Dynamics of Mentalization, Affect Regulation, and Psychosis Vulnerability: A Longitudinal Network Model

Objectives. Affective dysregulation is a significant risk factor for psychosis, which can be underpinned by disruptions of mentalizing and attachment processes. These disruptions may heighten psychosis risk by interacting with psychosis vulnerability domains such as schizotypy and aberrant salience. The current study examined the unfolding of affective dysregulation and psychosis vulnerability in the context of mentalization and attachment.Method. Study variables were measured using self-report scales. A two-wave cohort study design was implemented with a 6-month assessment interval. The cross-sectional and longitudinal associations between mentalizing, attachment, negative affect, aberrant salience, and schizotypy were estimated using network modeling. Results. The study involved 312 participants aged 18 to 37 years, with 77% identifying as female and 57% receiving mental health treatment during the follow-up period. Results indicated that mentalizing impairment was central in linking concurrent negative affect, attachment disturbances, and psychosis vulnerability, and served as a temporal bridge connecting multiple dimensions of psychosis vulnerability.Conclusion. Mentalizing impairments can heighten psychosis risk by maintaining affective dysregulation and consolidating psychosis vulnerability. The results may be influenced by potential sampling errors, as indicated by the analyses of network stability and accuracy. Interventions promoting mentalizing capacity may attenuate psychosis risk.