Mentalization as a Bridge Between Negative Affect and Psychosis Risk: A Cross-Sectional Network Model

Aim. Mentalization, a social-cognitive capacity involved in understanding one’s own and others’ mental states, facilitates affect regulation and self-organization. Mentalizing difficulties are associated with key features of psychosis, including emotional instability, social dysfunction, and self-disorders. The current study aimed to explore the associations between mentalization, affective dysregulation, and psychosis risk.Method. A cross-sectional design was employed, estimating network models to examine the associations among indices of mentalizing difficulties in identifying, appraising, and expressing mental states, negative affect (anxiety, stress, and depression), and psychosis risk dimensions (multidimensional schizotypy and aberrant salience). Results. The sample (N = 416) was predominantly female (n = 312), with ages ranging from 18 to 37 years (M = 28.71, SD = 4.53). More than half (n = 229) reported receiving mental health treatment, and 124 participants self-reported a personal history of psychosis. Mentalizing difficulties and negative schizotypy emerged as central to the network. Specifically, mentalizing difficulties served as a bridge between psychosis risk and negative affect, whereas negative schizotypy was associated with difficulties in emotion expression and depression. Conclusion. Our findings suggest that mentalizing difficulties may contribute to psychosis development by amplifying the tendency to respond to distress with disorganized thinking and perceptual distortions. Although strength centrality estimates showed acceptable reliability, psychometric support for bridge strength centrality was less robust, warranting further research into mentalization’s role in connecting negative affect to psychosis risk.