹Ž˜‡•–”‹ǡǤǤǡǤǤǤƬƒ˜ƒŽŽƒ”‘ǡǤ ȋʹͲͳͻȌǤ–ƒ„‹Ž‹–›ƒ†‰‡‡”ƒŽ‹œƒ–‹‘‘ˆ ‘„‹‡†–Š‡‘”›‘ˆ‹†ƒ† ‘‰‹–‹˜‡Psychiatric rehabilitation ”‡‡†‹ƒ–‹‘‹–‡”˜‡–‹‘•‹• Š‹œ‘’Š”‡‹ƒǣ ‘ŽŽ‘™journal. Ǧ—’”‡•—Ž–•Ǥ

ƒ”„‘ǡǤǡƬ‘””‡ŽŽǡǤǤȋʹͲͳͶȌǤŽ‹‹ ƒŽ’”‡†‹ –‘”•‘ˆ–Š‡”ƒ’‡—–‹ ”‡•’‘•‡–‘ƒ–‹’•› Š‘–‹ •Dialogues in clinical neuroscience 16 ‹• Š‹œ‘’Š”‡‹ƒǤ ǡ ȋͶȌǡͷͲͷǤ ƒ–Š‡”ǡǤǡ‡ǡǤǡ––‘ǡǤǤǡ‘˜‡Žǡ Ǥǡ—‡•‡”ǡǤǤǡƬ ‘ˆˆǡǤǤȋʹͲͲͷȌǤ’‹Ž‘–•–—†›‘ˆSchizophrenia ˆ— –‹‘ƒŽ‘‰‹–‹˜‡‡Šƒ˜‹‘”ƒŽŠ‡”ƒ’›ȋˆȌˆ‘”• Š‹œ‘’Š”‡‹ƒǤResearch, 74 ȋʹǦ͵ȌǡʹͲͳǦʹͲͻǤ ‘—–—”‡ǡǤǤǡ‡ǡǤǤǡƬ‘„‡”–•ǡǤǤSchizophreniaȋʹͲͲ͸ȌǤŠ‡ˆ— –‹‘ƒŽ•‹‰‹ˆ‹ ƒ ‡‘ˆ•‘ ‹ƒŽ ‘‰‹–‹‘ bulletin 32 ‹• Š‹œ‘’Š”‡‹ƒǣƒ”‡˜‹‡™Ǥ ǡ ȋͳȌǡͶͶǦ͸͵Ǥ †‡ ‘‰ǡǤǡ˜ƒ‘‡”•‰‘‡†ǡǤ ǤǤǡ‹‡”ƒǡǤǤǡƒ ‡–‘–ǡǤǡ—†‡”‹ǡǤǡ”‡†•ǡ ǤǡǤǤǤƬ‹Œ‡„‘”‰ǡ Ǥ ǤǤȋʹͲͳͻPsychologicalȌǤ‡–ƒ ‘‰‹–‹˜‡”‡ˆŽ‡ –‹‘ƒ†‹•‹‰Š––Š‡”ƒ’›ȋ Ȍ Medicine 49 ˆ‘”’ƒ–‹‡–•™‹–Š• Š‹œ‘’Š”‡‹ƒǤ ǡ ȋʹȌǡ͵Ͳ͵Ǧ͵ͳ͵Ǥ †‡ƒƒ–ǡǤǤǡ†‡ ‘‰Š‡ǡ Ǥǡ Š‘‡˜‡”•ǡǤƬ‡‡”ǡ ǤȋʹͲͲͻȌŠ‡‡ˆˆ‡ –‹˜‡‡••‘ˆŽ‘‰Harvard ReviewǦ–‡” of ’•› Š‘ƒƒŽ›–‹ –Š‡”ƒ’›ǣ•›•–‡Psychiatry 17 ƒ–‹ ”‡˜‹‡™‘ˆ‡’‹”‹ ƒŽ•–—†‹‡•Ǥ ǡ ȋͳȌǣͳ–ʹ͵Ǥ Nature Reviews ”‡‡ǡǤ Ǥǡ ‘”ƒǡǤǤǡƬ‡‡ǡ ǤȋʹͲͳͷȌǤ‘ ‹ƒŽ ‘‰‹–‹‘‹• Š‹œ‘’Š”‡‹ƒǤNeuroscience, 16 ȋͳͲȌǡ͸ʹͲǤ ”‡‡ǡǤ Ǥǡ ‘”ƒǡǤǤǡƬ‡‡ǡ ǤȋʹͲͳͻȌǤ‘•‘ ‹ƒŽƒ†•‘ ‹ƒŽ ‘‰‹–‹‘‹• Š‹œ‘’Š”‡‹ƒǣWorld Psychiatry 18 —””‡–‡˜‹†‡ ‡ƒ†ˆ—–—”‡†‹”‡ –‹‘•Ǥ Knowledgeǡ ȋʹȌǡͳͶ͸ TransferǦͳ͸ͳǤ Office. ‘™Ž‡†‰‡”ƒ•ˆ‡”ˆˆ‹ ‡ǡƒƒ•–”‹ Š–‹˜‡”•‹–›ǤȋʹͲͳ͸ȌǤ ‡–”‹‡˜‡† ƒ–ʹͲͳͻǡ‡ ‡„‡”ͳʹˆ”‘Š––’•ǣȀȀ™™™Ǥƒƒ•–”‹ Š–—‹˜‡”•‹–›ǤŽȀƒ„‘—–Ǧ—Ȁ‘–Š‡”Ǧ ‘ˆˆ‹ ‡•Ȁ‘™Ž‡†‰‡Ǧ–”ƒ•ˆ‡”Ǧ‘ˆˆ‹ ‡Ǥ ƒƒǡ Ǥǡˆ”‹ ƒ”—œǡǤǡ‘Žƒ‹ –‘”ǡǤǡƒ”–‹Ǧ‘ƒ›ǡ ǤȋʹͲͳ͹ȌǤ‘ ‹ƒŽ‘‰‹–‹‘ƒ•‡† Š‡”ƒ’‹‡•ˆ‘”‡‘’Ž‡™‹–Š Š‹œ‘’Š”‡‹ƒǣ ‘ —•‘‡–ƒ ‘‰‹–‹˜‡ƒ†‡–ƒŽ‹œƒ–‹‘Schizophrenia treatment. ’’”‘ƒ Š‡•Ǥ  ”‘—’•’‡ƒ ‡••‡„‘‘•Ǥ ƒ™•ǡǤǤǡƒ”Ž‹‰–‘ǡǤǡ‘†‡ŽǡǤǤǡ ‡ƒǡǤ ǤǡƬ ƒ—Šƒ”ǡǤȋʹͲͳͺȌǤ‘‰‹–‹˜‡ ‡Šƒ˜‹‘—”ƒŽŠ‡”ƒ’›ˆ‘”• Š‹œ‘’Š”‡‹ƒBMC psychology 6Ǧ‘—– ‘‡•ˆ‘”ˆ— –‹‘‹‰ǡ†‹•–”‡••ƒ†“—ƒŽ‹–›‘ˆ Ž‹ˆ‡ǣƒ‡–ƒǦƒƒŽ›•‹•Ǥ ǡ ȋͳȌǡ͵ʹǤ ‡‹ Š•‡”‹‰ǡ Ǥǡ—›–‡ǡǤǡ ‹Ž•‡”‘–ŠǡǤ Ǥǡ„„ƒ••ǡǤǡƒ”„‡”ǡ ǤǤǡ‡‡ˆ‡ǡ ǤǤǡǤǤǤƬ–‡‹‡”–ǡǤ ȋʹͲͳͷȌǤ•› Š‘†›ƒ‹ –Š‡”ƒ’›‡‡–•‡˜‹†‡ ‡The Lancet Psychiatry 2 Ǧ„ƒ•‡†‡†‹ ‹‡ǣƒ•›•–‡ƒ–‹ ”‡˜‹‡™ —•‹‰—’†ƒ–‡† ”‹–‡”‹ƒǤ The globalǡ ȋ͹Ȍǡ͸Ͷͺburden Ǧo͸͸ͲǤf disease: 2004 update. ƒ–Š‡”•ǡǤǡ ƒ–ǡǤǤǡƬ‘‡”ƒǡ ǤǤȋʹͲͲͺǤȌ ‡‡˜ƒǣ ‘”Ž† ‡ƒŽ–Š”‰ƒ‹œƒ–‹‘Ǥ

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‘”‡‘Ǧò•–‡”ǡǤǡƒ”–‹ǡǤǡƬƒ•–‘”ǡǤȋʹͲͳͺȌǤ”‡˜ƒŽ‡ ‡‘ˆ’•› Š‘–‹ †‹•‘”†‡”•ƒ†‹–• ƒ••‘ ‹ƒ–‹‘™‹–Š‡–Š‘†‘Ž‘‰‹ ƒŽ‹••—‡•Ǥ•›•–‡ƒ–‹ ”‡˜‹‡™ƒ†‡–ƒǦƒƒŽ›•‡•ǤŽ‘ ‘‡ǡͳ͵ȋͶȌǡ‡Ͳͳͻͷ͸ͺ͹Ǥ ‘•ǡǤǡ ”ƒ‡ǡǤǡ‹–ǡ Ǥǡ‹Œ‡ǡǤ Ǥǡ–ƒ”‹‰ǡǤǤǡƒ†‡” ƒƒ‰ǡǤǡǤǤǤƬ Š‹”„‡ ǡ Ǥ ȋʹͲͳͻȌǤ‘‰‹–‹˜‡„‡Šƒ˜‹‘”ƒŽ–Š‡”ƒ’›ˆ‘”•‘ ‹ƒŽƒ –‹˜ƒ–‹‘‹”‡ ‡–Journal of consulting and clinical psychologyǦ‘•‡–’•› Š‘•‹•ǣ87 ƒ†‘‹œ‡† ‘–”‘ŽŽ‡†–”‹ƒŽǤ ǡ ȋʹȌǡͳͷͳǤ –‡ƒ–‡ǡǤǡ‡‹Œ‡”•ǡ Ǥ ǤǡƬ‹–ǡǤȋʹͲͳ͸ȌǤ‡–ƒŽ‹•‡”‡„‡˜‘”†‡”‡†‡–Š‡”ƒ’‹‡˜‘‘”‘PsyXpert Ǧ ƒˆˆ‡ –‹‡˜‡’•› Š‘–‹• Š‡•–‘‘”‹••‡Ǥ ǡͶʹǦͷͲǤ ‹‡”ƒ•ǡǤȋʹͲͳͻǡƒ›͵ͳȌǤ‘”‰˜‘‘”’ƒ–‹´–‡‡–’•› Š‘•‡•‹•‘†‡”ƒƒ–•Ǥ‡ ‘Ž•”ƒ–ǡ’ǤͳǤ ‘™ǡ ǤǤǡ‹‡‡”ǡǤ Ǥǡ„„ƒ••ǡǤǡ‡‹ Š•‡”‹‰ǡ Ǥǡ”‹‡••‡ǡǤǡƬƒ„—‰ǡǤȋʹͲͳʹȌǤ‡–ƒǦ ƒƒŽ›•‹•‘ˆ’•› Š‘†›ƒ‹ ’•› Š‘–Š‡”ƒ’›‘—– ‘‡•ǣ˜ƒŽ—ƒ–‹‰–Š‡‡ˆˆ‡ –•‘ˆ”‡•‡Psychotherapy 49 ƒ” ŠǦ •’‡ ‹ˆ‹ ’”‘ ‡†—”‡•Ǥ ǡ ȋ͵Ȍǡʹ͹͸Ǥ ˜ƒ†‡‡”‰ǡǤǤǡ†‡‘–ǡǤǤǡ˜ƒ†‡”Ž‡—‰‡ŽǡǤǤǡ†‡‘‘•ǡǤǡ†‡ ‘‰ŠǡǤǡƒ‹‡ǡǤǡ Ƭ˜ƒ†‡” ƒƒ‰ǡǤȋʹͲͳͷȌǤ”‘Ž‘‰‡†‡š’‘•—”‡˜•‡›‡‘˜‡‡–†‡•‡•‹–‹œƒ–‹‘ƒ† ”‡’”‘ ‡••‹‰˜•™ƒ‹–‹‰Ž‹•–ˆ‘”’‘•––”ƒ—ƒ–‹ •–”‡••†‹•‘”†‡”‹’ƒ–‹‡–•™‹–ŠƒJAMA psychiatry 72 ’•› Š‘–‹ †‹•‘”†‡”ǣƒ”ƒ†‘‹œ‡† Ž‹‹ ƒŽ–”‹ƒŽǤ ǡ ȋ͵ȌǡʹͷͻǦʹ͸͹Ǥ ƒ”‡•‡ǡ Ǥǡ‡‡–•ǡ Ǥǡ”—‡”ǡǤǡ‹‡˜‡”•‡ǡǤǡƒ–ƒ•–‡”ǡǤǡ‹‡ Š–„ƒ—‡”ǡǤǡǤǤǤƬ‡–ƒŽŽǡǤǤ ȋʹͲͳʹȌǤŠ‹Ž†Š‘‘†ƒ†˜‡”•‹–‹‡•‹ ”‡ƒ•‡–Š‡”‹•‘ˆ’•› Š‘•‹•ǣƒ‡–ƒSchizophreniaǦƒƒŽ›•‹•‘ˆ’ƒ–‹‡– bulletin 38 Ǧ ‘–”‘Žǡ’”‘•’‡ –‹˜‡Ǧƒ† ”‘••Ǧ•‡ –‹‘ƒŽ ‘Š‘”–•–—†‹‡•Ǥ ǡ ȋͶȌǡ ͸͸ͳǦ͸͹ͳǤ ‹‡”ƒǡ Ǥǡ ƒ˜”‘†ǡ Ǥǡ”‹‡—ǡǤ ǤǡƬ‘‹‹ǡǤȋʹͲͲͷȌǤŠ‡‡ˆˆ‡ –‘ˆ ‘‰‹–‹˜‡„‡Šƒ˜‹‘”ƒŽ –”‡ƒ–‡–‘–Š‡’‘•‹–‹˜‡•›’–‘•‘ˆ• Š‹œ‘’Š”‡‹ƒ•’‡ –”—†‹•‘”†‡”•ǣƒ‡–ƒSchizophrenia research 77 Ǧ ƒƒŽ›•‹•Ǥ ǡ ȋͳȌǡͳWorldǦͻǤ Population Prospects: the 2019 revision

‹–‡†ƒ–‹‘•‘’—Žƒ–‹‘‹˜‹•‹‘ȋʹͲͳͻȌǡ Ǥ A ‡–”‹‡˜‡†ˆ”‘ Š––’•ǣȀȀ™™™Ǥ™‘”Ž†‘‡–‡”•Ǥ‹ˆ‘Ȁ™‘”Ž†Ǧ’‘’—Žƒ–‹‘Ȁƒ ‡••‡† ƒ—ƒ”›ʹ ʹͲʹͲǤ  

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146807_JonasWeijers_BNW_def.indd 215 28-10-2020 15:09 List of publications and invited lectures

List of publications and invited lectures

Peer-reviewed journal articles

†”‹ƒƒ•‡ǡǤǤǡ‡‹Œ‡”•ǡ Ǥ Ǥǡ‡‹††‡”ǡǤǤǡ‡‹–– —„‡”–•ǡ ǤǡƬ˜‡”•ǡǤȋʹͲͳͶȌǤ ‘ˆƒ„—Žƒ–‹‰”‡ƒ•‘•ˆ‘”„‡Šƒ˜‹‰„ƒ†ǣŠ‡’•› Š‘Ž‘‰‹ ƒŽ ‘•‡“—‡ ‡•‘ˆEuropean Journal of Socialunconsciously Psycholo activatedgy, 44 behaviour that violates one’s standards. ǡʹͷͷǦʹ͸͸Ǥ ‡‹Œ‡”•ǡ Ǥǡ–‡ƒ–‡ǡǤǡ—”‡Ž‹‰•Ǧ‘–‡‘‡ǡǤǡ‹‡ Š–„ƒ—‡”ǡǤǡƒ’ƒƒ”–ǡǤǡƒ–‡ƒǡǤǡƬ ‡Ž–‡ǡ ǤǤȋʹͲͳ͸ȌǤ‡–ƒŽ‹œƒ–‹‘BMCǦ psychiatry,„ƒ•‡†–”‡ƒ–‡–ˆ‘”’•› Š‘–‹ †‹•‘”†‡”ǣ’”‘–‘ ‘Ž‘ˆƒ 16 ”ƒ†‘‹œ‡† ‘–”‘ŽŽ‡†–”‹ƒŽǤ ȋͳȌǡͳͻͳǤ †”‹ƒƒ•‡ǡǤǤǡ”‘‡•‡ǡ ǤǤǡ‡‹Œ‡”•ǡ Ǥǡ ‘ŽŽ™‹–œ‡”ǡǤǤǡƬ‡––‹‰‡ǡ ǤȋʹͲͳͺȌǤEuropean Journal of Social Psychology, 48 š’Žƒ‹‹‰ —‡š’Žƒ‹ƒ„Ž‡ˆ‘‘† Š‘‹ ‡•Ǥ ȋͳȌǡͳͷǦʹͶǤ ‡‹Œ‡”•ǡ Ǥǡ ‘ƒ‰›ǡǤǡ—”‡Ž‹‰•Ǧ‘–‡‘‡ǡǤǡ‡”‘”•Š—‹œ‡ǡ Ǥǡ‹‡ Š–„ƒ—‡”ǡǤǡƬ‡Ž–‡ǡ ǤǤ ȋʹͲͳͺȌǤ‡–ƒŽ‹œ‹‰‹’ƒ‹”‡–ƒ•ƒ‡†‹ƒ–‘”„‡–™‡‡”‡’‘”–‡† Š‹Ž†Š‘‘†ƒ„—•‡ƒ†Psychiatry research, 259 ‘—– ‘‡‹‘ƒˆˆ‡ –‹˜‡’•› Š‘–‹ †‹•‘”†‡”Ǥ ǡͶ͸͵ǦͶ͸ͻǤ ‡‹Œ‡”•ǡ Ǥǡ‹‡ Š–„ƒ—‡”ǡǤǡ—”‡Ž‹‰•Ǧ‘–‡‘‡ǡǤǡƬ‡Ž–‡ǡ ǤǤȋʹͲͳͺȌǤ‡’‘”–‡†Š‹Ž†Š‘‘† „—•‡ƒ†–”‡••‡ƒ –‹˜‹–›‹•› Š‘•‹•ǣ‘ ‡’–—ƒŽ‡’Ž‹ ƒ–‹‘ƒ†š’Ž‘”ƒ–‹‘‘ˆFrontiers in psychiatry, 9 –ƒ–‹•–‹ ƒŽ’’”‘ƒ Š‡•Ǥ Ǥ –‡‡ƒ’ǡǤǡ‡‹Œ‡”•ǡ Ǥǡ ‡””ƒǡ Ǥǡ—”‡Ž‹‰•Ǧ‘–‡‘‡ǡǤǡƬ‡Ž–‡ǡ ǤǤȋʹͲͳͻȌǤŠ‡ ”‡Žƒ–‹‘•Š‹’„‡–™‡‡ Š‹Ž†Š‘‘†ƒ„—•‡ƒ†•‡˜‡”‹–›‘ˆ’•› Š‘•‹•‹•‡†‹ƒ–‡†„›Schizophrenia research. Ž‘‡Ž‹‡••ǣƒ‡š’‡”‹‡ ‡•ƒ’Ž‹‰•–—†›Ǥ  ‡‹Œ‡”•ǡ Ǥ Ǥǡ–‡ƒ–‡ǡǤ‡„„ƒ±ǡǤǡƒ–‡ƒǡǤǤǡ‡Ž–‡ǡ ǤǦǤǤ ǡƬ—”‡Ž‹‰•Ǧ‘–‡‘‡ǡ Ǥ ǤǤȋʹͲʹͲȌǤ‡–ƒŽ‹œƒ–‹‘ƒ†’•› Š‘•‹•ǣƒ”ƒ–‹‘ƒŽ‡ˆ‘”–Š‡—•‡‘ˆ‡–ƒŽ‹œƒ–‹‘Journal of –Š‡‘”›–‘—†‡”•–ƒ†ƒ†–”‡ƒ–‘Contemporary Psychotherapy, . Ǧƒˆˆ‡ –‹˜‡’•› Š‘–‹ †‹•‘”†‡”Ǥ ͳǦͳͲ ‡‹Œ‡”•ǡ Ǥ Ǥǡ–‡ƒ–‡ǡǤǡ‹‡ Š–„ƒ—‡”ǡǤǤǡƒ’ƒƒ”–ǡǤ ǤǤǡ—”‡Ž‹‰•ǡǤ ǤǤǡƬ‡Ž–‡ǡ ǤǤ ȋʹͲʹͲȌǤ‡–ƒŽ‹œƒ–‹‘Ǧ„ƒ•‡†–”‡ƒ–‡–ˆ‘”’•› Š‘–‹ †‹•‘”†‡”ǣƒ”ƒ–‡”Psychological Medicine. Ǧ„Ž‹†‡†ǡ—Ž–‹Ǧ ‡–‡”ǡ”ƒ†‘‹œ‡† ‘–”‘ŽŽ‡†–”‹ƒŽǤ  Trade journal article

–‡ƒ–‡ǡǤǡ‡‹Œ‡”•ǡ Ǥ Ǥǡ‹–ǡǤȋʹͲͳ͸ȌǤ‡–ƒŽ‹•‡”‡„‡˜‘”†‡”‡†‡–Š‡”ƒ’‹‡˜‘‘”‘PsyXpert Ǧ ƒˆˆ‡ –‹‡˜‡’•› Š‘–‹• Š‡•–‘‘”‹••‡Ǥ ǡͶʹǦͷͲǤ

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146807_JonasWeijers_BNW_def.indd 216 28-10-2020 15:09 List of publications and invited lectures

Invited lectures

‡‹Œ‡”•ǡ Ǥ Ǥǡ ‘ƒ‰›ǡǤǡ—”‡Ž‹‰•Mentalizing impairmentǦ‘–‡‘‡ǡǤǡ‡”‘”•Š—‹œ‡ǡ Ǥǡ‹‡ Š–„ƒ—‡”ǡǡ as mediator between reported childhood abuseƬ‡Ž and–‡ǡ ǤǤ ȋʹͲͳ͸ȌǤoutcome in nonaffective disorder. ”‡•‡–‡†ƒ–ǣ –‡”ƒ–‹‘ƒŽ‘‰”‡••‘‘”†‡”Ž‹‡ ‡”•‘ƒŽ‹–›‹•‘”†‡”ƒ†ŽŽ‹‡†‹•‘”†‡”•ǡ‹‡ƒǡ—•–”‹ƒǤAttachment processes in the development of psychosis: childhood trauma, ‡‹Œ‡”•ǡ Ǥ ǤȋʹͲͳͺȌǤmentalizing and loneliness Ǥ”‡•‡–‡†ƒ–ǣ‡–ƒ ‘‰‹–‹‘ƒ†’•› Š‘•‹••›’‘•‹—ǡ ”‘‹‰‡ǡ–Š‡‡–Š‡”Žƒ†•ǤChildhood abuse, loneliness and mentalization in non-affective psychotic ‡‹Œ‡”•ǡ Ǥ ǤȋʹͲͳͺȌǤdisorder ǡ’”‡•‡–‡†ƒ–ǣ –‡”ƒ–‹‘ƒŽ‘ˆ‡”‡ ‡‘ˆ‡–ƒŽ‹œƒ–‹‘ƒ•‡†”‡ƒ–‡–ˆ‘” •› Š‘•‹•ǡƒ†”‹†ǡ’ƒ‹Ǥ Mentaliseren bevorderende therapie bij ‡‹Œ‡”•ǡ Ǥ Ǥǡ–‡ƒ–‡ǡǤǡƬ‹‡ ‡”ǡ ǤȋʹͲͳͻȌǤpsychotische stoornissen. •› Š‹ƒ–‡”š’‡”–‰”‘‡’‡”•‘‘Ž‹ŒŠ‡‹†••–‘‘”‹••‡ǡ ‡”•ˆ‘‘”–ǡ–Š‡‡–Š‡”Žƒ†•Ǥ          

 A        

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146807_JonasWeijers_BNW_def.indd 217 28-10-2020 15:09 Acknowledgements

Dankwoord

Lotte

ƒƒ–‹„‡‰‹‡„‹Œ†‡„‡Žƒ‰”‹Œ•–‡’‡”•‘‘‹‹ŒŽ‡˜‡Ǥ ǡ‹ŒŽ‹‡ˆǤƒ˜‘‘”Œ‘—™ Ž‹‡ˆ†‡‡Œ‡‡‹†‡Ž‘œ‡‰‡†—Ž†‡–‹ŒǤŽŠ‡–Šƒ”†‡™‡”‡†‡˜‡”Ž‘”‡œ‘†ƒ‰‡†‹‡†‡ •Ž‡ Š–•±±†‘‡Žǣ‘œ‡–‘‡‘•–ǡ†‹‡™‡„‹‡‘”–‡–‡‡œ‘‘–Œ‡‘‰‡†‡Ž‡Ǩ Š‘—˜ƒ Œ‘—Š‡–ƒŽŽ‡”‡‡•–Ǥ Pap en mam ƒ–——”Ž‹Œ‘‘˜‡‡Ž†ƒƒƒ‹Œˆƒ‹Ž‹‡Ǥ ǡ†ƒ˜‘‘”ƒŽŒ—ŽŽ‹‡•–‡—‡ Ž‹‡ˆ†‡ǡ‹Š‘—˜ƒŒ—ŽŽ‹‡Ǥ —ŽŽ‹‡Š‡„„‡‘’‡‡”†‡”‡™‹Œœ‡‡‡ ”— ‹ƒŽ‡„‹Œ†”ƒ‰‡‰‡Ž‡˜‡”†ƒƒŠ‡– †‹–’”‘‡ˆ• Š”‹ˆ–Ǥ‘†‡”Œ—ŽŽ‹‡Šƒ†‹ò„‡”Šƒ—’–‹‡–„‡•–ƒƒǡ™ƒ–†‡–‘–•–ƒ†‘‹‰Pap ˜ƒ†‹– ’”‘‡ˆ• Š”‹ˆ–Šƒ†‰‡ ‘’Ž‹ ‡‡”†Ǥ ǡŒ‘—™‰‡—ƒ ‡‡”†‡ǡ ‘’ƒ••‹‡˜‘ŽŽ‡‡”‹–‹• Š‡„Ž‹‘’ ƒŽŽ‡”Šƒ†‡œƒ‡Š‡‡ˆ–‹ŒƒŽ˜”‘‡‰˜‘‘”„‡”‡‹†‘’‹Œ™‡”ƒŽ•–Š‡”ƒ’‡—–‡™‡–‡• Šƒ’’‡”ǤMam , van jou ‘erfde’ ik de liefde voor de psychodynamische benad‡”‹‰ǡ™ƒƒ”‹‡’ƒ–Š‹‡ǡ transparantie en begrip voorop staan. Jesse en Nina, wat een geluk heb ik met zo’n lieve broer ‡• Š‘‘œ—•Ǥ—Š‡–’”‘‡ˆ• Š”‹ˆ–Žƒƒ”‹•ǡŠ‘‘’‹˜‡‡Ž‡‡”–‹Œ†‡–Œ—ŽŽ‹‡†‘‘”–‡—‡Daan en Sanne „”‡‰‡ǤŽ‹‡˜‡–‹•‡‘—ǡ™ƒ–„‡‹„Ž‹Œ†ƒ–‹Œ—ŽŽ‹‡ȋ’‡‡–Ȍ‘‘„‡Ǩ ǡŠ‡–†‘‡– ‡˜‡‡Ž‰‘‡††ƒ–Œ—ŽŽ‹‡ƒƒ•–‹Œœ™ƒ‰‡”‡• Š‘‘œ—•‘‘‰‡™‘‘Š‡‡Žˆ‹Œ‡˜”‹‡†‡œ‹ŒǨ‘ ‘‘‹†ƒ–™‡‘‰‡˜‡‡”–‡‰‡Ž‹Œœ—ŽŽ‡„‡‰‹‡ƒƒŠ‡–‘—†‡”• Šƒ’Ǥ ƒ‡‰‡‡ƒ†‡”Jos en Coby ‘’’‡Ž˜‘‘”•–‡ŽŽ‡‡–™‹‡‹†‡œ‡„‹Œœ‘†‡”‡–‹Œ†Ž‹‡˜‡”†‘‘”œ‘—™‹ŽŽ‡„”‡‰‡Ǥ ǡ †ƒ˜‘‘”ƒŽŒ—ŽŽ‹‡„‡–”‘‡Š‡‹†‡•–‡—Ǥƒ–„‘ˆ‹‡–Œ—ŽŽ‹‡ƒŽ•• Š‘‘‘—†‡”•ǡ‡™ƒ–‰ƒƒ– ‘œ‡œ‘‘„‘ˆˆ‡‡–Œ—ŽŽ‹‡ƒŽ•‰”‘‘–‘—†‡”•ǨAlle deelnemende patiënten  ƒ‰‹ƒ–——”Ž‹Œ‹‡–‘˜‡”•ŽƒƒǢŒ—ŽŽ‹‡œ‹Œ‹•• Š‹‡™‡Ž†‡ „‡Žƒ‰”‹Œ•–‡‡•‡‹†‡–‘–•–ƒ†‘‹‰˜ƒ†‹–™‡”ǤŽŠ‡–‘†‡”œ‘‡†”ƒƒ‹–—‹–‡‹†‡Ž‹Œ ‘Œ—ŽŽ‹‡‡™‡”†‰‡†”ƒ‰‡†‘‘”Œ—ŽŽ‹‡Ǥƒ–‘–œ‡––‡†ˆ‹Œ‡•–‘‡”†ƒ–Œ—ŽŽ‹‡Š‡–Š‡„„‡ ƒƒ‰‡†—”ˆ††‡‡Ž–‡‡‡ƒƒ‡‡‡š’‡”‹‡–˜ƒ–™‡‡Œƒƒ”ȋǨȌ‡†ƒ–Œ—ŽŽ‹‡‘•Œ—ŽŽ‹‡ ˜‡”–”‘—™‡Š‡„„‡™‹ŽŽ‡‰‡˜‡Ǥ Š‡„Œ—ŽŽ‹‡Ž‡”‡‡‡ƒŽ•‘‰‡Ž‘ˆ‡Ž‹Œ†ƒ’’‡”‡‡•‡ †‹‡ǡ‘†ƒ•–‡‰‡•Žƒ‰‡‹Š‡–Ž‡˜‡ǡ†‡•–”‹Œ†‹‡–Coriene ten Kate ‘’‰‡˜‡Ǥ ǡ˜‡‡Ž†ƒǡ˜‡‡Ž†ƒǤ‘†‡”Œ‘—™˜‹•‹‡™ƒ•†‹–’”‘Œ‡ –‘‘‹–˜ƒ†‡ ‰”‘†‰‡‘‡Ǥ ‡Š‡„–‡‰‡Ãˆ‡ –‡‡”†‡–Œ‡’ƒ••‹‡˜‘‘”Ǥ ‡„‡–†ƒƒ”ƒƒ•–œ‡‡” ˜‘”‡†‰‡™‡‡•–‹‹Œ‘–™‹‡Ž‹‰ǡ‹‡–Ž‘—–‡”†‡ ‘‰‹–‹‡˜‡ǡƒƒ”˜‘‘”ƒŽ‘‘‹Œ ƒˆˆ‡ –‹‡˜‡‘–™‹‡Ž‹‰ǤProf. J.P. Selten, beste Jean-Paul ǡ‹„‡Œ‘—Š‡–‡‡•–‡”‡–‡Ž‹Œ˜‘‘”Š‡–•— ‡• ™ƒƒ”‡‡™‡‘œ‡ƒ”–‹‡Ž‡Š‡„„‡‰‡’—„Ž‹ ‡‡”†Ǥ Š‡„Œ‡‡”˜ƒ”‡ƒŽ•‡‡œ‡‡”—†‹‰‡ „‡‰‡‡•–‡”†™‡–‡• Šƒ’’‡”†‹‡œ‹Œ‡‹‰‡’ƒ††—”ˆ––‡„‡™ƒ†‡Ž‡Ǥ ‘—™ˆ‡‡†„ƒ ˆ—‰‡‡”†‡ƒŽ• ‡‡•Ž‹Œ’•–‡‡˜‘‘”†‡‰‡‡•–Ǥ±˜ƒ†‡‡‡”•–‡ ‘‡–ƒ”‡†‹‡Œ‡‡ ‰ƒˆǡ™ƒ•†ƒ–‹‘‡•–

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146807_JonasWeijers_BNW_def.indd 218 28-10-2020 15:09 Acknowledgements

Ž‡”‡‘„‡‘’––‡Ž‡”‡• Š”‹Œ˜‡‡‘Š‘‘ˆ†˜ƒ„‹Œœƒ‡–‡• Š‡‹†‡Ǥ ˜”‡‡•†ƒ–‹‡‡ Šƒ”†Ž‡‡”•‡Ž‡‡”Ž‹‰„‡‰‡„Ž‡‡ǢŽƒ–‡™‡Š‡–‡”‘’Š‘—†‡†ƒ–Š‡–‹Œ̶’‡”•‘‘Ž‹Œ‡•–‹ŒŽ̶‹•Ǥ ‡–Œ‘—™˜‹•‹‡Š‡„Œ‡‹Œ•‹œ‹‡•†‡’•› Š‘•‡œ‘”‰‘‘‡‡‰”‘–‡†‹‡•–„‡™‡œ‡Ǥ™‹–‹‰Œƒƒ” ‰‡Ž‡†‡™ƒ•Š‡–‘‰‡‡œ‘†‡‘–‡•’”‡‡˜ƒ†‡•‘ ‹ƒŽ‡‹˜Ž‘‡†‡‘’Š‡–‘–•–ƒƒ˜ƒ ’•› Š‘•‡•ǡ†ƒ–™ƒ•ƒ‡Ž‹Œ‡‡‰‡‡–‹• Š‡ǡ†‡‰‡‡”ƒ–‹‡˜‡Š‡”•‡ƒƒ†‘‡‹‰Ǥƒƒ”Œ‹Œ ‘zondigde’ hardnekkig door, ook al was dat toen niet modieus. Gelukkig heb je met je visie en ‘†‡”œ‘‡‡‹‰‡‡‡‡‰‡•Ž‡—”†‹Œ‘—™œ‘†‡˜ƒŽǡ™ƒ––‡‰Prof. Dr. Elisabeth Eurelings-Bontekoe, beste Liesbeth ‡™‘‘”†‹‰™‡–‡™‡™‡Ž„‡–‡”Ǥ ǡ†ƒ˜‘‘”ƒŽŒ‡ˆ‡‡†„ƒ ǡƒƒ” ˜‘‘”ƒŽ‘‘Œ‡•–‡—Ǥ ‡ ‘„‹‡‡”–‡‡• Š‡”’‡‰‡‡•–‡–‡‡™ƒ”Šƒ”–ǡ‡‹‰‡• Šƒ’’‡†‹‡ †‡‹‡••‡–‹‡‡Žœ‹Œ‹†‡’•› Š‘Ž‘‰‹‡Ǥ’„‡Žƒ‰”‹Œ‡‘‡–‡™ƒƒ”‘’‹™‘”•–‡Ž†‡‡–Š‡– ’”‘ ‡•ǡ™‹•–Œ‹Œ’”‡ ‹‡•†‡Œ—‹•–‡†‹‰‡–‡œ‡‰‰‡‘‹Œ˜‘‘”—‹––‡Š‡Ž’‡Ǥ‘‹˜‘‘”Œ‘— zware tijden kon je er oprecht zijn voor mij. Dat vind ik zó’n mooie eigenschap. Jouw klinische „Ž‹‡Œ‡–‡‰‡†”ƒƒ†•Š‡‹†œ‹Œœ‡‡”‹•’‹”‡”‡†‰‡™‡‡•–Ǥ‘Œ‹ŒŠ‡„–ǡ‹™‡‡”™‹Ž˜ƒ†‡™ƒƒ ˜ƒ†‡†ƒ‰ǡƒŽ–‹Œ†Œ‡‡‹‰‡‘‡”•‰‡˜ƒ”‡Ǥ‹•• Š‹‡‘–†ƒ–‘†ƒ–Œ‡Œ‡‡‹‰‡™‡”‡Š‡– ‘‡–ƒƒ”†ƒƒ”‘’ƒŽ–‹Œ†‹‡‡„”‡†‡”ǡŠ‹•–‘”‹• Š’‡”•’‡ –‹‡ˆŠ‡„–—‡’Žƒƒ–•‡Ǥƒ–‹•‡‡ Š‘—†‹‰†‹‡‘‰Žƒ‰œƒŽ”‡•‘‡”‡‹‹ŒǤ „‡–”‘–•‘‡–Œ‡•ƒ‡‰‡™‡”––‡‘‰‡ Š‡„„‡ǤDr. Viechtbauer dear Wolfgang ǡ ǡ–Šƒ›‘—ˆ‘”Š‡Ž’‹‰‡ƒ˜‹‰ƒ–‡–Š”‘—‰Š–Š‡Žƒ„›”‹–Š –Šƒ–‹•—Ž–‹Ž‡˜‡Ž”‡‰”‡••‹‘ƒƒŽ›•‹•ǤŽ•‘ǡ–Šƒ›‘—ˆ‘”†‹•’‡ŽŽ‹‰–Š‡’‡”•‹•–‡–”—‘”–Šƒ– •–ƒ–‹•–‹ ‹ƒ• ƒ‘–„‡™ƒ”ǡ•‘ ‹ƒ„Ž‡ƒ†ˆ—›ǤDear Martin Debbané, Anthony Bateman  Peter Fonagy, ƒ† –Šƒ›‘—ˆ‘”›‘—” ‘ŽŽƒ„‘”ƒ–‹‘‘•‡˜‡”ƒŽ’ƒ’‡”•Ǥ•‹‰ˆ‘”›‘—”ˆ‡‡†„ƒ ™ƒ•ǡƒ––‹‡•ǡ‹–‹‹†ƒ–‹‰ǡ„—–›‘—” ‘‡–•™‡”‡ƒŽ™ƒ›•†‡Ž‹˜‡”‡†™‹–Š‰”ƒ ‡ƒ†Ž‹‰Š–Š‡ƒ”–‡†‡••Ǥ‘—”‹•‹‰Š–•™‡”‡ ‹˜ƒŽ—ƒ„Ž‡ǡ–Šƒ›‘—ˆ‘”›‘—”–”—Ž›‹•’‹”ƒ–‹‘ƒŽ™‘”Ǥ

ƒ–——”Ž‹Œ‘‘†ƒƒƒƒŽŽ‡–‡ƒ•†‹‡Š‡„„‡„‹Œ‰‡†”ƒ‰‡ƒƒŠ‡–‘†‡”œ‘‡ǡ‡‡– A ƒ‡†‡„‡Šƒ†‡Žƒ”‡†‹‡Š‡„„‡‡‡‰‡™‡”–ƒƒŠ‡–’”‘Œ‡ –Ǥƒ–‡‡‰‡Ž—†ƒ–‹‡–œ—Ž‡MBT- gedreven,team in Voorhout consciëntieuze collega’s heb mogen werken.Rutger Rampaart, Allereerst Irma natuurlijk Siecker, dank Rosa aan Klaver, het Yvonne Noij, Andrea‡‹Š‡–„‹Œœ‘†‡”†ƒƒƒ Landman, Iliana Borisova, Mary Boes, Heidi Geutjes . VIP-team Leiden ‡ ˜‘‘”Š—†‹”‡ –‡ „‹Œ†”ƒ‰‡  ‡– ƒ‰ƒ–——”Ž‹Œ‘‘‹‡–‘–„”‡‡ǡ‘†ƒ–Œ—ŽŽ‹‡œ‘˜‡‡ŽLeon Jansen Willem’ƒ”–‹ ‹’ƒ–‡„‡”‡‹†Š‡„„‡‰‡”‡‰‡‡‡–‡†‘‡Ǥ Š‡–„‹Œœ‘†‡”†ƒƒƒ Jan van Utrecht ‡ ˜‘‘”Œ—ŽŽ‹‡„‹Œ†”ƒ‰‡ƒƒ†‡–Š‡”ƒ’‹‡ǡƒƒ”‘‘˜‘‘”†‡ƒ‹‡”™ƒƒ”‘’Anneke Duijn Œ—ŽŽ‹‡‡™‡Ž‘Š‡„„‡‰‡Š‡–‡‹Š‡––‡ƒǤƒƒ”ƒƒ•–˜‡‡Ž†ƒƒƒ Ǥ ‡–™ƒ• ‘–œ‡––‡†ˆ‹ŒŠ‘‡Œ‡‹ŒǡƒŽ•„‹Œƒ˜ƒœ‡Žˆ•’”‡‡†ǡŠ‡„–‰‡Š‘Ž’‡–‘‡‹ŒWijkteam Zoetermeer ‘†‡”œ‘‡• ‘–”ƒ ––‡‡‹†‡Ž‹‡’Ǥƒ–——”Ž‹Œ‘‘†ƒƒƒ Ester Schellingerhout,Ǣ™ƒ–‡‡ ‘‘‹‡–Š‡”ƒ’‹‡‰”‘‡’†”ƒƒ‹†‡Œ—ŽŽ‹‡Ǩ Š‡–„‹Œœ‘†‡”™‹Ž‹†ƒƒ”˜‘‘”

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146807_JonasWeijers_BNW_def.indd 219 28-10-2020 15:09 Acknowledgements

Nandl Lokhorst, Maaike van Hooff en Karin Schoenmaker FACT-team

Altrecht Zeist Peter„‡†ƒ‡Ǥ‡•Ž‘––‡™‹Ž van Beek, Yolanda Licher,‹ Erik Smid, Sonja Knecht en„‡†ƒ‡˜‘‘”Š—„‹Œ†”ƒ‰‡ǡ‡ Sabine Werr –ƒ‡ ‡Ǥ Els ƒ‘‘ƒƒŠ‡–‘†‡”œ‘‡•–‡ƒ˜ƒ†‡’•› Š‘•‡Ž‹Œ„‹Œ‹˜‹‡”†—‹‡Ǥ ™ƒ–™ƒ•‹ „Ž‹Œ‡–Œ‘—ƒŽ• ‘ŽŽ‡‰ƒǤ ˜‘†Œ‡ƒ„‹–‹‡‹•’‹”‡”‡†‡Œ‡Ž‡˜‡•Ž—•–ƒƒ•–‡‡Ž‹ŒǤ‘˜‡ƒŽ’”‹Œ• ‹Œ‘—™•–‘‡”Š‡‹†Ǥ ™‡‡–‘‰‰‘‡†Š‘‡Œ‡Š‘‘‰œ™ƒ‰‡”Œ‡‘†‡”œ‘‡‘˜‡”†‡‹˜Ž‘‡†˜ƒ•–”‡••Fabian –‹Œ†‡•œ™ƒ‰‡”• Šƒ’‘’’•› Š‘’ƒ–Š‘Ž‘‰‹‡•–‘†–‡˜‡”†‡†‹‰‡Ǥ ǡ‹‹•‘œ‡—‹–‰‡„”‡‹†‡ ™‡–‡• Šƒ’•ˆ‹Ž‘•‘ˆ‹• Š‡†‹• —••‹‡•–‹Œ†‡•†‡Ž— ŠǨ ‡ ‘„‹‡‡”–˜ƒƒ• Šƒ’ǡ ‡‹‰‡œ‹‹‰Š‡‹†ǡ‡Š—‘”‡– ‘’ƒ••‹‡Ǥƒ‡‡”‰ƒŒ‡‘•‘—Yvonne ‡‡•‡‡”‘†Ž‡‹†‹‰Žƒ‰•Œ‡ ˜ƒ”‡•‰‡˜‡ǫ ǡœ‘‘‘‹‘–‡œ‹‡Š‘‡Œ‹Œ‡‡’”‘‘–‹‡–”ƒŒ‡ –ǡ‘‡†‡”• Šƒ’‡—‘‘ ‡‡‘’Ž‡‹†‹‰–‘–˜‡”’Ž‡‡‰—†‹‰•’‡ ‹ƒŽ‹•– ‘„‹‡‡”–Jori, ‡†ƒ–œ‘†‡”‡‡”‹’ǡœ— Š–‘ˆŽƒ Š–Ǥ ƒƒ”—‡˜‡Ž‡‘‰‡‡’—–Œ‡ƒƒœ—‹‰‡Ǥ Š‡–’”‘‘˜‡”‡™ƒ•—‹–‡‹†‡Ž‹Œ‹‡– Š‡Ž‡ƒƒŽ™ƒ–Œ‡‡”˜ƒ˜‡”™ƒ Š–Šƒ†‡Œ‡ƒƒ–‡†‡†ƒ’’‡”‡‡—œ‡‘Œ‡‡‹‰‡’ƒ†–‡ „‡™ƒ†‡Ž‡ǡƒƒ”†ƒ–™ƒ•™‡Ž‡‡‰‡‹•˜‘‘”˜‘‡‡‹ŒǨ ‡™ƒ•‡‡œ‡‡”’”‡––‹‰‡ ‘ŽŽ‡‰ƒRik, ‡„Ž‡‡ˆ‘‘„‹Œ–‡‰‡•Žƒ‰ƒŽ–‹Œ†‡’ƒ–Š‹• ŠǤ Œ‹Œ„‡–‹‡–ƒŽŽ‡‡‡‡™‡–‡• Šƒ’’‡”’—”•ƒ‰ ƒƒ”‘‘‰‡™‘‘‡‡ƒŽŽ”‘—†‹–‡ŽŽ‡ –—‡‡Žǡ‡‡‡œ‡‡”’”‡––‹‰‡„‘˜‡†‹‡Ǥ ‡•’”‡‡‡– Œ‘—‘†‡‰ƒƒ‘˜‡”†‡ǡCarmen ™Š‹•‡›ǡ†‡‡–™‡”–Š‡‘”‹‡˜ƒ’•› Š‘’ƒ–Š‘Ž‘‰‹‡‡ ‘”†ƒJP ‡–‡”•‘Ǥ ǡ†‡Œ‘‰•–‡Ž‘‘–ƒƒ†‡„‘‘˜ƒ ǡŠ‘—˜‘Ž‡‰ƒœ‘†‘‘”Ǩ‘†”ƒŒ‡†‹‡ ‡†‹• Š‡–Š‹• Š‡‰‘‡†‡—”‹‰„‹‡Š‡„–‰ƒƒ–ƒŽŽ‡•˜ƒœ‡ŽˆǢǦȌǤ ‡Ž‘‘ˆ‡ǡ‹ƒŠ‡–™‡–‡Ǥ ƒƒƒHanneke†‡‘ van†‡”œ‘‡•ƒ••‹•–‡–‡ der Werf, Latifa si ‡AmerƒŽŽ‡•–—†‡–‡†‹‡œ‘‹Œ˜‡”‹‰ƒŽŽ‡†ƒ–ƒŠ‡„„‡Valentein Hol ˜‡”œƒ‡Ž†Ǥ  Floor van‡ den Berge ǡŒ—ŽŽ‹‡„‡–‡Š‡–•’‹–•ƒˆǡ‡ Patrick Imanse Š‘‡Ǩ‘‘‹Š‘‡”—•–‹‰Œ—ŽŽ‹‡–‡™‡”‰‹‰‡Ǥ ‡ ǡ™ƒ–œ‹ŒŒ—ŽŽ‹‡ ‡‡†‘‘”œ‡––‡”•Ǩ —ŽŽ‹‡™ƒ”‡‡”˜ƒƒˆŠ‡–„‡‰‹–”ƒ•’ƒ”ƒ–‘˜‡”†ƒ–‘†‡”œ‘‡‹‡–Œ—ŽŽ‹‡ ˆƒ˜‘”‹‡–‡„‡œ‹‰Š‡‹†™ƒ•ǡƒƒ”Œ—ŽŽ‹‡Š‡„„‡Œ‡‡”†‘‘”Š‡‡‰‡•Žƒ‰‡Ǥ‘‘‘‹‘–‡œJorinde Gerrmann Lisa Steenkamp ‹‡Š‘‡ ‡’ƒ–Š‹• ŠŒ—ŽŽ‹‡‡–†‡’ƒ–‹´–‡‘‰‹‰‡Ǥ ‡ ǡŒ—ŽŽ‹‡‰‹‰‡ ƒ„‹–‹‡—•ƒƒ†‡•Žƒ‰‡–†‡‹‡—™•–‡ǡ‡–ƒƒ‰‡Ž‡‡”†‡•–ƒ–‹•–‹• Š‡‡–Š‘†‡•‘œ‘†‡ ‹‰‡™‹‡Ž†‰‡•–”— –—”‡‡”†‡†ƒ–ƒ˜ƒ†‡•›ƒ–‡–‡–‡‡Ǥ —ŽŽ‹‡Š‡„„‡’”ƒ Š–‹‰‘†‡”œ‘‡Marleen van Pelt Emma Deckers ‰‡†ƒƒǡƒŽ‡ Š–’”‘‘˜‡†—•Ǧ™ƒƒ”†‹‰Ǥ ‡ ǡ™ƒ–™ƒ”‡Œ—ŽŽ‹‡ ‹Œ˜‡”‹‰Ǩ‹‡–ƒŽŽ‡‡†‡†‡Œ—ŽŽ‹‡ƒŽŽ‡™‡”œƒƒŠ‡†‡—‹–—–‡†ǡƒƒ”Œ—ŽŽ‹‡• Š”‡˜‡‘‘‘‰ ‡‡Š‡—•‡‰‹†•˜‘‘”†‡˜‘Ž‰‡†‡•–ƒ‰‹ƒ‹”‡ȋ‹‡–•™ƒ–†—‹†‡Ž‹Œ‘–„”ƒ–‘‡Œ—ŽŽ‹‡„‹Œ‹ŒEsther van Zoen „‡‰‘‡ȌǤ ǡŒ‹Œ™ƒ•Š‡‡•Ž—‹–‡”˜ƒŠ‡–’”‘Œ‡ –‡‡”‰’”‡––‹‰‘‡‡–‡ ™‡”‡Ǥ ‡„‡–‡‡‡‘” ‘’ƒ••‹‡˜‘ŽŽ‡’•› Š‘Ž‘‘‰†‹‡–‡‰‡Ž‹Œ‡”–‹Œ†‰‡Š‡‡ŽŠƒƒ”‡‹‰‡‰ƒ‰ †—”ˆ––‡‰ƒƒǤ ‹Œ†ƒ‰ƒƒ–‘‘—‹–ƒƒ”‹‡†‡”‡‡†‹‡‡†‡Žƒƒ–•–‡–™‡‡Œƒƒ”Š‡‡ˆ–‰‡Š‘Ž’‡„‹ŒŠ‡– Œ‘‰Ž‡”‡˜ƒ†‡™‡”œƒƒŠ‡†‡˜‘‘”‹Œ’”‘‡ˆ• Š”‹ˆ–‡†‡ Ǧ‘’Ž‡‹†‹‰Ǥ Š‡„†‡ƒˆ‰‡Ž‘’‡ –‹Œ†‡‹‰‡Ž‹ŒƒŽ•”‡Žƒ–‹‡ˆ‘–•’ƒ‡‡”˜ƒ”‡Ǥƒ–——”Ž‹Œ™‹Ž‹†ƒƒ”˜‘‘”‹Œ‘’Ž‡‹†‹‰•‰”‘‡’

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146807_JonasWeijers_BNW_def.indd 220 28-10-2020 15:09 Acknowledgements

GZ19B

„‡†ƒ‡Ǥ‡”‡Žƒš–‡ǡ‘Ǧ‘•‡•‡•ˆ‡‡”˜ƒ‘œ‡‰”‘‡’‹•„‡•‡––‡Ž‹Œ‡œ‘”‰–‡”˜‘‘”Fleur van Ierschot †ƒ–‹‘‘‹––±‰‡•–”‡•–„‡‘˜‡”†‡‘’Ž‡‹†‹‰Ǥ Š‡–„‹Œœ‘†‡”‘‘†ƒƒƒ ǡ †‹‡Žƒ‰‡”ƒŽ•Œƒƒ”‰”‘‡’Ǧ˜‡”–‡‰‡™‘‘”†‹‰‡”™‹Ž†‡ˆ—‰‡”‡œ‘†ƒ–‹‹ƒŽŽ‡”—•–‹Œ ’”‘‡ˆ• Š”‹ˆ–‘ƒˆ”‘†‡Ǥ‘†ƒƒƒ‹Œ™‡”„‡‰‡Ž‡‹†‡”•ǡ•—’‡”˜‹•‘”‡‡Mieke de Jong, Yvonne Verburg, Michael Holwerda, Koert Velders, Daan Jonker’”ƒ–‹Œ„‡‰‡Ž‡‹†‡”•ǣ ‡ Ǥ —ŽŽ‹‡Ž‡‡‡”•–—˜‘‘”•–—ƒƒ”–‡•–”‡˜‡‘†‡‘’Ž‡‹†‹‰‹‡–‘†‡Ž‘‘•œ™ƒƒ”–‡Wijkteam Gouda makenWest en datPolikliniek is goed gelukt! Gouda Daarnaast moet ik absoluut ook mijn collega’s van ‡†‡ noemen. Dank dat jullie mij zo’n prettige tijd hebben gegeven! ‘‘”†‡‰‡‘‡†‡Ž‹Œ‡•ˆ‡‡”Š‡„‹‡‘’„‡‹†‡Ž‘ ƒ–‹‡•‡”‰™‡Ž‘‰‡˜‘‡Ž†ǤSchool of Mental Health and Neuroscience ‘™‹Ž‹†‡‡†‡™‡”‡”•˜ƒ†‡ Debora op ‘t Eijnde Truda Driesen˜ƒ ƒƒ•–”‹ Š–‹˜‡”•‹–›„‡†ƒ‡˜‘‘”Š—Š—Ž’Ǥ ‡ ™‹Ž‹‹Š‡– „‹Œœ‘†‡”‡˜‡‹Š‡–œ‘‡–Œ‡œ‡––‡Ǥƒ˜‘‘”Š‡–„‡ƒ–™‘‘”†‡˜ƒ‹Œ‡‹†‡Ž‘œ‡˜”ƒ‰‡ ‘˜‡”Ͷ†‡†‡‹˜‘‡”˜ƒƒŽ†‹‡„‡”‰‡†ƒ–ƒǨ —ŽŽ‹‡•–‘†‡ƒŽ–‹Œ††‹”‡ –’ƒ”ƒƒ–‘lifeline ’”‘„Ž‡‡‘’ –‡Ž‘••‡Ǥ —ŽŽ‹‡™ƒ”‡‡‡Š‡—•‡ Ǥ directie van GGZ Rivierduinen œ‘—‘‘‹Œ†ƒ™‹ŽŽ‡—‹–‡ƒƒ”†‡ ˜‘‘”Š— ˆ‹ƒ ‹´Ž‡•–‡—‡Š‡–Ž‡ˆ†ƒ–œ‡Š‡„„‡‰‡–‘‘†‘‡–†‹–’”‘Œ‡ –ƒƒ†‡•Žƒ‰–‡‰ƒƒǤlast but not least  Eddie, ǡ†ƒƒƒ‹Œ˜”‹‡†‡†‹‡‡‡”ǡ™ƒƒ”‘†‹‰ǡ†‘‘”Š‡‡Š‡„„‡ ‰‡•Ž‡‡’–Ǥ Š‘‡ƒœ‘˜‡‡Ž–ƒŽ‡–‡œ‘˜‡‡Ž„‡• Š‡‹†‡Š‡‹†‹±±’‡”•‘‘•ƒ‡‘‡ǫ œ‘—†ƒƒ”‡‡ ‘’Ž‹‡–‘˜‡”™‹ŽŽ‡ƒ‡ǡƒƒ”˜‘Ž‰‡•Œ‘—™‡‹‰‡‘†‡”œ‘‡ƒ‰†ƒ– ‹‡–Ǥƒ‰ƒŒ‡ƒƒ•–Œ‡• Š‘‡‡Ž‘’‡Ǥƒƒ”‘œ‡‰‹ƒƒ”ǣ‰‘‡†„‡œ‹‰‰‘œƒŠǨƒ˜‘‘”Œ‡ •–‡—ǡ‡†‡‡‹†‡Ž‘‘•‡ƒ†‡”‡†‡‰‡•’”‡‡Ǥƒ‘‘†ƒ–Œ‡‡Š‡„–‰‡Ž‡‡”††ƒ–Œ‡ƒŽ•œ‡ŽˆǦ ”‡•’‡ –‡”‡†‘†‡”œ‘‡‡”‡’•› Š‘Ž‘‘‰„‡•–Š‡–™‡”˜ƒ†‡’•› Š‘ƒƒŽ›–‹ ‹ƒ‰„‡•–—†Sjoerd ‡”‡Ǥ „‡„‡˜‘‘””‡ Š–Œ‘—‹Œ˜”‹‡†–‡‘‰‡‘‡‡Ǥ ǡŒ‹Œ„‡–‘‘‹–ǡƒƒ”‘‘‡ Š–‘‘‹–ǡ te beroerd om iets voor een ander te doen. Je bent zo’n fijne maat en toffe vent. Heel gaaf (en

‡‡„‡‡–Œ‡ŒƒŽ‘‡”•ƒ‡†Ȍ‘–‡œ‹‡Š‘‡Œ‹Œ—‡–Œ‡‡‹‰‡„‡†”‹ŒˆŒ‡‡‹‰‡‘‡”•–”‡–‹Š‡– A Ž‡˜‡Ǥ ‡„‡–†ƒƒ”‹‡‡˜‘‘”„‡‡Ž†˜‘‘”‡Ǥ ‡‡Ž˜‡‡Ž†ƒ˜‘‘”†‡’”ƒ Š–‹‰‡ ‘˜‡”˜ƒ†‹–Roel ’”‘‡ˆ• Š”‹ˆ–Ǥ ǡŠ‡–œƒŽ˜‘‘”‹ŒƒŽ–‹Œ†‡‡›•–‡”‹‡„Ž‹Œ˜‡Š‘‡‹‡ƒ†–‡‰‡Ž‹Œ‡”–‹Œ†œ‘•‘ ‹ƒƒŽ ˆ‹Œ‰‡˜‘‡Ž‹‰ƒœ‹ŒJeroen‡œ—Ž‡Šƒ”†‡‰”ƒ’’‡ƒƒ‡Ǥ ‡„‡–‡‡‘„ƒƒ–œ— Š–‹‰‡ǡ˜”‹Œ‰‡˜‹‰‡ ‡‘’”‡ Š–‡˜”‹‡†Ǥ ǡŒ‡„‡–‡‡‡ Š–‡”‘–•‹†‡„”ƒ†‹‰‡•–‹‡‡‰‡™‘‘Š‡– ‰”ƒ’’‹‰•–‡Ž‹†˜ƒ‘œ‡‰”‘‡’Ǥ ‹•†‡–‹Œ††ƒ–Œ‡‡˜‡„‹Œ‘•‡—„‹Žƒ‹”Š‘‘”†‡Ǩ‹‡–™‡‡ ƒƒ†‡˜Ž‘‰‡˜‘‘”„‹ŒǤ‘Œ‡˜‘Ž‰‡†‡™‡‡™‡‡”‡‡ˆ‹Ž‹Œ‡ǫ™ƒ‡‡”‰ƒƒ™‡”‹šRalf, œ‹‡ǫ „‘›‘ǡ‹˜‹†Š‡–‘‘‹Š‘‡‘˜‡”• Š”‘‡‡–‡‰‡†”ƒƒ†•Œ‹Œ‹Š‡–Ž‡˜‡•–ƒƒ–Ǥ ‡ laat je niet leiden door algemene verwachtingen of ‘hoe het hoort’, Rickmƒƒ”†‘‘”‡‡œ‘‡–‘ Š– ƒƒ”ƒ—–Š‡–‹ ‹–‡‹–‡‡ Š–‡•‡Ž‹Œ ‘–ƒ –Ǥƒ–˜‡”†‹‡–ƒŽŽ‡Ž‘ˆǤ ǡ‹˜‹†Š‡–‘‘‹Š‘‡ „‡™—•–Œ‹ŒŒ‡‡—œ‡•ƒƒ–‡Š‘‡Œ‡‹Š‡–Ž‡˜‡•–ƒƒ–Ǥ‰‡• Š‹ŒŽ‹Œ‰ƒƒ–Š‡–Œ‡ƒŽŽ‡ƒƒŽ‡”‰ ‰‡ƒ‡Ž‹Œƒˆǡƒƒ”Œ‡•–ƒƒ–Œ‡œ‡Žˆ‹‡––‘‡‘ƒŽ–‡˜‡‡Žƒ Š–‡”‘˜‡”–‡Ž‡—‡‡„Ž‹Œˆ–Œ‡œ‡Žˆ

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Reinier

‘–™‹‡Ž‡Ǥƒ–‹•ƒ˜‘Ž‰‡•™ƒƒ”†‹‰Ǥ ǡŒ‹Œ„‡–Š‡–Ž‡˜‡†‡„‡™‹Œ•†ƒ–‡‡‰‘‡†‡„——” ‘‘‡‡ƒƒ•–‡˜”‹‡†ƒœ‹ŒǤ ˜‹†Š‡–„‡™‘†‡”‡•™ƒƒ”†‹‰Š‘‡Š‡–Œ‡Ž—–‘œ‘˜‡‡Ž ‡‡”‰‹‡‹Œ‡˜”‹‡†• Šƒ’’‡–‡„Ž‹Œ˜‡•–‡‡Ǥ‘‘‹‘–‡œ‹‡Š‘‡Œ‹Œ‡–— Š–‡”Š‡‹†ǡŠ—‘”ǡ –”ƒ•’ƒ”ƒ–‹‡‡‡‡†ƒ’’‡”‡™‡–•„ƒƒ”Š‡‹†ǡ†‡‘„•–ƒ‡Ž•‹Œ‡Ž‡˜‡–‡Ž‹Œˆ‰ƒƒ–ǤŠ‡†‡Jaapiooooo, ƒ’’— ‹‘‹•‘‰•–‡‡†•Š‡‡”Ž‹ŒǤ Š‘‡ƒ‹‡ƒ††‹‡œ×˜‡‡Ž‰‡Ž†˜‡”†‹‡––‡‰‡Ž‹Œ œ‘‡’ƒ–Š‹• Šœ‹Œǫƒ–Š‡„‹‰‡‘–‡˜ƒ‘œ‡–‘ Š–†‘‘”†‡–”‡ Š–•‡Š‡—˜‡Ž”—‰ȋ‡†‡ ™Šiskey om 11 uur ‘s ochtends)! Wat begon als een jazzband (hoeStefan heetten we ook alweer?!) is —‹–‰‡„Ž‘‡‹†–‘–‡‡˜”‹‡†• Šƒ’†‹‡‹‹‡–œ‘—™‹ŽŽ‡‹••‡Ǥ ǡˆ‹Œ‡˜‡–‡‹Œ‘—†•–‡ ˜”‹‡†Ǩ ‡–Š‡‡ˆ–‹ŒŽ‡˜‡˜‡””‹Œ–‘Œ‘—ƒŽ•‹†•‹Œ˜‹‡”†‡Œƒƒ”–‡‡‡Ǥ ‡„‡–‡‡ ‘‡”–”‘—™‡ǡˆ‹Œ‡˜‡–Ǥ œ‘—Œ‡™‡Ž™‹ŽŽ‡˜”ƒ‰‡‘–‡•–‘’’‡‡–Š‡–‘’‹´”‡˜ƒ‹Œcreepy Martin Ž‡˜‡•‡—œ‡•ǡ™ƒ–Š‡–„‡‰‹–—™‡Ž‡‡„‡‡–Œ‡ –‡™‘”†‡Ǥ ǡ™ƒ–„‡‰‘ƒŽ•‡‡ ‰‘‡† ‘ŽŽ‡‰‹ƒƒŽ ‘–ƒ –‹‡‹†‡‹•—‹–‰‡‰”‘‡‹†–‘–‡‡œ‡‡”‰‡™ƒƒ”†‡‡”†‡˜”‹‡†• Šƒ’Ǥ‡ Š‘””‘”‹‰Š–‹•‡‡”‘‡Ž‘œ‡†‘‘†‰‡•–‘”˜‡ƒƒ”†‡•’‡ŽŽ‡–Œ‡•‹††ƒ‰‡ȋƬǨȌ‡†‡Wijnand œ‡Žˆ‰‡„”‘—™‡ȋ•‘•‘–’Ž‘ˆˆ‡†‡Ȍƒ”–‹„‹‡”–Œ‡•ǡœ‹Œ™ƒ–‹Œ„‡–”‡ˆ–‡‡„Ž‹Œ˜‡”–Œ‡Ǩ ǡ Œ‹ŒŠ‡„–‡‡‘˜‡”• Š”‘‡‡‹‰‡œ‹‹‰‡„Ž‹‘’Š‡–Ž‡˜‡‡†‡’•› Š‘–Š‡”ƒ’‹‡†‹‡‹Œ ‹•’‹”‡‡”–Ǥ „‡œ‡‡”„Ž‹Œ†ƒ–‹Œ‡Š‡„Ž‡”‡‡‡–‹Œ†‡•†‡Mieke, ƒ‰˜ƒ†‡•› Š‘–Š‡”ƒ’‹‡Ǥ ‘‰‡™‡‘‰˜ƒƒ™ƒ†‡Ž‡Žƒ‰• ‘—†•‡‰”ƒ Š–‡Ǥ Œ‘—™— Š–‡”‡ǡ‰”ƒ’’‹‰‡‹Œ‘’†‡ ™‡”‡Ž†œ‘”‰–‡”˜‘‘”†ƒ–‹‡–‹Œ„‡‡‹‡–•‡‡”‘’†‡‰”‘†„Ž‹Œˆ•–ƒƒǤ ˜‹†Œ‡‡‘” †ƒ’’‡”‡•–‘‡”Ǥ ‘‡Œ‹Œ‘‰ƒƒ–‡–˜‡”ƒ†‡”‡†‡‘•–ƒ†‹‰Š‡†‡‹•‡‡˜‘‘”„‡‡Ž†˜‘‘”‘•Steven ƒŽŽ‡ƒƒŽǤ ǡ‹Œ‡‡•–”‡ ‡–‡˜”‹‡†Ǥƒ†ƒ–Œ‡‡‘’•Ž‡‡’–‘—™ƒ‡–†‡ ‡–ƒ ‘‰‹–‹‡Ǧ‰”‘‡’‹ Ž‘”‡ ‡Ǩ‡Š‡„„‡‡”‘‘‹‡ǡ‹‡–•–‡Žƒ‰‡ƒ˜‘†‡‹†‡”‘‡‰ †‘‘”‰‡„”ƒ Š–Ǥ‡„‹Œ™‡”‹‰‡˜ƒ†‹‡ƒ˜‘†‡‡‡‹Œ‡‘˜‡”‹‰‡•‹‡–‹†ƒƒˆǤ‘†ƒ ˜‘‘”Œ‡ ‘ŽŽƒ„‘”ƒ–‹‡„‹Œ‡‡˜ƒ†‡ƒ”–‹‡Ž‡Ǥ Š‘‘’†ƒ–‡”‘‰˜‡Ž‡‘‰‡˜‘Ž‰‡Ǥƒ–œ‡‰Gijs en Femke! ‘— œ‡Žˆǡ‡ œ‹Œ–‘ Š‡‹‰‡Ž‹ŒŠ‡–œ‡Žˆ†‡ȋ‘ˆ–‘ Š‹‡–ǫȌǤ ƒ‡ •–‡””‡‹Œ‡‹†‡‹ˆ‡Ž‡• Š‹–œ‡Ž•‡–‡‹‡‡˜‹‡• ƒˆ±„‡Š‘”‡–‘–‹ŒŽ‡—•–‡ Š‡”‹‡”‹‰‡—‹–†‹–”ƒ”‡ ‘”‘ƒ–‹Œ†’‡”Ǥ‡‘‡”†‡‰‡Ž‹Œ‡˜ƒƒ–‹‡™‡”†–‹‡ƒƒŽŽ‡—‡”‡– Œ—ŽŽ‹‡ƒŽ•‰‡œ‡Ž• Šƒ’ǡ™ƒ–‡‡‰‡™‘‡„‘•™ƒ†‡Ž‹‰™‡”†’Ž‘–•‡Ž‹‰‡‡†‹‘•ƒˆƒ”‹Ǥ 

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Curriculum Vitae

‘ƒ• ‹Œ•‡‹Œ‡”•™ƒ•„‘”‘’”‹Ž–Š‡ͺ–Šǡͳͻͺ͸‹‹Œ‡‰‡ǡ–Š‡‡–Š‡”Žƒ†•Ǥ ‡ƒ––‡†‡†Stedelijk Gymnasium Š‹•Š‹‰Š• Š‘‘Žƒ––Š‡ ‹‹Œ‡‰‡„‡–™‡‡ͳͻͻͺƒ†ʹͲͲͶǡƒˆ–‡”™Š‹ ŠŠ‡ ™‡––‘–”‡ Š–‹˜‡”•‹–›™Š‡”‡Š‡•–—†‹‡†Ž‹‹ ƒŽ•› Š‘Ž‘‰›ǡ‘ ‹ƒŽ•› Š‘Ž‘‰›ƒ† Philosophy. He obtained his bachelor’s degree in 2009. Having discovered both a passion for • ‹‡–‹ˆ‹ ”‡•‡ƒ” Šƒ†ƒ‹–‡”‡•–‹ Ž‹‹ ƒŽ’”ƒ –‹ ‡Social and He–althƒ†„‡‹‰—––‡”Ž›—ƒ„Ž‡–‘ Š‘‘•‡ Psychology Clinical Psychology „‡–™‡‡–Š‡–Š‡†‡ ‹†‡†–‘ƒ––‡†–Š‡ ƒ†  master’s programsSelf at RegulationUtrecht University. Lab After university he started working as a juniorAltrecht Mental”‡•‡ƒ” Š‡”ƒ––Š‡ Health Institute ‘ˆ–”‡ Š–‹˜‡”•‹–›ƒ†ƒ•ƒ’•› Š‘Ž‘‰‹•–ƒ– Ǥ Žƒ–‡RivierduinenʹͲͳ͵Š‡™ƒ•‘ˆˆ‡”‡†–Š‡‘’’‘”–—‹–›–‘™‘”ƒ•ƒŠ Mental Health Institute Maastricht UniversityǦ•–—†‡– ƒ†’•› Š‘Ž‘‰‹•–ƒ––Š‡ ƒ† ǡ•–—†›‹‰ ƒ†’”ƒ –‹ ‹‰’•› Š‘–Š‡”ƒ’›Ǥ ʹͲͳͻǡŠ‡•–ƒ”–‡†ƒ–™‘Ǧ›‡ƒ”’‘•–Ǧmaster’s program to become ƒ‡–ƒŽŠ‡ƒŽ–ŠǦ ƒ”‡’•› Š‘Ž‘‰‹•–ǡ ‘–‹—‹‰Š‹•™‘”™‹–Š’ƒ–‹‡–•™‹–Š•‡˜‡”‡‡–ƒŽ‹ŽŽ‡•• ‹ƒ Ž‡š‹„Ž‡••‡”–‹˜‡‘—‹–›”‡ƒ–‡––‡ƒ‹ ‘—†ƒǤ  A

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