Further data on the reliability of the mentalization imbalances scale and of the modes of mentalization scale

  • Giulia Gagliardini Department of Humanities, "Carlo Bo" University of Urbino, Italy.
  • Laura Gatti Department of Humanities, "Carlo Bo" University of Urbino, Italy.
  • Antonello Colli | antonello.colli@uniurb.it Department of Humanities, "Carlo Bo" University of Urbino, Italy.


The aim of this study was to provide data on the Inter-Rater Reliability (IRR) and the test-retest reliability of the Mentalization Imbalances Scale (MIS) and the Modes of Mentalization Scale (MMS) in two different studies. Three junior raters and two senior raters assessed blindly 15 session transcripts of psychotherapy of five patients, using both the MIS and the MMS. The same 15 sessions were rated after the junior raters completed a training at the use of the scales and after on month from the end of the training to assess testretest reliability. Four therapists used the MIS and the MMS to provide different ratings of 22 patients undergoing a psychotherapy in different settings. Intraclass Correlation Coefficient (ICC) values ranged from sufficient to good and increased after the training. Test re-test reliability was sufficient for both scales (Study 1). ICC values ranged from sufficient to good, and were globally higher than the ones found in the first study sample (Study 2). Our results provide support to the inter-rater reliability of the MIS and the MMS.



PlumX Metrics


Download data is not yet available.


Baron-Cohen, S., Wheelwright, S., Hill, J., Raste, Y., & Plumb, I. (2001). The ‘Reading the Mind in the Eyes’ test revised version: a study with normal adults, and adults with Asperger syndrome or high-functioning autism. Journal of Child Psychology and Psychiatry, 42 (2), 241–251. DOI: https://doi.org/10.1111/1469-7610.00715

Bateman, A.W., Bolton, R., & Fonagy, P. (2013). Antisocial personality disorder: A mentalizing framework. The Journal of Lifelong Learning in Psychoanalysis, XI (2),178–186. doi: 10.1176/appi.focus.11.2.178 DOI: https://doi.org/10.1176/appi.focus.11.2.178

Bateman, A.W., & Fonagy, P. (2004). Psychotherapy for borderline personality disorder. Mentalization based treatment. Oxford: Oxford University Press. DOI: https://doi.org/10.1093/med:psych/9780198527664.001.0001

Bateman A.W., & Fonagy, P. (2016). Mentalization Based Treatment for Personality Disorders: A Practical Guide. Oxford: Oxford University Press. DOI: https://doi.org/10.1093/med:psych/9780199680375.001.0001

Blackshaw, A.J., Kinderman, Hare, D. J., & Hatton, C. (2001). Theory of mind, causal attribution and paranoia in Asperger syndrome. Autism, 5, 147–163. doi:10.1177/1362361301005002005 DOI: https://doi.org/10.1177/1362361301005002005

Blagov, B., Bi, W., Shedler, J., & Westen, D. (2012). The Shedler-Westen Assessment Procedure (SWAP): Evaluating psychometric questions about its reliability, validity, and fixed score distribution. Assessment, 19(3), 370–382. doi: 10.1177/1073191112436667. DOI: https://doi.org/10.1177/1073191112436667

Davidson, K. M., Obonsawin, M. C., Seils, M., & Patience, L. (2003). Patient and clinician agreement on personality using the SWAP-200. Journal of Personality Disorders, 17 (3), 208-218.doi:10.1521/pedi. DOI: https://doi.org/10.1521/pedi.

Dimitrijević, A., Hanak, N., Dimitrijević, A.A., & Marjanović, Z.J. (2017). The Mentalization Scale (MentS): A Self-Report Measure for the Assessment of Mentalizing Capacity, Journal of Personality Assessment, 100 (3), 268-280. doi:10.1080/00223891.2017.1310730 DOI: https://doi.org/10.1080/00223891.2017.1310730

Fonagy, P., Leigh, T., Steele, M., Steele, H., Kennedy, R., Mattoon, G., ... Gerber, A. (1996). The relation of attachment status, psychiatric classification, and response to psychotherapy. Journal of Consulting and Clinical Psychology, 64 (1), 22-31. doi:10.1037/0022-006X .64.1.22

Fonagy. P., Luyten, P., Moulton-Perkins, A., Lee, Y.W., Warren, F., Howard, S. … Lowyck, B. (2016). Development and Validation of a Self-Report Measure of Mentalizing: The Reflective Functioning Questionnaire. PloS One, 11 (7). doi:10.1371/journal.pone.0158678 DOI: https://doi.org/10.1371/journal.pone.0158678

Fonagy, P., Target, M., Steele, H., & Steele, M. (1998). Reflective- Functioning manual: Version 5 for application to adult attachment interview. Unpublished manual. London: University College.

Gagliardini, G., & Colli, A. (2019). Assessing mentalization: Development and preliminary validation of the Modes of Mentalization Scale. Psychoanalytic Psychology, 36(3), 249-258.doi: 10.1037/pap0000222 DOI: https://doi.org/10.1037/pap0000222

Gagliardini, G., Gullo, S., Caverzasi, E., Boldrini, A., Blasi, S., & Colli, A. (2018). Assessing mentalization in psychotherapy: First validation of the Mentalization Imbalances Scale. Research in Psychotherapy: Psychopathology, Process and Outcome, 21(3), 164-177. doi: 10.4081/ripppo.2018.339 DOI: https://doi.org/10.4081/ripppo.2018.339

Hausberg, M.C., Schulz, H., Piegler, T., Happach, C.G., Klöpper, M., Brütt, A.L. … Andreas, S. (2012). Is a self-rated instrument appropriate to assess mentalization in patients with mental disorders? Development and first validation of the mentalization questionnaire (MZQ). Psychotherapy Research, 22 (6), 699-709. doi: 10.1080/10503307.2012.709325 DOI: https://doi.org/10.1080/10503307.2012.709325

Huprich, S.K., Bornstein, R.F. & Schmitt, T.A. (2011). Self-report methodology is insufficient for improving the assessment and classification of Axis II personality disorders. Journal Personality Disorder, 25 (5), 557-70. doi: 10.1521/pedi.2011.25.5.557. DOI: https://doi.org/10.1521/pedi.2011.25.5.557

Katznelson, H. (2014). Reflective function: A review. Clinical Psychology Review, 34(2), 107–117.doi: 10.1016/j.cpr.2013.12.00

Lievens, F. (2001). Assessor training strategies and their effects on accuracy, interrater reliability, and discriminant validity. Journal of Applied Psychology, 86 (2), 255-264. doi: 10.1037//0021-9010.86.2.255 DOI: https://doi.org/10.1037//0021-9010.86.2.255

Meehan, K.B., Levy, K.N., Reynoso, J.S., Hill, L.L., & Clarkin, J.F. (2009). Measuring reflective function with a multidimensional rating scale: comparison with scoring reflective function on the AAI. Journal of the American Psychoanalytic Association, 57 (1), 208-13. doi: 10.1177/00030651090570011008 DOI: https://doi.org/10.1177/00030651090570011008

Morey, L.C. (2014). Borderline features are associated with inaccurate trait self-estimations. Borderline Personality Disorders and Emotion Dysregulation, 1 (1), 4. doi: 10.1186/2051-6673-1-4 DOI: https://doi.org/10.1186/2051-6673-1-4

Oakley, B.F.M., Brewer, R., Bird, G., & Catmur, C. (2016). Theory of mind is not theory of emotion: A cautionary note on the Reading the Mind in the Eyes Test. Journal of Abnormal Psychology, 125 (6), 818-823. doi:10.1037/abn0000182 DOI: https://doi.org/10.1037/abn0000182

Rudden, M., Milrod, B., Target, M., Ackerman, S., & Graf, E. (2006). Reflective functioning in panic disorder patients: A pilot study. Journal of the American Psychoanalytic Association 54(4), 1339-1343. doi.org/10.1177/00030651060540040109 DOI: https://doi.org/10.1177/00030651060540040109

Shrout, P. E., & Fleiss, J. L. (1979). Intraclass correlations: Uses in assessing rater reliability. Psychological Bulletin, 86 (2), 420–428. doi:10.1037/0033-2909.86.2.420 DOI: https://doi.org/10.1037/0033-2909.86.2.420

Skårderud, F. (2007). Eating one’s words, part II: The embodied mind and reflective function in anorexia nervosa – theory. European Eating Disorders Review, 15(4), 243–252.doi:10.1002/erv.778 DOI: https://doi.org/10.1002/erv.778

Sperman, C. (1904). The Proof and Measurement of Association between Two Things. The American Journal of Psychology, 15 (1), 72-101. DOI: https://doi.org/10.2307/1412159

Taubner, S., Hörz, S., Fischer-Kern. M., Doering, S., Buchheim, A., & Zimmermann, J. (2013). Internal structure of the Reflective Functioning Scale. Psychological Assessement, 25 (1), 127-135. doi: 10.1037/a0029138 DOI: https://doi.org/10.1037/a0029138

Taubner, S., Kessler, H., Buchheim, A., Kächele, H., & Staun, L. (2011). The role of mentalization in the psychoanalytic treatment of chronic depression. Psychiatry, 74 (1), 49–57. doi: 10.1521/psyc.2011.74.1.49 DOI: https://doi.org/10.1521/psyc.2011.74.1.49

Westen, D., & Weinberger, D. (2004). When clinical description becomes statistical prediction. American Psychologist, 59 (7), 595-613. doi: 10.1037/0003-066X.59.7.595 DOI: https://doi.org/10.1037/0003-066X.59.7.595

Mentalization, reflective function, assessment, inter rater reliability
  • Abstract views: 286

  • PDF: 166
  • HTML: 0
How to Cite
Gagliardini, G., Gatti, L., & Colli, A. (2020). Further data on the reliability of the mentalization imbalances scale and of the modes of mentalization scale. Research in Psychotherapy: Psychopathology, Process and Outcome, 23(1). https://doi.org/10.4081/ripppo.2020.450