Mentalisierung und externalisierende Verhaltensstörungen in der Adoleszenz

Social cognition creates the conditions for successful human interaction. Externalizing disorders are characterized by a failure of adequate social cooperation. Therefore, social cognition seems to be a key factor in understanding externalizing behavior, its etiology and treatment options. The present article combines the clinical theory of mentalization with the state-of-the-art of empirical data on externalizing behavior and of the theory-of-mind research as well as research on social information processing. Empirical evidence suggests that there are distinct deficits in social cognition depending on the type of aggression (proactive or reactive). However, even though it is known from a neurobiological perspective that social cognition is reorganized in adolescence, research on externalizing behavior and social cognition in adolescence is limited. Hence the analysis of two studies is presented which compared reflective functioning between a group of late adolescent violent offenders and a control group. A total of 42 young men participated in the studies and were interviewed with the adult attachment interview. Interviews were coded with the reflective functioning scale. Results showed that violent offenders scored significantly lower on the reflective functioning scale than age and gender matched controls. This result is independent of intelligence. Instrumental proactive aggression and psychopathic tendencies are also strongly associated with lower reflective functioning. The results underline the importance of therapeutic interventions for externalizing adolescents which enhance reflective functioning.