Volume 24, Issue 6 (9-2025)
TB 2025, 24(6): 98-112 |
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Shirvani F, Arabmomeni A. The Effectiveness of Mentalization-Based Training on Emotion Regulation and Psychological Flexibility in Adolescents with Insecure Attachment. TB 2025; 24 (6) :98-112
URL: http://tbj.ssu.ac.ir/article-1-3874-en.html
URL: http://tbj.ssu.ac.ir/article-1-3874-en.html
, allahyar.arabmomeni@iau.ac.ir
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The Effectiveness of Mentalization-Based Training on Emotion Regulation and Psychological Flexibility in Adolescents with Insecure Attachment
Fateme Shirvani (M.Sc.)1, Allahyar Arabmomeni (Ph.D.)2
1.M.Sc. Student, Department of Psychology, Kho.C., Islamic Azad University, Khomeinishahr, Iran
2.Corresponding Author: Associate professor, Department of Sports Sciences, Kho.C., Islamic Azad University, Khomeinishahr, Iran Email:allahyar.arabmomeni@iau.ac.ir Tel:09133688572
Abstract
Introduction: Adolescence is one of the most challenging and most important cognitive stages, in which emotional regulation and psychological flexibility are of utmost importance. This study was conducted with the aim of the effectiveness of mentalization-based training on emotion regulation and psychological flexibility in adolescents with insecure attachment.
Methods: In this quasi-experimental study with a pretest–posttest and controlled design, 30 adolescent girls with attachment issues aged 14-17 years in Isfahan were selected and randomly assigned to two groups: experimental and control. The educational protocol was implemented over 12 sessions, each lasting 90 minutes. Emotion regulation and psychological flexibility were assessed at both pre-test and post-test stages. The assessment tools included the Adolescent Version of the Experiences in Close Relationships-Revised (ECR-R) (2000), the Difficulties in Emotion Regulation Scale (DERS) (2004), and the Acceptance and Action Questionnaire-II (AAQ-II). Data analysis was performed using multivariate analysis of covariance (MANCOVA) with SPSS 26 at a significance level of 0/05.
Results: The findings indicated that mentalization-based training significantly improved emotion regulation (F=818.05) and its dimensions among adolescents with insecure attachment, including non-acceptance of emotional responses (F=242/14), difficulties in engaging in goal-directed behavior (F=419/37), impulse control difficulties (F=398/15), lack of emotional awareness (F=13/24), limited access to emotion regulation strategies (F=458/31), and lack of emotional clarity (F=207/78) (p<0/05). Furthermore, a significant improvement in psychological flexibility (F=441/05) was observed following the intervention (p<0/05).
Conclusion: Given the significant effectiveness of mentalization training in improving emotion regulation and psychological flexibility among adolescents with insecure attachment, it is recommended that this intervention be implemented as a preventive, therapeutic, and feasible approach within educational and healthcare systems.
Keywords: Mentalization, Emotion Regulation, Flexibility, Adolescent
Conflict of interest: The authors declared no conflict of interest.
References
1-Eshbekovich U, Sayfullayevna M. Psychological factors shaping emotional states in early adolescence. ASEAN Journal of Community and Special Needs Education. 2024; 3(2): 81-88.
2-Mikulincer M, Shaver P. An attachment perspective on loss and grief. Current Opinion in Psychology. 2021; 45(1): 10-28.
3-Dagan O, Groh A, Madigan S & et al. Lifespan development theory of insecure attachment and internalizing symptoms: Integrating meta-analytic evidence via a testable evolutionary mis/match hypothesis. Brain Sciences. 2021; 11(9): 1226.
4-Gross J, John O. Discovering the impact of emotion regulation and interpersonal communication on romantic relationships among adults. Journal of Psychiatry and Behavioral Sciences. 2021; 8(1): 1–8.
5-Wei PC, Yu HQ. The relationship between childhood psychological abuse and social media addiction among college students: the mediating role of fear of missing out and the moderating role of left-behind experience. Archives of Medical Science. 2024;20(3):798-805.
6-Ain N, Ali A, Sitwat A. Differences in social support, emotion invalidation, psychological needs, cognitive emotion regulation in maritally adjusted and maladjusted women in Pakistan: A matched pairs design. Journal of Community Psychology. 2024;52(7):929-949.
7-Nedim P, Kahraman S, Hündür U. A correlational study of social media-related fomo and psychological flexibility among adults: An acceptance and commitment therapy perspective. Asia Pacific Journal of Counselling and Psychotherapy. 2025; 12(2): 29-44.
8-Salavou V, Papanikolaou K, Pehlivanidis A, Giannakopoulos G. Mentalization and emotion regulation in adolescent attachment: A scoping review. Children (Basel). 2026;13(3):420.
9-Bateman A, Fonagy P. Mentalization-based treatment for personality disorders: A practical guide. Oxford University Press. 2021; 496-528. 019968037X, 9780199680375
10-Simonsen S, Popolo R, Juul S & et al. Treating avoidant personality disorder with combined individual metacognitive interpersonal therapy and group mentalizbBased treatment: A Pilot Study. The Journal of Nervous and Mental Disease. 2021; 26: 213-219.
11-Esposito G, Totaro S, Di Maro A, Passeggia R. The role of epistemic trust in the relationship between attachment and mentalization: a systematic review. Mediterranean Journal of Clinical Psychology. 2024; 12(1).121-132.
12-Simkiss N, Gray N, Malone G & et al. Improving mental health literacy in year 9 high school children across Wales: a protocol for a randomised control treatment trial (RCT) of a mental health literacy programme across an entire country. BMC Public Health. 2020;20(1):727.
13-Maleki B. Effectiveness of mentalization-based therapy on the aggression and emotional regulation difficulties of depressed male adolescents. Current Psychology. 2025; 44:13924-32.
14-Ramazi E, Zolfaghari A, Zanganeh Motlagh F. The effectiveness of Mentalization Training on Aggression and Prevention of Self-Harm Behavior in adolescent. Rooyesh. 2026; 14(11): 141-150.
15-Lettun P, Fonagy P, Bateman A. Mentalization-based interventions in adolescent depression: Theoretical perspectives. Clinical Child Psychology and Psychiatry. 2024; 29(2):210–227.
16-Abbasi M, Bahrami E, Emami al agha S & et al. The effect of mentalization-based therapy on psychological flexibility and responsibility of single-parent male students. RBS. 2025; 23 (3): 627-637.
17-Shabani H. Investigating the effectiveness of mentalization therapy on cognitive flexibility and mental well-being and anxiety in adolescent girls, Journal of New Research Approaches in Management and Accounting. 2024; 8(92): 16-30.
18-Smits M, Luyten P, Feenstra D & et al. Trauma and outcomes of mentalization-based therapy for individuals with borderline personality disorder. American Journal of Psychotherapy. 2022; 1.75(1):12–20.
19-Graham J, Unterschute S. A reliability generalization meta-analysis of self-report measures of adult attachment. Journal of Personality Assessment. 2015;97(1):31-41.
20-Asgarizadeh A, Pakdaman S, Hunjani M & et al. Iranian adaptation of the revised adult attachment scale: Validity and reliability in the general population. Journal of Applied Psychology. 2023;17(2):167-191 (In Persian).
21-Gratz K, Roemer L. Multidimensional assessment of emotion regulation and dysregulation: Development, factor structure, and initial validation of the difficulties in emotion regulation scale. Journal of Psychopathology and Behavioral Assessment. 2004; 26(1):41-54.
22-Falahi V, Narimani M, Atadokht A. Psychometric properties of the short form of difficulty in emotion regulation in a group of Iranian adolescents. Journal of Shahid Sadoughi University of Medical Sciences. 2022; 29 (5): 3721 – 3735.
23-Ong C, Barthel A, Hofmann S. The relationship between psychological inflexibility and well-being in adults: A meta-analysis of the acceptance and action Questionnaire. Behavior Therapy. 2024;55(1):26-41.
24-Bagherzadeh J, Ahmadi S, Zahrakar K. The effectiveness of mentalization-based training on students’ academic self-handicapping and cognitive emotion regulation. QJFR. 2025; 22 (2) :29-46.
25-Rizzi E, Weijers J, Kate C & et al. Mentalization based treatment for a broad range of personality disorders: a naturalistic study. BMC Psychiatry. 2024;24(1):429.
26-Ozeren G S. The correlation between emotion regulation and attachment styles in undergraduates. Perspectives in Psychiatric Care. 2022; 58(2): 482-490.
27-Arnold M, Fonagy P, Bateman A. Mentalization-based training improves psychological flexibility in emotionally dysregulated adolescents. Journal of Adolescence. 2020; 82: 1–12.
28-Peters M. Trauma and mentalization ability in older patients: An empirical contribution to the effect of trauma in old age. Gero Psych: The Journal of Gerontopsychology and Geriatric Psychiatry. 2021; 11(3); 121–134.
Fateme Shirvani (M.Sc.)1, Allahyar Arabmomeni (Ph.D.)2
1.M.Sc. Student, Department of Psychology, Kho.C., Islamic Azad University, Khomeinishahr, Iran
2.Corresponding Author: Associate professor, Department of Sports Sciences, Kho.C., Islamic Azad University, Khomeinishahr, Iran Email:allahyar.arabmomeni@iau.ac.ir Tel:09133688572
Abstract
Introduction: Adolescence is one of the most challenging and most important cognitive stages, in which emotional regulation and psychological flexibility are of utmost importance. This study was conducted with the aim of the effectiveness of mentalization-based training on emotion regulation and psychological flexibility in adolescents with insecure attachment.
Methods: In this quasi-experimental study with a pretest–posttest and controlled design, 30 adolescent girls with attachment issues aged 14-17 years in Isfahan were selected and randomly assigned to two groups: experimental and control. The educational protocol was implemented over 12 sessions, each lasting 90 minutes. Emotion regulation and psychological flexibility were assessed at both pre-test and post-test stages. The assessment tools included the Adolescent Version of the Experiences in Close Relationships-Revised (ECR-R) (2000), the Difficulties in Emotion Regulation Scale (DERS) (2004), and the Acceptance and Action Questionnaire-II (AAQ-II). Data analysis was performed using multivariate analysis of covariance (MANCOVA) with SPSS 26 at a significance level of 0/05.
Results: The findings indicated that mentalization-based training significantly improved emotion regulation (F=818.05) and its dimensions among adolescents with insecure attachment, including non-acceptance of emotional responses (F=242/14), difficulties in engaging in goal-directed behavior (F=419/37), impulse control difficulties (F=398/15), lack of emotional awareness (F=13/24), limited access to emotion regulation strategies (F=458/31), and lack of emotional clarity (F=207/78) (p<0/05). Furthermore, a significant improvement in psychological flexibility (F=441/05) was observed following the intervention (p<0/05).
Conclusion: Given the significant effectiveness of mentalization training in improving emotion regulation and psychological flexibility among adolescents with insecure attachment, it is recommended that this intervention be implemented as a preventive, therapeutic, and feasible approach within educational and healthcare systems.
Keywords: Mentalization, Emotion Regulation, Flexibility, Adolescent
Conflict of interest: The authors declared no conflict of interest.
References
1-Eshbekovich U, Sayfullayevna M. Psychological factors shaping emotional states in early adolescence. ASEAN Journal of Community and Special Needs Education. 2024; 3(2): 81-88.
2-Mikulincer M, Shaver P. An attachment perspective on loss and grief. Current Opinion in Psychology. 2021; 45(1): 10-28.
3-Dagan O, Groh A, Madigan S & et al. Lifespan development theory of insecure attachment and internalizing symptoms: Integrating meta-analytic evidence via a testable evolutionary mis/match hypothesis. Brain Sciences. 2021; 11(9): 1226.
4-Gross J, John O. Discovering the impact of emotion regulation and interpersonal communication on romantic relationships among adults. Journal of Psychiatry and Behavioral Sciences. 2021; 8(1): 1–8.
5-Wei PC, Yu HQ. The relationship between childhood psychological abuse and social media addiction among college students: the mediating role of fear of missing out and the moderating role of left-behind experience. Archives of Medical Science. 2024;20(3):798-805.
6-Ain N, Ali A, Sitwat A. Differences in social support, emotion invalidation, psychological needs, cognitive emotion regulation in maritally adjusted and maladjusted women in Pakistan: A matched pairs design. Journal of Community Psychology. 2024;52(7):929-949.
7-Nedim P, Kahraman S, Hündür U. A correlational study of social media-related fomo and psychological flexibility among adults: An acceptance and commitment therapy perspective. Asia Pacific Journal of Counselling and Psychotherapy. 2025; 12(2): 29-44.
8-Salavou V, Papanikolaou K, Pehlivanidis A, Giannakopoulos G. Mentalization and emotion regulation in adolescent attachment: A scoping review. Children (Basel). 2026;13(3):420.
9-Bateman A, Fonagy P. Mentalization-based treatment for personality disorders: A practical guide. Oxford University Press. 2021; 496-528. 019968037X, 9780199680375
10-Simonsen S, Popolo R, Juul S & et al. Treating avoidant personality disorder with combined individual metacognitive interpersonal therapy and group mentalizbBased treatment: A Pilot Study. The Journal of Nervous and Mental Disease. 2021; 26: 213-219.
11-Esposito G, Totaro S, Di Maro A, Passeggia R. The role of epistemic trust in the relationship between attachment and mentalization: a systematic review. Mediterranean Journal of Clinical Psychology. 2024; 12(1).121-132.
12-Simkiss N, Gray N, Malone G & et al. Improving mental health literacy in year 9 high school children across Wales: a protocol for a randomised control treatment trial (RCT) of a mental health literacy programme across an entire country. BMC Public Health. 2020;20(1):727.
13-Maleki B. Effectiveness of mentalization-based therapy on the aggression and emotional regulation difficulties of depressed male adolescents. Current Psychology. 2025; 44:13924-32.
14-Ramazi E, Zolfaghari A, Zanganeh Motlagh F. The effectiveness of Mentalization Training on Aggression and Prevention of Self-Harm Behavior in adolescent. Rooyesh. 2026; 14(11): 141-150.
15-Lettun P, Fonagy P, Bateman A. Mentalization-based interventions in adolescent depression: Theoretical perspectives. Clinical Child Psychology and Psychiatry. 2024; 29(2):210–227.
16-Abbasi M, Bahrami E, Emami al agha S & et al. The effect of mentalization-based therapy on psychological flexibility and responsibility of single-parent male students. RBS. 2025; 23 (3): 627-637.
17-Shabani H. Investigating the effectiveness of mentalization therapy on cognitive flexibility and mental well-being and anxiety in adolescent girls, Journal of New Research Approaches in Management and Accounting. 2024; 8(92): 16-30.
18-Smits M, Luyten P, Feenstra D & et al. Trauma and outcomes of mentalization-based therapy for individuals with borderline personality disorder. American Journal of Psychotherapy. 2022; 1.75(1):12–20.
19-Graham J, Unterschute S. A reliability generalization meta-analysis of self-report measures of adult attachment. Journal of Personality Assessment. 2015;97(1):31-41.
20-Asgarizadeh A, Pakdaman S, Hunjani M & et al. Iranian adaptation of the revised adult attachment scale: Validity and reliability in the general population. Journal of Applied Psychology. 2023;17(2):167-191 (In Persian).
21-Gratz K, Roemer L. Multidimensional assessment of emotion regulation and dysregulation: Development, factor structure, and initial validation of the difficulties in emotion regulation scale. Journal of Psychopathology and Behavioral Assessment. 2004; 26(1):41-54.
22-Falahi V, Narimani M, Atadokht A. Psychometric properties of the short form of difficulty in emotion regulation in a group of Iranian adolescents. Journal of Shahid Sadoughi University of Medical Sciences. 2022; 29 (5): 3721 – 3735.
23-Ong C, Barthel A, Hofmann S. The relationship between psychological inflexibility and well-being in adults: A meta-analysis of the acceptance and action Questionnaire. Behavior Therapy. 2024;55(1):26-41.
24-Bagherzadeh J, Ahmadi S, Zahrakar K. The effectiveness of mentalization-based training on students’ academic self-handicapping and cognitive emotion regulation. QJFR. 2025; 22 (2) :29-46.
25-Rizzi E, Weijers J, Kate C & et al. Mentalization based treatment for a broad range of personality disorders: a naturalistic study. BMC Psychiatry. 2024;24(1):429.
26-Ozeren G S. The correlation between emotion regulation and attachment styles in undergraduates. Perspectives in Psychiatric Care. 2022; 58(2): 482-490.
27-Arnold M, Fonagy P, Bateman A. Mentalization-based training improves psychological flexibility in emotionally dysregulated adolescents. Journal of Adolescence. 2020; 82: 1–12.
28-Peters M. Trauma and mentalization ability in older patients: An empirical contribution to the effect of trauma in old age. Gero Psych: The Journal of Gerontopsychology and Geriatric Psychiatry. 2021; 11(3); 121–134.
Type of Study: Research |
Subject:
Psychology
Received: 2025/12/31 | Accepted: 2026/02/24 | Published: 2025/09/1
Received: 2025/12/31 | Accepted: 2026/02/24 | Published: 2025/09/1
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