A previous post flagged up some remarkable findings derived from use of the Movie for the Assessment of Social Cognition (MASC), which confirmed the prediction of the diametric model where hyper-mentalizing in Borderline Personality Disorder (BPD) was concerned. Now—and for the first time ever—a further study has used similar means to try to ascertain whether a reduction in hyper-mentalizing is achieved following treatment of adolescent BPD inpatients and whether other forms of mentalizing are also reduced.

The first major finding of the study was a specific relation between borderline traits and symptoms on the one hand and hyper-mentalizing on the other that appears to be independent of most other anomalies of mentalizing—again confirming that hyper-mentalism is the problem.

The second major finding of this study was that the tendency to hyper-mentalize “was malleable by inpatient treatment,” and as I pointed out in the previous post, suitably programmed computers might help. Indeed, adolescent BPD patients might be ideally suited to computerized psychotherapy for three very good reasons.

First and foremost, their age: Adolescents today are already familiar with computer technology of all kinds, and so would not experience the difficulties that older patients might in being confronted with it.

But age cuts both ways. The problem here is that, in accordance with the Flynn effect, there has been “a huge adult vocabulary gain of 17.80 points” averaging 0.328 points per year since 1950 in the USA. Flynn adds that “What was unanticipated is the huge difference between adult gains and child gains: adults have opened up a gap of 13.40 IQ points or 0.893 SDs.” He concludes:

Circa 1950, when parents addressed their teenage children the latter understood them and answered in kind. Today, their children understand them. But to a significant degree, they cannot answer in kind or use their parents’ vocabulary when talking to their peers or anyone from the adult world.

Psychotherapists also belong to the adult world, and so this is another reason why they should consider computerized alternatives. You could design systems to which adolescents would be better able to respond than they would to an actual adult!

Finally, BPD might be particularly susceptible to computerized psychotherapy because it represents a high-functioning form of psychotic spectrum disorder (PSD). Where autism spectrum disorder (ASD) is concerned, high-functioning subjects are most likely to be helped by mentalistic and social skills training, simply because their IQ is in the normal range (or even above it) and because their deficits are not too disabling. Exactly the same would apply to high-functioning PSD—except of course that it would be mechanistic and anti-hyper-mentalistic skills training that would be indicated, and no better way of delivering it can be found than computers. Indeed, something like MASC would lend itself very readily to computer-based, self-paced de-mentalizing training.

As I have commented before: computerized psychotherapy has a great future and will probably become the therapy of choice for PSD as well as ASD, albeit for diametrically opposite reasons!

(With thanks to my colleague and co-author of the imprinted brain theory, Bernard Crespi.)

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