The following battery of self-report questionnaires was individually administered under the supervision of trained clinical psychologists (M.D. and D.B.) to make sure participants understood the items.
The Reflective Functioning Questionnaire (RFQ) [26 ] measures the level of certainty (RFQc) and uncertainty (RFQu) about mental states. The Certainty about Mental States (RFQc) subscale consists of 6 items focusing on the extent to which individuals disagree with statements such as “I don’t always know why I do what I do”. All items are scored by participants on a 7-point Likert type scale, ranging from “completely disagree” to “completely agree”. Items are subsequently rescored to capture more extreme levels of certainty, so that very low agreements on this scale reflect hypermentalizing, while some agreement reflects adaptive levels of certainty about mental states. To this end, these items are recoded to 3, 2, 1, 0, 0, 0, 0. The Uncertainty about mental states (RFQu) subscale, which in the extreme captures hypomentalizing, also consists of 6 items scored on the same 7-point Likert type scale. Responses to items such as “Sometimes I do things without really knowing why”, are recoded to 0, 0, 0, 0, 1, 2, 3, again to ensure that high scores reflect a stance characterized by an almost complete lack of knowledge about mental states, while lower scores reflect acknowledgment of the opaqueness of one’s own mental states and that of others, typical of genuine mentalizing.
The Cognitive subscale of the Basic Empathy Scale (BES) [32 (link)–33 ] was used to estimate participants’ level of cognitive empathy (BEScog). The BES includes nine items rated on a 5-point Likert scale ranging from “strongly disagree” to “strongly agree”.
The Toronto Alexithymia Scale (TAS) [34 (link)–36 (link)] encompasses 20 items (rated on a 5-point scale), yielding three subscale scores which measure difficulties in identifying feelings (TASif), difficulties in describing feelings (TASdf), and lack of focus on internal emotional experiences (external-oriented thinking; TASeot).
The Kentucky Inventory of Mindfulness Skills (KIMS) [37 (link)] is a 39 item inventory (rated on a 5-point scale) used to assess abilities in focusing one’s attention in a non-judgemental way or accepting the occurrence of a present experience. The Describing (KIMSdes) and Acting with awareness (KIMSac) subscales were used in this study.
The Borderline Personality Inventory (BPI) [38 –39 (link)] was used to assess participants’ total level of borderline traits (BPItot) in the previous year, based on 54 items rated on a 7-point scale. Item 20 in the inventory (“I have already non-suicidally self-injured myself”) was dichotomized (1 = never, 2–7 = at least one episode) to identify participants who had recently engaged in NSSI.
The Youth and Adult Self-Reports (YSR/ASR) [40 –41 ] measure the level of general internalizing (YSR/ASRint) and externalizing (YSR/ASRext) symptoms. Participants rated the extent to which a series of 119 statements described their behavior over the past 6 months, using a 3-point scale.
The Reflective Functioning Questionnaire (RFQ) [26 ] measures the level of certainty (RFQc) and uncertainty (RFQu) about mental states. The Certainty about Mental States (RFQc) subscale consists of 6 items focusing on the extent to which individuals disagree with statements such as “I don’t always know why I do what I do”. All items are scored by participants on a 7-point Likert type scale, ranging from “completely disagree” to “completely agree”. Items are subsequently rescored to capture more extreme levels of certainty, so that very low agreements on this scale reflect hypermentalizing, while some agreement reflects adaptive levels of certainty about mental states. To this end, these items are recoded to 3, 2, 1, 0, 0, 0, 0. The Uncertainty about mental states (RFQu) subscale, which in the extreme captures hypomentalizing, also consists of 6 items scored on the same 7-point Likert type scale. Responses to items such as “Sometimes I do things without really knowing why”, are recoded to 0, 0, 0, 0, 1, 2, 3, again to ensure that high scores reflect a stance characterized by an almost complete lack of knowledge about mental states, while lower scores reflect acknowledgment of the opaqueness of one’s own mental states and that of others, typical of genuine mentalizing.
The Cognitive subscale of the Basic Empathy Scale (BES) [32 (link)–33 ] was used to estimate participants’ level of cognitive empathy (BEScog). The BES includes nine items rated on a 5-point Likert scale ranging from “strongly disagree” to “strongly agree”.
The Toronto Alexithymia Scale (TAS) [34 (link)–36 (link)] encompasses 20 items (rated on a 5-point scale), yielding three subscale scores which measure difficulties in identifying feelings (TASif), difficulties in describing feelings (TASdf), and lack of focus on internal emotional experiences (external-oriented thinking; TASeot).
The Kentucky Inventory of Mindfulness Skills (KIMS) [37 (link)] is a 39 item inventory (rated on a 5-point scale) used to assess abilities in focusing one’s attention in a non-judgemental way or accepting the occurrence of a present experience. The Describing (KIMSdes) and Acting with awareness (KIMSac) subscales were used in this study.
The Borderline Personality Inventory (BPI) [38 –39 (link)] was used to assess participants’ total level of borderline traits (BPItot) in the previous year, based on 54 items rated on a 7-point scale. Item 20 in the inventory (“I have already non-suicidally self-injured myself”) was dichotomized (1 = never, 2–7 = at least one episode) to identify participants who had recently engaged in NSSI.
The Youth and Adult Self-Reports (YSR/ASR) [40 –41 ] measure the level of general internalizing (YSR/ASRint) and externalizing (YSR/ASRext) symptoms. Participants rated the extent to which a series of 119 statements described their behavior over the past 6 months, using a 3-point scale.
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