Towards psychological wellbeing: A comprehensive examination of mentalization in Turkish preschool children

Mentalization, the process of thinking about mental states (e.g. emotions, thoughts, beliefs, intentions) of self and others, comprises an important component of psychological wellbeing by representing a unique set of social-emotional and cognitive skills to survive in a complex social world. Mentalization has been widely studied in clinical studies and to a lesser extent in developmental research; but there is some confusion in the literature regarding its conceptualization and operationalization. Developmental literature offers a rich source of information on humans' capacity to understand the mind via extensive research on theory of mind and children's understanding of emotions. The concept of mentalization is related to theory of mind and affective understanding but is not solely composed of these skills. Instead, it is an umbrella concept that covers these social-cognitive skills as well as their explicit usage in interpersonal interactions. Clinical literature provides a wide range of theoretical explanations for the development of mentalization by highlighting its links with children's self-regulation skills, attachment representations, symbolic play capacity and psychological wellbeing; and suggests that mentalization develops through caregivers' accurate mentalizing practices within attachment relationships. However, empirical research in this field is mostly based on low-sized and mixed-aged clinical samples. In addition, recent theoretical suggestions highlight the multidimensional nature of mentalization, but very few studies, if any, investigated its different dimensions in young children. This thesis aims to comprehensively examine mentalization in early childhood, a developmental period where there is a rapid growth in the social, emotional, and cognitive processes that underly the mentalizing ability. In this respect, the multidimensional nature of mentalization was investigated cross-sectionally via multiple measurement methods from a sample of 103 Turkish preschool children (Mmonths= 53.11, SD=10.26; 59 male) and their mothers during a 3-hour home-visit. With an aim to assess children's mentalization skills and mentalization-related constructs, children were administered an affect knowledge task, a theory of mind task, and an attachment-based story stem task to measure the explicit usage of mental state words (self-directed, other-directed, emotion-based, cognition-based). In addition, they were engaged in 20-minutes free play segments with an experimenter for assessment of play behavior. To obtain observational scores for children's mental state talk, attachment representations, and play activity, the data was coded in detail by three empirically-based coding procedures. Parents also completed questionnaires for their children's self-regulation skills, behavior problems, and adverse life experiences. Parental mentalization was assessed through a self-report questionnaire, which tapped non-mentalizing attitudes, certainty of mental states, and interest and curiosity in mental states; and a 5-minute speech sample protocol, which was used for the first time in Turkey to be coded for parental reflective functioning. The results confirmed the multidimensional nature of mentalization and revealed significant associations between mentalization and children's healthy social-emotional functioning. As predicted, there was a positive association between children's affect knowledge, theory of mind, and usage of mental state words. These dimensions of mentalization in children were found to be related to social-emotional constructs in separate ways: Theory of mind was related to better self-regulation skills and lower levels of externalizing behaviors, but not to attachment representations and play activity. Explicit usage of mental state words, on the other hand, was related to all these variables, but the types of mental state words differed in terms of their associations to self-regulation, attachment representations, play activity, and behavior problems. Self-directed and emotion-based mental state words were related to better self-regulation skills, secure attachment representations, and lower levels of externalizing behaviors, whereas other-directed and cognition-based mental state words were related to disorganized attachment representation and non-adaptive play patterns. Furthermore, as expected, parental mentalization was positively related to children's usage of emotion-based mental state words, self-regulation skills, secure attachment representations, adaptive play patterns, and lower levels of behavior problems. The findings of the study also provided preliminary evidence for the use of the 5-minute speech sample protocol to be coded for parental reflective functioning with Turkish parents. The results were discussed with respect to previous literature and to further avenues for implications. Overall, the study contributed to the literature though providing findings assembling a wide variety of mentalization-related constructs under the same roof to understand the elements of mentalization in social-emotional development in non-clinical preschool-aged children. Using a multi-faceted assessment of mentalization helped to investigate the multidimensional nature of mentalization and marked the significance of going beyond the assessment of theory of mind to study mentalization in young children in developmental research. Thus, this thesis elucidates the concept of mentalization through integrating theoretical explanations with empirical findings and establishes an inclusive operationalization of mentalization in the developmental literature.