An Ecological Perspective on Theory of Mind: The Development of Understanding Other Minds within the Context of Adverse Childhood Experiences
Adverse childhood experiences of 47, 5-14-year-old children (M=9.91, SD=2.05) receiving residential treatment were studied in the context of mentalization-based narrative therapy over the initial, middle, and final stages of treatment to assess the relationship among Theory of Mind, mentalization-based narrative treatment, and symptomatology. Narratives were coded using a modified version of The Narrative Content Analysis System (NCAS) (Foa, DiSavino and Turk, 1995) to assess the narrative features associated with a reduction in symptomatology over time. Symptomatology was assessed at the three stages of treatment using the Semi-Structured Clinical Interview for Children and Adolescents (SCICA) (McConaughy and Achenbach, 2001). Results revealed that children who accurately used mental state terms to describe the thoughts and feelings of themselves and their caregivers were more likely to also demonstrate lower levels of internalizing symptoms at the end of treatment. The narratives of these children were also more coherent than those of children manifesting high levels of internalizing symptoms. Children with low levels of internalizing symptoms at Time 3 appeared to develop a personal narrative of their adverse experience, which was coherent and accurately depicted an awareness of the underlying thoughts and feelings central to the adverse event. Furthermore, 18.9% of the variance in improvement in internalizing symptoms was attributed to improvements in narrative coherence and Theory of Mind; thus supporting the examination of mental
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