Profiles of mentalizing in individuals with antisocial behavior: Comparing state- and trait-mentalizing

Objectives Mentalizing is a crucial factor in understanding antisocial behavior. The current study focuses on mapping mentalization within a population of patients with antisocial behavior (n = 108) and compares trait and state mentalizing. Methods Three instruments were used to assess mentalizing abilities: the Reflective Functioning Scale, an emotion recognition task, and a Virtual Reality experiment. Mentalizing profiles were determined with latent class analyses and subsequently examined their relations. Results Patients with antisocial behavior exhibited poor mentalizing capacities. They showed problems with general mentalizing capacities, specific problems in emotion recognition and reduced emotional reactivity. Half of the participants displayed reduced trust towards others during state mentalizing, indicating imbalances between automatic and controlled mentalizing. A part of the population showed hostile attribution bias, related to increased anger and threat perception and reduced experienced trust in direct social interaction. State-mentalizing and trait-mentalizing were not related. Conclusion The findings align with previous studies on mentalizing in individuals with antisocial personality disorder. However, this study underscores the importance of further investigating the heterogeneity of mentalizing capacity within this population, especially in comparing state- and trait mentalizing. Mapping underlying mentalizing patterns of these patients may provide directions for tailoring therapeutic interventions.