Mentalizing is the human capacity to understand actions of others and one's own behavior in terms of intentional mental states, such as feelings, wishes, goals and desires. Mentalizing is a transtheoretical and transdiagnostic concept that has been applied to understanding vulnerability to psychopathology and has attracted considerable research attention over the past decades. This paper reports on a pre-registered systematic review of evidence concerning the role of mentalizing as a moderator and mediator in psychological interventions in adults. Studies in adults were reviewed that address the following questions: (a) does pre-treatment mentalizing predict treatment outcome; (b) do changes in mentalizing across treatment predict outcome; (c) does adherence to the principles or protocol of mentalization-based treatment predict outcome; and (d) does strengthening in-session mentalizing impact the therapeutic process via improved alliance, alleviated symptoms, or improved interpersonal functioning? Results suggest that mentalizing might be a mediator of change in psychotherapy and may moderate treatment outcome. However, the relatively small number of studies ( = 33 papers based on 29 studies, totaling 3124 participants) that could be included in this review, and the heterogeneity of studies in terms of design, measures used, disorders included, and treatment modalities, precluded a formal meta-analysis and limited the ability to draw strong conclusions. Therefore, theoretical and methodological recommendations for future research to improve the quality of existing research in this area are formulated.

中文翻译：

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心智化在成人心理干预中的作用：系统回顾和未来研究建议

心智化是人类根据有意的心理状态（例如感觉、愿望、目标和愿望）理解他人行为和自己行为的能力。心理化是一个跨理论和跨诊断的概念，已应用于理解精神病理学的脆弱性，并在过去几十年中引起了相当多的研究关注。本文报告了对有关心智化作为成人心理干预中的调节者和中介者作用的证据的预先注册的系统审查。回顾了针对成人的研究，解决了以下问题：（a）治疗前心理化是否可以预测治疗结果？ (b) 治疗过程中心理化的变化是否可以预测结果； (c) 遵守基于心理化的治疗原则或方案是否可以预测结果； (d) 加强治疗过程中的心理化是否会通过改善联盟、减轻症状或改善人际功能来影响治疗过程？结果表明，心理化可能是心理治疗变化的中介因素，并可能调节治疗结果。然而，本次综述中可能纳入的研究数量相对较少（= 33篇论文，基于29项研究，总共3124名受试者），并且研究在设计、使用的措施、所包括的疾病和治疗方式方面存在异质性，排除了该综述的可能性。正式的荟萃分析限制了得出强有力结论的能力。因此，提出了未来研究的理论和方法建议，以提高该领域现有研究的质量。